Before you begin using a medication, be sure to inform your doctor of any medical conditions or Allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use Jentadueto.
Alcohol intake: Alcohol increases the risk of developing lactic acidosis for people taking metformin. If you are taking Jentadueto, avoid excessive alcohol intake. If you drink alcohol often or heavily, discuss with your doctor how Jentadueto may affect you, how your alcohol intake may affect the dosing and effectiveness of Jentadueto, and whether any special monitoring is needed.
Anemia: Rarely, metformin causes low levels of red blood cells. If you experience symptoms of reduced red blood cell count (anemia) such as shortness of breath, feeling unusually tired or pale skin, contact your doctor as soon as possible.
Your doctor will do blood tests regularly to monitor the number of specific types of blood cells, including red blood cells, in your blood.
Blood sugar monitoring: Monitor your blood sugar regularly at intervals as discussed with your doctor or diabetes educator.
Congestive Heart Failure and heart disease: The safety and effectiveness of linagliptin has not been established for people with congestive heart failure (CHF) or heart disease. For this reason, Jentadueto is not recommended for people with CHF or heart disease.
If you have CHF or heart disease, discuss with your doctor how Jentadueto may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Jentadueto, and whether Jentadueto is appropriate for you.
Dye or contrast agents: If you are going to have an X-ray procedure that uses dye or a contrast agent, you may need to stop taking Jentadueto for a short time. Contact your doctor for instructions.
Hypoglycemia (low blood sugar): Hypoglycemia can occur when linagliptin - metformin is used in combination with a sulfonylurea (e.g., glyburide, Gliclazide) or insulin. Your doctor may suggest a lower dose of your sulfonylurea or insulin when you start Jentadueto.
Hypoglycemia may also occur when you don't eat enough, exercise strenuously without eating enough, or drink alcohol. If you experience low blood sugar (e.g., headache, drowsiness, weakness, dizziness, confusion, irritability, hunger, fast heartbeat, sweating, and feeling jittery) contact your doctor.
During times of stress (e.g., fever, trauma, surgery, infection), your doctor may suggest that you temporarily stop Jentadueto and use insulin to help control your blood sugar levels.
Kidney function: Kidney Disease or reduced kidney function may cause Jentadueto to build up in the body, causing side effects and increasing the risk of lactic acidosis. If you have reduced kidney function or kidney disease, discuss with your doctor how Jentadueto may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Jentadueto, and whether any special monitoring is needed.
Liver function: If you have reduced liver function or liver disease, you may be at an increased risk of developing lactic acidosis. Discuss with your doctor how Jentadueto may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Jentadueto, and whether any special monitoring is needed. Jentadueto is not recommended if you have severely reduced liver function.
Lactic acidosis: Lactic acidosis is a rare but serious problem that occurs due to metformin accumulation (i.e., the body doesn't get rid of it fast enough) during treatment. If you have severe kidney disease, you are at higher risk of developing lactic acidosis. Since alcohol may increase the risk of lactic acidosis, do not drink a lot of alcohol over the short- or long-term while taking Jentadueto. When it does occur (very rarely), it is fatal in 50% of cases. If you experience symptoms of lactic acidosis (e.g., weakness, tiredness, drowsiness, unusual muscle pain, trouble breathing, stomach pain with nausea, vomiting or diarrhea, feeling cold, dizziness, lightheadedness, or slow or irregular heartbeat), stop taking Jentadueto and get immediate medical attention.
Pancreatitis: Jentadueto may cause or worsen pancreatitis (inflammation of the pancreas). If you have a history of pancreatitis, gallstones, Alcoholism, or high triglycerides, you may be more at risk of experiencing this and should be closely monitored by your doctor while taking Jentadueto.
If you experience symptoms of pancreatitis (e.g., upper left abdominal pain, back pain, nausea, fever, chills, rapid heartbeat, swollen abdomen or prolonged and severe abdominal pain with or without vomiting), contact your doctor immediately.
Surgery: Jentadueto should be stopped temporarily for surgery (except for minor surgery where food and fluid intake is not restricted). You will be restarted on Jentadueto once you are eating and drinking, and your kidney function has been tested and is normal. Talk to your doctor for specific instructions.
Thyroid function: For people who have an underactive thyroid, metformin can cause the amount of thyroid hormone in the body to decrease further. If you have an underactive thyroid gland, discuss with your doctor how Jentadueto may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Jentadueto, and whether any special monitoring is needed.
Vitamin B12 levels: Metformin may decrease vitamin B12 levels. Your doctor will monitor your B12 levels with blood tests while you are taking Jentadueto.
Pregnancy: Metformin should not be used during pregnancy. If you become pregnant while taking Jentadueto, contact your doctor immediately. During pregnancy, blood glucose levels should be kept as close to normal as possible using insulin.
Breast-feeding: It is not known if linagliptin passes into breast milk. Metformin does pass into breast milk. If you are breast-feeding, Jentadueto may affect your baby, and so it is recommended that you do not use linagliptin - metformin.
Children: The safety and effectiveness of using Jentadueto have not been established for children less than 18 years old.
Seniors: Seniors are more likely to have reduced liver and kidney function, and may be at increased risk of experiencing side effects to Jentadueto.
