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The following information outlines crucial safety and warning details associated with the use of Kazano (alogliptin/metformin). Please read carefully and consult with your healthcare provider if you have any questions or concerns.

• Lactic Acidosis: This serious condition, although rare, can occur due to the accumulation of metformin in the body. It is potentially life-threatening if untreated. Those at higher risk include older adults, individuals with kidney or liver conditions, heart failure, heavy alcohol use, or those undergoing surgery or imaging procedures with iodinated contrast. If you experience symptoms such as unusual fatigue, dizziness, severe drowsiness, cold skin, muscle pain, breathing difficulties, irregular heartbeat, or stomach pain with nausea, stop taking Kazano immediately and seek medical help.

• Pancreatitis: There have been rare cases of pancreatitis associated with alogliptin. Consult your doctor if you have a history of pancreatitis or experience symptoms like severe abdominal pain.

• Heart Failure: Discuss with your healthcare provider whether Kazano is appropriate for you if you have a history of heart failure or kidney issues. There may be an increased risk of heart failure, particularly if you've had a recent heart-related event.

• Allergic Reactions: Serious allergic reactions to Kazano, including rash, swelling, difficulty breathing, or anaphylaxis, are rare but possible. Discontinue use and get immediate medical attention if these symptoms occur.

• Liver Issues: Alogliptin has been linked to abnormal liver function tests, which may indicate liver damage. Regular monitoring may be necessary.

• Vitamin B12 Deficiency: Long-term use of metformin can lead to vitamin B12 deficiency, potentially causing anemia. Ensure adequate dietary intake of vitamin B12 and calcium.

• Hypoglycemia: The risk of low blood sugar increases when Kazano is combined with other diabetes medications such as insulin. Symptoms of hypoglycemia can be severe and life-threatening, requiring prompt medical attention.

• Joint Pain: Severe joint pain has been reported with medications similar to alogliptin. If you experience joint discomfort, consult your doctor.

• Severe Skin Reaction: Some individuals taking alogliptin have developed bullous pemphigoid, a serious skin condition. Discontinue use and seek treatment if you develop itchy or blistering rashes.

Contraindications: Do not use Kazano if you have severe kidney issues or a metabolic acidosis condition like diabetic ketoacidosis. Always consult your healthcare provider before starting Kazano, especially if you have any of the above conditions or concerns.

Common side effects:

• nausea
• vomiting
• stomach upset
• diarrhea
• bloating
• gas
• upper respiratory tract infections
• cold symptoms
• cough
• runny nose
• headaches
• back pain
• urinary tract infections
• slightly elevated blood pressure

Serious side effects:

• signs of lactic acidosis
• symptoms of pancreatitis
• serious liver issues
• hypoglycemia
• high blood sugar
• rare but serious allergic reaction

Interactions with high risk of serious adverse effects and should be avoided:

• Acetrizoic Acid
• Diatrizoate
• Ethiodized Oil
• Iobenzamic Acid
• Iobitridol
• Iocarmic Acid
• Iocetamic Acid
• Iodamide
• Iodipamide
• Iodixanol
• Iodohippuric Acid
• Iodopyracet
• Iodoxamic Acid
• Ioglicic Acid
• Ioglycamic Acid
• Iohexol
• Iomeprol
• Iopamidol
• Iopanoic Acid
• Iopentol
• Iophendylate
• Iopromide
• Iopronic Acid
• Ioseric Acid
• Iosimide
• Iotasul
• Iothalamate
• Iotrolan
• Iotroxic Acid
• Ioxaglate
• Ioxitalamic Acid
• Ipodate
• Metrizamide
• Metrizoic Acid
• Tyropanoate Sodium

Interactions with moderate risk that may require dose adjustment, closer monitoring, or timing changes:

• Aspirin
• Balofloxacin
• Besifloxacin
• Bupropion
• Capmatinib
• Chloroquine
• Ciprofloxacin
• Dasabuvir
• Dofetilide
• Dolutegravir
• Enoxacin
• Fleroxacin
• Flumequine
• Gatifloxacin
• Gemifloxacin
• Hydroxychloroquine
• Ioversol
• Lanreotide
• Levofloxacin
• Lomefloxacin
• Moxifloxacin
• Nadifloxacin
• Norfloxacin
• Octreotide
• Ofloxacin
• Ombitasvir
• Paritaprevir
• Pasireotide
• Pazufloxacin
• Pefloxacin
• Pioglitazone
• Prulifloxacin
• Ritonavir
• Rufloxacin
• Sitagliptin
• Sparfloxacin
• Tafenoquine
• Thioctic Acid
• Tosufloxacin
• Vandetanib

Interactions with low risk that usually do not require a change in therapy:

• Acebutolol
• Atenolol
• Betaxolol
• Bisoprolol
• Bitter Melon
• Carteolol
• Carvedilol
• Celiprolol
• Colesevelam
• Esmolol
• Fenugreek
• Furazolidone
• Glucomannan
• Guar Gum
• Iproniazid
• Isocarboxazid
• Labetalol
• Levobunolol
• Linezolid
• Methylene Blue
• Metipranolol
• Metoprolol
• Moclobemide
• Nadolol
• Nebivolol
• Nialamide
• Oxprenolol
• Patiromer
• Penbutolol
• Phenelzine
• Pindolol
• Practolol
• Procarbazine
• Propranolol
• Psyllium
• Ranolazine
• Rasagiline
• Rifampin
• Safinamide
• Selegiline
• Sotalol
• Timolol
• Tranylcypromine
• Verapamil