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When taking Kombiglyze XR, it is crucial to be aware of the potential risks and necessary precautions due to the presence of metformin and saxagliptin in the medication. Below are important safety considerations to keep in mind:

• Lactic Acidosis: This rare but serious condition can occur due to metformin accumulation, particularly in patients with kidney or liver issues, heart failure, heavy alcohol use, or those undergoing procedures with iodinated contrast. Symptoms include unusual tiredness, dizziness, severe drowsiness, chills, blue or cold skin, muscle pain, irregular heartbeat, or stomach pain with nausea, vomiting, or diarrhea. Stop taking the medication and seek medical attention immediately if these symptoms arise.

• Heart Failure: Saxagliptin, a component of Kombiglyze XR, has been associated with heart failure. Be vigilant for symptoms such as shortness of breath, fluid retention, rapid weight gain, and increased fatigue. Consult your healthcare provider if these occur, especially if you have a history of heart or kidney problems.

• Low Vitamin B12 Levels: Metformin can lead to reduced vitamin B12 levels, potentially causing anemia. Symptoms like fatigue, muscle weakness, low appetite, or tingling in extremities should prompt a discussion with your provider, who may monitor your vitamin B12 levels every 2-3 years.

• Low Blood Sugar Levels (Hypoglycemia): Kombiglyze XR can cause hypoglycemia, especially when used with other diabetes medications. Symptoms include shakiness, fast heartbeat, sweating, confusion, sleepiness, headache, vision changes, or excessive hunger. Discuss any concerns with your healthcare provider.

• Joint Pain: Saxagliptin may result in severe joint pain, occurring from one day to years after starting the medication. Report any joint discomfort to your provider promptly.

• Pancreatitis: Rare cases of pancreatitis have been reported. Severe stomach or back pain, or persistent vomiting, should be reported to your healthcare provider immediately.

• Skin Blisters (Bullous Pemphigoid): Rare fluid-filled blisters on the skin may occur. Consult your healthcare provider if this happens, as cessation of the medication and specialist treatment may be necessary.

• Allergic Reactions: Severe allergic reactions have been noted, particularly at the start of treatment. Symptoms include rash, hives, swelling of the face, tongue, or throat, and difficulty breathing. Seek immediate medical help if these occur.

Discuss any existing health conditions and medications with your healthcare provider before starting Kombiglyze XR to ensure safe and effective use.

When taking this medication, you may experience some common side effects. These include nausea, vomiting, stomach upset, diarrhea, headaches, and a metallic taste in the mouth. Additionally, some people report upper respiratory tract infections, runny or stuffy nose, sore throat, and bladder infections. These effects are usually mild, but if they persist or worsen, it's a good idea to consult a healthcare professional.

More serious side effects, though less common, require prompt medical attention. These include signs of lactic acidosis such as extreme tiredness, muscle pain, stomach pain, and breathing difficulties. If you notice symptoms of heart failure like shortness of breath, swelling of the ankles or feet, and sudden weight gain, seek medical help immediately. Pancreatitis is another serious condition that may occur, characterized by severe stomach pain extending to the back, persistent vomiting, and fever.

Allergic reactions are rare but serious and include symptoms like rash, severe dizziness, swelling of the face, lips, or throat, and trouble breathing. Immediate medical intervention is necessary if these symptoms appear. Additionally, watch for signs of low blood sugar such as sweating, shaking, fast heartbeat, and dizziness, especially if you consume alcohol, skip meals, or engage in strenuous exercise.

In rare cases, patients might experience low vitamin B12 levels, leading to symptoms such as numbness or tingling in the hands or feet, muscle weakness, and confusion. Always discuss any new or worsening symptoms with your healthcare provider to ensure safe and effective treatment. Remember, while this list covers many potential side effects, it may not include all possibilities.

Certain medications can influence how saxagliptin is processed in your body, potentially impacting its effectiveness. Medications such as azole antifungals (including itraconazole and ketoconazole), nefazodone, telithromycin, and ritonavir are known to have such effects. Additionally, beta-blockers (like metoprolol, propranolol, and timolol eye drops for glaucoma) might mask the typical rapid or pounding heartbeat that signals low blood sugar (hypoglycemia). However, they do not affect other low blood sugar symptoms such as dizziness, hunger, or sweating.

It's important to note that many medications can alter blood sugar levels, complicating their management. Before making any changes to your medication regimen, consult with your doctor or pharmacist to understand potential impacts on your blood sugar. Regularly monitor your blood sugar as advised, and report any signs of high or low blood sugar to your doctor immediately. Your healthcare provider might need to adjust your diabetes medication, exercise routine, or diet accordingly.