Metformin (met-FOR-min), Sitagliptin (sit-a-GLIP-tin)

Treats type 2 diabetes. Used together with proper diet and exercise to help control blood sugar.

Brand Name(s):

Janumet

When This Medicine Should Not Be Used:

How to Use This Medicine:

Tablet

• Your doctor will tell you how much of this medicine to use and how often. Your dose may need to be changed several times in order to find out what works best for you. Do not use more medicine or use it more often than your doctor tells you to.
• It is best to take this medicine with food or milk.
• Carefully follow your doctor's instructions about any special diet or exercise program.

If a dose is missed:

• If you miss a dose or forget to use your medicine, use it as soon as you can. If it is almost time for your next dose, wait until then to use the medicine and skip the missed dose. Do not use extra medicine to make up for a missed dose.

How to Store and Dispose of This Medicine:

• Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light.
• Ask your pharmacist, doctor, or health caregiver about the best way to dispose of any leftover medicine after you have finished your treatment. You will also need to throw away old medicine after the expiration date has passed.
• Keep all medicine away from children and never share your medicine with anyone.

Drugs and Foods to Avoid:

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Make sure your doctor knows if you are using cimetidine (Tagamet®), digoxin (Lanoxin®, Digitek®), isoniazid, morphine, nicotinic acid (niacin), procainamide (Procanbid®), quinidine, quinine, ranitidine (Zantac®), trimethoprim (Proloprim®, Trimpex®), or vancomycin (Vancocin®).
• Tell your doctor if you are also using birth control pills, certain blood pressure medicines (such as nifedipine, diltiazem, Procardia®), diuretics or water pills (such as amiloride, furosemide, triamterene, Lasix®, Dyrenium®), phenothiazine medicines (such as prochlorperazine, Compazine®, Mellaril®, Phenergan®, Thorazine®, Trilafon®), phenytoin (Dilantin®), steroids (such as prednisone or Medrol®), or thyroid medicine.
• Do not drink alcohol while you are using this medicine.

Warnings While Using This Medicine:

• Make sure your doctor knows if you are pregnant or breastfeeding, or if you have liver disease, kidney problems, or heart disease. Tell your doctor if you plan to have surgery, or X-rays that require dyes to be injected in your veins. Make sure your doctor knows if you get hurt or sick, especially if you have severe vomiting, diarrhea, or fever.
• Make sure any doctor or dentist who treats you knows that you are using this medicine. You may need to stop using this medicine several days before having surgery or medical tests.
• This medicine may cause a rare, but serious condition called lactic acidosis in some people. Call your doctor right away if you get sick, or if you have unusual tiredness, weakness, muscle pain, trouble breathing, fever, or nausea.
• If your blood sugar gets too low, you may feel weak, drowsy, confused, anxious, or very hungry. You may also sweat, shake, or have blurred vision, a fast heartbeat, or a headache that will not go away. If you have symptoms of low blood sugar (hypoglycemia), check your blood sugar. If your blood sugar is 70 mg/dL (milligrams per deciliter) or below, do one of the following: Drink 4 ounces (one-half cup) of fruit juice, or eat 5 to 6 pieces of hard candy, or take 2 to 3 glucose tablets. Re-check your blood sugar 15 minutes later. If your blood sugar is above 70 mg/dL, eat a snack or a meal. If your blood sugar is still below 70 mg/dL, drink one-half cup juice, or eat 5 to 6 pieces of candy, or take 2 to 3 glucose tablets. Carry candy or some type of sugar with you at all times, especially if you are away from home. You can take this if you feel that your blood sugar is too low, even if you do not have a blood glucose meter. Always carefully follow your doctor's instructions about how to treat your low blood sugar. Learn what to do if your blood sugar gets too low. Teach friends, co-workers, and family members what they can do to help if you have low blood sugar.
• Your doctor will need to check your blood or urine at regular visits while you are using this medicine. Be sure to keep all appointments.

Possible Side Effects While Using This Medicine:

Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing.
• Change in how much or how often you urinate.
• Dizziness, shakiness, or increased hunger.
• Extreme weakness, tiredness, or confusion.
• Lightheadedness or fainting.
• Rapid breathing, trouble breathing, or nausea and vomiting.

If you notice these less serious side effects, talk with your doctor:

• Diarrhea or upset stomach.
• Headache.
• Runny or stuffy nose, or sore throat.