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Do not use the combination of Sitagliptin & Metformin in patients with hepatic disease.
Before initiating the combination and at least annually thereafter, assess renal function and verify as normal.
May need to discontinue the combination and temporarily use insulin during periods of stress and decreased intake of fluids and food as may occur with fever, trauma, infection or surgery.
Use in Children: Safety and effectiveness of Sitagliptin/Metformin in pediatric patients under 18 years of age have not been established.
Use in the Elderly: Because Sitagliptin and Metformin are substantially excreted by the kidney, and because aging can be associated with reduced renal function, combination of Sitagliptin and Metformin should be used with caution as age increases. Care should be taken in dose selection and should be based on careful and regular monitoring of renal function.
