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This medication comes with important safety and warning information that you should review carefully. If you have any questions or concerns, consult your healthcare provider for guidance. Below are key points to consider:

• Lactic Acidosis: A rare but serious condition where lactic acid builds up in the blood, potentially becoming life-threatening. Risk factors include being over 65, having kidney or liver issues, heart problems, dehydration, heavy alcohol use, undergoing surgery, or using contrast dye for X-rays. Symptoms to watch for are unusual fatigue, dizziness, severe drowsiness, chills, cold or blue skin, muscle pain, breathing difficulties, irregular heartbeat, or stomach pain with nausea/vomiting/diarrhea. Seek medical attention immediately if these symptoms occur.

• Pancreatitis: Inflammation of the pancreas is a rare occurrence with this medication. If you experience persistent belly pain that may spread to the back, along with nausea and vomiting, stop the medication and seek medical help immediately.

• Heart Failure: There is a potential link between this medication and heart failure. If you have a history of heart or kidney issues, inform your healthcare team. Symptoms to be vigilant for include shortness of breath, rapid or irregular heartbeat, swelling in ankles or feet, rapid weight gain, and chest pain. Immediate medical help should be sought if these symptoms appear.

• Kidney Function: Reports of sudden kidney failure requiring dialysis have been noted. This risk is higher for older adults and those with pre-existing kidney issues. Regular blood work is essential to monitor kidney function during treatment.

• Vitamin B12 Deficiency: Long-term use of this medication may decrease vitamin B12 absorption, possibly leading to anemia. Symptoms include low energy, muscle weakness, poor appetite, or tingling in hands or feet. Periodic blood tests may be necessary to monitor vitamin B12 levels.

• Hypoglycemia (Low Blood Sugar): This medication can cause dangerously low blood sugar levels, especially when combined with other diabetes medications or alcohol. Recognize symptoms such as shakiness, hunger, confusion, weakness, nervousness, rapid heartbeat, or sweating, and discuss treatment options with your healthcare team.

• Joint Pain: Severe joint pain may occur at any time during treatment. If you experience significant joint discomfort, consult a healthcare professional.

• Severe Skin Reactions: An itchy, blistering rash known as bullous pemphigoid has been reported. If you notice itchy skin or blisters, stop the medication and contact your care team.

• Severe Allergic Reactions: Although rare, severe allergic reactions can occur. Symptoms include hives, blisters, skin peeling, breathing difficulties, or facial swelling. Immediate medical intervention is critical.

Contraindications: Do not use this medication if you have Type 1 diabetes, poor kidney function, metabolic acidosis (including diabetic ketoacidosis), or have had an allergic reaction to sitagliptin or metformin in the past.

Always keep your healthcare provider informed of your complete medical history before starting this medication.

When taking this medication, some individuals may encounter common side effects such as nausea, vomiting, stomach upset, diarrhea, headache, and weakness. A metallic taste in the mouth is also possible. These effects are usually mild and temporary, but if they persist or worsen, it's important to consult a healthcare provider. Additionally, some people might experience upper respiratory tract infections.

It's crucial to be aware of more serious side effects, which, though rare, require immediate medical attention. These include signs of pancreatitis, characterized by persistent nausea, vomiting, severe abdominal pain, and loss of appetite. Lactic acidosis is another serious condition, with symptoms such as severe stomach pain, nausea, a sudden drop in blood pressure, low body temperature, and a slow heart rhythm. Kidney problems can manifest as a change in urine output, itching, and swelling in the ankles or feet.

Heart failure is a severe side effect, with symptoms like shortness of breath, unusual tiredness, swelling of the legs or feet, and rapid weight gain. Allergic reactions, though rare, are serious and can include rash, hives, swelling (especially of the face, tongue, or throat), severe dizziness, and trouble breathing. Always seek medical help immediately if these symptoms occur.

For those managing diabetes, low blood sugar can occur, especially if combined with other diabetes medications. Symptoms include sudden sweating, shaking, fast heartbeat, hunger, blurred vision, dizziness, or tingling hands/feet. To prevent low blood sugar, maintain regular meals and avoid skipping them. Conversely, high blood sugar might present as increased thirst and urination, necessitating adjustments in medication, diet, or exercise as advised by a healthcare provider. If you experience side effects not listed here, contact a healthcare professional for advice.

When taking Janumet (sitagliptin/metformin), it is important to be aware of potential drug interactions. Inform your doctor and pharmacist about all the medications and supplements you use, including prescription, over-the-counter, vitamins, and herbal supplements. Some interactions can impact your treatment plan:

1. Not Recommended Combinations: Janumet should not be used with certain medications like Acetrizoic Acid, Diatrizoate, and others listed, as these might require your doctor to find alternative treatments.

2. Use with Caution: For some drugs, such as Acarbose, Aspirin, and certain antibiotics like Ciprofloxacin, using them with Janumet is generally not advised but might be necessary for some patients. If so, your healthcare provider may adjust dosages or usage frequency.

3. Possible Side Effect Risks: Other drugs, including beta-blockers like Metoprolol and Propranolol, as well as supplements like Bitter Melon and Fenugreek, may increase the risk of side effects. However, they may still be part of your treatment if both medications are deemed necessary by your doctor, who will then monitor and adjust your treatment as needed.

Always keep track of your blood sugar levels and report any symptoms of high or low blood sugar to your doctor promptly. Adjustments to your diabetes medication, diet, or exercise plan might be necessary based on your treatment regimen.