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When taking Zituvimet (sitagliptin/metformin), it is crucial to be aware of potential risks and safety precautions. Below is a summary of important safety information and warnings.

• Lactic Acidosis: This serious condition, resulting from an excess of lactic acid in the blood, may rarely occur with metformin. It is more common in individuals with kidney or liver problems, 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, breathing difficulties, irregular heartbeat, or stomach pain coupled with nausea, vomiting, or diarrhea. Seek immediate medical assistance if you experience these symptoms.

• Pancreatitis: Some patients have developed inflammation of the pancreas while on this medication. Symptoms include persistent belly pain that may extend to the back, nausea, and vomiting. Discontinue use and consult a healthcare provider if these occur.

• Heart Failure: There may be an association between DPP-4 inhibitors, such as sitagliptin, and heart failure. Symptoms include shortness of breath, irregular heartbeat, swelling of the ankles or feet, sudden weight gain, and chest pain. Discuss any history of heart failure with your healthcare provider before starting this medication.

• Kidney Issues: Reports have noted acute kidney failure requiring dialysis in some cases. Older adults or those with pre-existing kidney conditions are at higher risk. Regular blood tests are recommended to monitor kidney function.

• Vitamin B12 Deficiency: Long-term use can lead to decreased vitamin B12 absorption, potentially causing anemia. Symptoms such as low energy, muscle weakness, or tingling in the hands or feet should be reported to your healthcare provider. Periodic blood tests are advised.

• Hypoglycemia: Combining this medication with other diabetes drugs like insulin or sulfonylureas can cause low blood sugar, which can be severe. Recognize symptoms such as shakiness, confusion, or an elevated heartbeat and have a plan to manage them.

• Joint Pain: Severe joint pain has been reported with DPP-4 inhibitors. Consult a healthcare professional if you experience significant discomfort.

• Severe Skin Reaction: Bullous pemphigoid, a blistering rash, may occur. Discontinue use and contact a healthcare provider if you develop blisters or sores.

• Allergic Reactions: Though rare, severe allergic reactions such as hives, blisters, or swelling may occur. Immediate medical help is necessary if these symptoms develop.

• Contraindications: This medication should not be used by individuals with Type 1 diabetes, poor kidney function, metabolic acidosis (including diabetic ketoacidosis), or known allergies to sitagliptin or metformin. Discuss with your healthcare provider if these conditions apply to you.

Always consult your healthcare provider for personalized advice and before making any changes to your medication regimen.

When taking this medication, some common side effects you might experience include nausea, vomiting, stomach upset, diarrhea, headache, and a metallic taste in the mouth. These are generally mild and should not cause alarm, but if they persist or worsen, it's advisable to consult your healthcare provider. Additionally, some individuals may experience upper respiratory tract infections and weakness.

More serious side effects, although rare, require immediate medical attention. These include signs of lactic acidosis, such as a sudden drop in blood pressure, low body temperature, slow heart rhythm, and severe stomach pain. Pancreatitis is another serious condition to watch for, characterized by persistent nausea, vomiting, and upper abdominal pain. Heart failure symptoms like shortness of breath, rapid weight gain, and swelling of the legs or feet should also be addressed urgently.

Kidney problems may manifest as reduced urination, itching, and swelling of the ankles or feet, and should prompt a consultation with your doctor. A severe allergic reaction to the medication, though uncommon, is serious and includes symptoms like rash, severe dizziness, and trouble breathing.

It is important to differentiate between low and high blood sugar symptoms, as the drug can influence blood sugar levels, especially when combined with other diabetes medications. Symptoms of low blood sugar include sweating, shaking, and dizziness, while high blood sugar may cause increased thirst and urination. Ensuring regular meal schedules and monitoring your body's reactions are essential practices. Always consult your healthcare provider for guidance tailored to your specific needs.