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The following safety information is essential for anyone taking Zituvio (sitagliptin). It details potential risks and necessary precautions to take while using this medication. If you have any concerns, please consult with your healthcare provider.

• Pancreas Concerns: While rare, there have been instances of pancreatitis, or pancreatic inflammation, in individuals using Zituvio (sitagliptin). If you experience symptoms such as upper stomach pain, fever, nausea, or vomiting, discontinue use and seek medical advice immediately.

• Heart Failure Risk: Some studies have indicated a possible association between DPP-4 inhibitors, such as Zituvio (sitagliptin), and heart failure. The specific risk with Zituvio remains unclear. If you have heart or kidney issues, discuss potential risks with your healthcare provider.

• Kidney Injury: There have been cases of acute kidney injury in patients taking Zituvio (sitagliptin), with some requiring dialysis. Your healthcare provider may conduct blood tests to monitor kidney function, especially if you have pre-existing kidney conditions. Report any significant changes in urination to your provider.

• Allergic Reactions: Rarely, this medication can cause severe allergic reactions, particularly in those with a history of allergy to DPP-4 inhibitors. Symptoms may include rash, skin peeling, swelling, difficulty breathing, or dizziness. These reactions are more common within the first three months of treatment. Discontinue use and seek emergency medical attention if symptoms occur.

• Joint Pain: Severe joint pain has been reported in some patients taking medications similar to Zituvio (sitagliptin). This pain can manifest at any time after starting the medication but usually resolves upon discontinuation. Consult your healthcare provider if you experience joint discomfort.

• Severe Skin Reactions: Some individuals have developed a blistering rash known as bullous pemphigoid while taking Zituvio (sitagliptin). Should you experience itchy skin, blisters, or sores, stop taking the medication and contact your healthcare provider for appropriate treatment.

Please follow these guidelines closely and maintain open communication with your healthcare provider while using Zituvio (sitagliptin).

When taking this medication, it's important to be aware of potential side effects, which can range from mild to severe. Commonly, some individuals may experience symptoms similar to a common cold, such as a runny or stuffy nose and sore throat. These are generally mild but should be discussed with your healthcare provider if they persist or worsen. Headaches have also been reported by some users.

In certain cases, more serious side effects can occur, which require immediate medical attention. These include signs of pancreatitis, such as persistent nausea, vomiting, or severe abdominal pain. Heart failure symptoms, like sudden weight gain, difficulty breathing, unusual tiredness, and swelling in the feet or ankles, are critical warning signs. Additionally, sudden kidney problems may manifest as reduced urination, swelling in the legs or ankles, fatigue, and nausea. It is crucial to seek urgent care if you experience these symptoms.

Rare but serious allergic reactions can also occur, marked by rash, itching, swelling (particularly of the face, tongue, or throat), severe dizziness, or difficulty breathing. If you notice these symptoms, seek medical help immediately. While these severe reactions are infrequent, it's important to remain vigilant.

Remember, this is not an exhaustive list of side effects, and if you experience any unusual changes in your health, it is advisable to consult your healthcare provider. Your health and safety are paramount, and early intervention can prevent complications.

Beta-blockers, including medications like metoprolol, propranolol, and eye drops for glaucoma such as timolol, can mask the rapid or pounding heartbeat typically felt when blood sugar levels drop too low (hypoglycemia). However, they do not affect other signs of low blood sugar, such as dizziness, hunger, or sweating. It is important to regularly monitor your blood sugar levels and discuss any changes in medication with your doctor or pharmacist, as many drugs can influence blood sugar management. If you notice symptoms of either high or low blood sugar, contact your doctor immediately. Adjustments to your diabetes medication, exercise routine, or diet may be necessary.

Zituvio (sitagliptin) can interact with various medications or supplements. Always inform your doctor and pharmacist about any medications or supplements you are taking, whether they are prescribed, over-the-counter, vitamins, or herbal products. While the list provided is not exhaustive, it highlights some possible interactions. Medications like acarbose, various antibiotics, and antidiabetics might require dose adjustments or careful monitoring if used together with Zituvio. Furthermore, combining Zituvio with certain beta-blockers, such as acebutolol, atenolol, and others, may increase the risk of side effects, but might still be necessary for optimal treatment. Your doctor may need to adjust the dosage or frequency of use for these medications.