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Precautions and Warnings for Sitagliptin

Precautions and warnings for sitagliptin include the potential for drug interactions, as well as the risk of taking the drug if you have kidney problems. Prior to beginning treatment, tell your healthcare provider about any medical conditions you may have and what medications you are currently taking. Precautions and warnings for sitagliptin also extend to people who are allergic to any ingredient used to make the medication.

Sitagliptin: What Should I Tell My Healthcare Provider?

You should talk with your healthcare provider prior to taking sitagliptin (Januvia®) if you have:
  • Kidney problems, including kidney failure (renal failure)
  • A history of pancreatitis (inflammation or infection of the pancreas)
  • Any allergies, including allergies to foods, dyes, or preservatives.
Also, let your healthcare provider know if you are:
  • Pregnant or thinking of becoming pregnant
  • Breastfeeding.
Tell your healthcare provider about all of the medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements.

Specific Precautions and Warnings for Sitagliptin

Warnings and precautions to be aware of prior to taking sitagliptin include the following:
  • Very preliminary data suggests incretin mimetics, such as sitagliptin, may increase the risk of precancerous cellular changes (called pancreatic duct metaplasia) in people with type 2 diabetes. Researchers are continuing to study the possibility that incretin mimetics might increase the risk of pancreatic cancer, although at this time there is not enough information to know for sure if there is any increased risk.
  • There have been some reports of pancreatitis in people taking sitagliptin. This is probably most likely to occur shortly after the drug is first started or when the dosage is increased. Be sure to let your healthcare provider know right away if you have signs of pancreatitis, such as:
    • Nausea
    • Vomiting
    • Loss of appetite
    • Severe, persistent abdominal pain that sometimes radiates to the back.
  • Sitagliptin is considered a pregnancy Category B medication. This means that it is probably safe for use in pregnant women, although the full risks taking the drug during pregnancy are not known. Talk to your healthcare provider before taking sitagliptin when pregnant (see Januvia and Pregnancy).
  • It is not known if sitagliptin passes through breast milk. Therefore, if you are breastfeeding or plan to start, discuss this with your healthcare provider prior to beginning treatment.
  • Sitagliptin is cleared from the body by way of the kidneys, and people with kidney problems (including people on dialysis) need to take lower doses of the medication.
  • The risk of low blood sugar (hypoglycemia) is low for sitagliptin. Also, taking the drug with metformin (Fortamet®, Glucophage®, Glucophage XR®, Glumetza®, or Riomet®), pioglitazone (Actos®), or rosiglitazone (Avandia®) usually does not increase the risk of low blood sugar. However, sitagliptin has not been studied with other diabetes drugs, and it is not known if the drug will increase the chance of hypoglycemia when taken with these other medications (see Januvia and Blood Sugar).
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