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This medication comes with important safety information that you should review carefully. It is crucial to discuss any concerns with your healthcare provider to ensure your safety and well-being while using this drug.

• Lactic Acidosis Risk: This medication contains metformin, which can rarely lead to a serious condition known as lactic acidosis. This risk is heightened in older adults, individuals with kidney or liver disease, cases of dehydration, heart failure, heavy alcohol consumption, and during certain medical procedures involving iodinated contrast. If you experience symptoms like extreme tiredness, dizziness, severe drowsiness, chills, cold or blue skin, muscle pain, difficulty breathing, abnormal heartbeat, or abdominal pain with nausea, vomiting, or diarrhea, stop the medication and seek immediate medical attention.

• Pancreatitis: There have been rare reports of pancreas inflammation (pancreatitis), which could manifest as persistent abdominal pain radiating to the back, nausea, and vomiting. Discontinue the medication and consult a healthcare professional if these symptoms arise.

• Heart Failure: Some studies have suggested a potential link between DPP-4 inhibitor treatments, like this medication, and heart failure. It is crucial to inform your healthcare provider of any history of heart failure or kidney issues before commencing treatment. Seek immediate medical help if you notice signs of heart failure, such as shortness of breath, rapid or irregular heartbeat, swelling of the ankles or feet, rapid weight gain, or chest pain.

• Kidney Problems: Sudden kidney failure has been reported in some cases, occasionally requiring dialysis. Those with a history of kidney issues or advanced age may be at greater risk. Regular blood tests will be conducted to monitor kidney function during treatment.

• Vitamin B12 Deficiency: Long-term use can reduce vitamin B12 absorption, potentially causing anemia. Symptoms include fatigue, muscle weakness, loss of appetite, or tingling in the hands or feet. Regular blood tests to monitor vitamin B12 levels may be necessary.

• Hypoglycemia: This medication, alone or with other diabetes drugs, can cause dangerously low blood sugar levels. Symptoms include shakiness, extreme hunger, confusion, weakness, anxiety, rapid heartbeat, or sweating. Be familiar with recognizing and managing low blood sugar episodes.

• Joint Pain: Severe joint pain, possibly occurring from one day to years after starting the medication, has been reported. Consult a healthcare provider if you experience joint discomfort.

• Severe Skin Reactions: Some users have developed an itchy, blistering rash (bullous pemphigoid). Stop the medication and contact your healthcare team if you experience itchy skin, blistering rashes, or sores.

• Allergic Reactions: Rare but severe allergic reactions may occur. Symptoms include hives, blistering skin, difficulty breathing, or swelling of the face or throat. Seek immediate medical attention if these occur.

Contraindications: This medication should not be used if you have Type 1 diabetes, poor kidney function, metabolic acidosis (including diabetic ketoacidosis), or if you are allergic to sitagliptin or metformin. Always consult your healthcare provider if these apply to you.

When taking this medication, some common side effects may include mild symptoms like nausea, vomiting, diarrhea, headache, and a metallic taste in the mouth. It's also possible to notice a tablet in your stool. These effects are generally not a cause for concern, but if they persist or worsen, consulting a healthcare provider is advisable. Some individuals might also experience upper respiratory tract infections or stomach upset.

Be aware of more serious side effects that require immediate medical attention. These include signs of pancreatitis, such as persistent nausea, vomiting, and severe abdominal pain that may radiate to the back. Lactic acidosis is another severe condition to watch for, with symptoms like sudden drops in blood pressure, low body temperature, slow heart rhythm, weakness, and stomach pain. If you notice any signs of kidney problems, such as decreased urination or swelling, or symptoms of heart failure like shortness of breath, rapid weight gain, or swelling in the legs, seek urgent care.

Low blood sugar is not common with this medication unless combined with other diabetes treatments or triggered by inadequate food intake or excessive exercise. Symptoms to watch for include sudden sweating, shaking, fast heartbeat, hunger, blurred vision, dizziness, or tingling in the hands or feet. Carry glucose tablets or gel to quickly address low blood sugar situations.

Although rare, severe allergic reactions can occur and require prompt medical help. Symptoms may include rash, itching, swelling (especially of the face, tongue, or throat), severe dizziness, or trouble breathing. Always report any unusual or bothersome side effects to your healthcare provider for guidance.

Beta-blockers, including medications like metoprolol, Propranolol, and certain glaucoma eye drops such as Timolol, can mask the fast or pounding heartbeat that typically indicates low blood sugar (hypoglycemia). However, they do not affect other symptoms of low blood sugar like dizziness, hunger, or sweating. It's important to monitor your blood sugar levels regularly and communicate any significant changes to your doctor. Adjustments to your diabetes medication, exercise routine, or diet may be required based on these results. Consult your healthcare provider before starting, stopping, or modifying any medication, as many drugs can influence blood sugar control.

Janumet, which contains Sitagliptin and Metformin, may interact with various medications and supplements. Inform your doctor and pharmacist about all drugs and supplements you are taking, including over-the-counter options and herbal products. Some medications should not be combined with Janumet, while others may require dose adjustments if taken together. Notable interactions include certain imaging contrast agents and other diabetes medications such as Acarbose and Glipizide. Beta-blockers like metoprolol and propranolol, along with other drugs, might increase the risk of side effects but could be necessary for your treatment. Your doctor will guide you on how to manage these interactions safely.