Do not use Janumet XR if you are allergic to sitagliptin, metformin or any other ingredients in the medication, have unstable or insulin-dependent or type 1 diabetes, metabolic acidosis (including ketoacidosis, history of ketoacidosis or lactic acidosis), liver or kidney problems, severe heart problems or heart failure, lack of oxygen in blood, drink a lot of alcohol, are stressed, have severe infections, are experiencing trauma, are going to have surgery or during the recovery phase, suffer from dehydration, are breastfeeding, are pregnant or plan to become pregnant, are going to receive an injection of dye or contrast agent for an X-ray. Ask your doctor when to stop taking Janumet XR and when to start again. Janumet XR may interact with other anti-diabetes drugs such as glyburide, other medications such as furosemide, nifedipine, drugs that decrease rate of elimination of metformin from the body such as ranolazine, vandetanib, dolutegravir and cimetidine, certain blood thinners such as phenprocoumon or other antivitamin K anticoagulants, ACE inhibitors used to control blood pressure, other drugs tend to produce hyperglycemia (high blood sugar) and may lead to a loss of blood sugar control such as thiazide and other diuretics (water pills), ACE inhibitors, corticosteroids, phenothiazines, thyroid products, estrogens or estrogens plus progestogen, oral contraceptives, phenytoin, nicotinic acid, sympathomimetics, Calcium channel blocking drugs, isoniazid, beta-2-agonists. Since alcohol may increase the risk of lactic acidosis caused by metformin you should not drink a lot of alcohol if you take Janumet XR. When Janumet XR is used in combination with sulfonylurea or insulin, low blood sugar can occur. Your physician may consider lowering the dose of the sulfonylurea or insulin. Take precautions to avoid low blood sugar while driving or using machinery as this medication can lead to dizziness or light-headedness.
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