You should not use this medicine if you have severe kidney disease or diabetic ketoacidosis (call your doctor for treatment).
You may develop lactic acidosis, a dangerous build-up of lactic acid in your blood. Call your doctor or get emergency medical help if you have unusual muscle pain, trouble breathing, stomach pain, dizziness, feeling cold, or feeling very weak or tired.
Before taking this medicine
You should not use  Janumet XR if you are allergic to metformin or sitagliptin (Januvia), or if you have severe kidney disease or diabetic ketoacidosis (call your doctor for treatment with insulin).
Tell your doctor if you have ever had:
kidney disease (your kidney function may need to be checked before and while you are taking this medicine);
liver disease;
heart disease;
pancreatitis;
high triglycerides (a type of fat in the blood);
gallstones; or
alcoholism.
You may develop lactic acidosis, a dangerous build-up of lactic acid in your blood. This may be more likely if you have other medical conditions, a severe infection, chronic alcoholism, or if you are 65 or older. Ask your doctor about your risk.
If you need to have surgery or any type of x-ray or CT scan using a dye that is injected into your veins, you may need to temporarily stop taking Janumet XR. Be sure your caregivers know ahead of time that you are using this medication.
Follow your doctor's instructions about using this medicine if you are pregnant or you become pregnant. Controlling diabetes is very important during pregnancy, and having high blood sugar may cause complications in both the mother and the baby.
Metformin may stimulate ovulation in a premenopausal woman and may increase the risk of unintended pregnancy. Talk to your doctor about your risk.
It may not be safe to breastfeed while using this medicine. Ask your doctor about any risk.
This medicine is not approved for use by anyone younger than 18 years old.
