Treviamet Special Precautions

Acidosis Lactic.
Pancreatitis: Acute pancreatitis, including hemorrhagic or necrotizing pancreatitis, both fatal and non-fatal, has been reported post-marketing. Put an immediate stop to Metformin Hydrochloride and Sitagliptin film-coated tablets if pancreatitis is suspected.
Heart Failure: Two other DPP-4 inhibitor class members have shown evidence of heart failure. Sitagliptin with metformin hydrochloride film-coated tablets should be carefully considered for patients with known heart failure risk factors. Keep an eye out for symptoms in patients.
Acute renal failure: Post-marketing reports have been made; dialysis may be necessary in certain cases. Evaluate renal function before starting Metformin Hydrochloride and Sitagliptin film-coated tablets, and at least once a year after that.
Insufficient Vitamin B: Metformin may cause vitamin B levels to drop. Measure vitamin B every two to three years and hematologic parameters once a year.
Hypoglycemia with Concomitant Use of Insulin or Insulin Secretagogues: Using insulin and/or an insulin secretagogue together increases the risk of hypoglycemia. It might be necessary to use less insulin or insulin secretagogue.
Hypersensitivity Reactions: Following the release of a product, there have been reports of severe allergy reactions. Patients on DPP-4 inhibitors have been observed to get severe and incapacitating arthritis. Examine as a potential reason for excruciating joint pain, and stop using the medication if necessary.
Bullous Pemphigoid: Post-marketing reports of patients on DPP-4 inhibitors necessitated hospitalisation. Instruct patients to report any blisters or erosions that appear. Stop taking Sitagliptin and metformin hydrochloride film-coated tablets if bullous pemphigoid is detected.
Hepatic Impairment: Patients who have hepatic impairment should not use.
Use in the Elderly: Evaluate renal function more often.