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When using Steglujan (ertugliflozin / sitagliptin), it is crucial to be aware of the following safety information and warnings. Discuss any concerns with your healthcare provider.

• Pancreatitis Risk: This medication can cause sudden inflammation of the pancreas, potentially leading to severe conditions like hemorrhagic or necrotizing pancreatitis. Seek immediate medical attention if you experience persistent severe stomach pain, possibly extending to your back, with or without vomiting. Those with a history of pancreatitis, alcoholism, kidney issues, gallstones, or high triglyceride levels should be particularly cautious.

• Low Blood Pressure: Steglujan may lead to low blood pressure due to fluid loss. Symptoms include dizziness, lightheadedness, fatigue, or blurred vision. Be especially vigilant if you have kidney problems, are elderly, already have low blood pressure, or are taking diuretics.

• Ketoacidosis: Rarely, this medication can cause a serious condition known as ketoacidosis, characterized by high levels of ketones in the body. Discontinue use and seek medical help if you experience severe dehydration, nausea, vomiting, stomach pain, tiredness, or shortness of breath. Risks include taking high doses, reducing insulin intake, fever, low calorie intake, surgery, pancreatic problems, alcohol abuse, or prolonged fasting.

• Kidney Issues: There is a risk of kidney damage due to fluid loss, particularly for those with low blood volume, existing kidney or heart problems, or those taking medications like diuretics, ACE inhibitors, ARBs, or NSAIDs. Notify your provider if you experience changes in diet or significant fluid loss. Your kidney function should be monitored before and during treatment.

• Urinary and Genital Infections: Increased risk of urinary tract infections, genital yeast infections, and serious infections like Fournier's gangrene. Seek immediate medical help if you have symptoms such as pain or burning while urinating, frequent urination, blood in urine, or genital symptoms including fever, itching, or swelling.

• Risk of Amputation: There is a rare risk of leg and foot amputations. Report any new pain, tenderness, sores, or ulcers in your feet or legs to your provider. Those with a history of amputation, blood circulation problems, foot ulcers, or who are male, have high baseline A1C, or take diuretics or insulin should be extra cautious.

• Heart Failure: There may be an increased risk of heart failure, especially in individuals with a history of heart or kidney issues. Report symptoms like shortness of breath, sudden weight gain, or swelling in the feet.

• Low Blood Sugar: When combined with insulin or medications that increase insulin levels, Steglujan can cause low blood sugar. Symptoms include headache, sleepiness, hunger, irritability, dizziness, confusion, sweating, shakiness, weakness, or rapid heartbeat. A dose adjustment may be necessary.

• Joint Pain: Severe joint pain may occur, which typically resolves upon discontinuation of the medication.

• Serious Skin Reactions: Rarely, this medication can cause bullous pemphigoid, a condition with large, fluid-filled blisters requiring hospitalization. Stop use and contact your provider if you notice blisters or skin breakdown.

Contraindications: Do not use Steglujan if you have severe kidney issues, end-stage kidney disease, or are undergoing dialysis. Consult your healthcare provider if any of these apply to you.

When taking this medication, you might experience some common side effects such as dizziness, lightheadedness, or frequent urination. These are usually mild, but if they persist or worsen, it is important to contact your healthcare provider. To help reduce dizziness or lightheadedness, try getting up slowly from sitting or lying down. Common side effects also include yeast infections in females (9-12%) and males (4%), upper respiratory tract infections, headaches, and more frequent urination.

In some cases, other side effects like back pain, weight loss, thirst, stomach pain, nausea, diarrhea, and an increase in LDL cholesterol levels might occur. These side effects are generally not severe, but it's good to be aware of them and discuss any concerns with your healthcare provider.

However, there are rare but serious side effects that require immediate medical attention. These include signs of pancreatitis, such as persistent stomach pain that may radiate to the back and vomiting, or signs of ketoacidosis, which include dehydration, nausea, stomach pain, and shortness of breath. Acute kidney injury may present as low urine output or swelling in the legs, while heart failure symptoms include shortness of breath and sudden weight gain. Serious skin reactions or an unusual bacterial infection in the genital area known as Fournier's gangrene, which involves fever and pain or swelling, also warrant urgent care.

In rare cases, the medication might lead to dehydration, potentially causing serious kidney damage; thus, maintaining adequate fluid intake is crucial. Additionally, a serious allergic reaction might occur, characterized by rash, swelling, or trouble breathing, which requires immediate medical attention. Lastly, keep an eye on your feet for sores or ulcers, as the medication could increase the risk of lower limb amputation, especially if you have existing risk factors.