Steglujan

• Risk factors: Taking high doses | Lowering your insulin dose or missing insulin doses | Sudden fever | Lower calorie intake | Ketogenic (keto) diet | Surgery | Pancreatic problems | Dehydration | Alcohol use disorder

Some people who take SGLT2 inhibitors, like the ertugliflozin in Steglujan, have had ketoacidosis. This happens when your body makes too many ketones for energy. When there are too many ketones, your blood gets too acidic. This can be very dangerous. Your risk can be higher if you're sick, not eating much, drinking a lot of alcohol, or just had surgery.

Stop taking Steglujan (ertugliflozin / sitagliptin) and get medical help right away if you have signs of ketoacidosis. These can include severe dehydration, like feeling very thirsty or having a very dry mouth. Other signs can be nausea, vomiting, stomach pain, tiredness, and shortness of breath.

Some people taking sitagliptin, which is in Steglujan, have had pancreatitis (or inflammation of the pancreas). This can sometimes cause damage to the pancreas and can be serious. It's not clear if your risk is higher if you've had this problem in the past. But let your prescriber know if you have a history of pancreatitis to be safe.

Get medical help right away if you have signs of pancreatitis while taking Steglujan (ertugliflozin / sitagliptin). This can include stomach pain that won't go away, which can sometimes spread to your back. Sometimes, it can come with vomiting.

• Risk factors: Kidney problems | Older adults | Low blood pressure | Taking diuretics (water pills)

Steglujan (ertugliflozin / sitagliptin) can make your body lose fluid. This can sometimes lead to low blood pressure and make you feel dizzy. Sit or lie down if you get dizzy, lightheaded, or tired. Make sure to tell your prescriber if this happens.

• Risk factors: Kidney problems

Some people who took SGLT2 inhibitors, like ertugliflozin in Steglujan, have had sudden kidney problems. It can make problems worse in people who already have kidney issues.

Before starting Steglujan (ertugliflozin / sitagliptin), tell your prescriber if you have kidney problems. Your prescriber might check your kidneys with blood tests before and during treatment. This helps make sure your kidneys are okay and it's safe for you to take the medication.

Call your care team right away if you're not urinating as much, have swelling in the legs, or feel short of breath. These could be signs of kidney problems.

• Risk factors: History of urinary tract infections | History of genital yeast infections | People who are uncircumcised

Steglujan (ertugliflozin / sitagliptin) can raise your risk of getting urinary tract infections (UTIs). It can also make you more likely to get a genital infection like a yeast infection. Although rare, some people have gotten a very serious and dangerous genital infection called Fournier's gangrene.

Let a healthcare professional know right away if you have signs of a UTI. This can include feeling pain or burning when you urinate, needing to urinate often, or seeing blood in your urine. Also get medical advice if you think you have a genital infection. Look for signs like fever and itching, pain, soreness, redness, or swelling in that area. Your care team can help treat the problem.

• Risk factors: History of previous amputation | Lower limb infection | Diabetic foot ulcers | Peripheral arterial disease (narrowed blood vessels) | Other blood circulation problems | Male | High A1C | Taking diuretics (water pills) or insulin

Although rare, Steglujan (ertugliflozin / sitagliptin) might raise some people's risk of needing an amputation. In studies, amputations of the toe or foot were most common. People who needed amputation were more likely to have had a higher A1C from the start, an amputation in the past, or diabetic foot ulcer. The most common reasons for amputation were leg infections and foot ulcers.

Pay careful attention to your legs and feet while taking Steglujan (ertugliflozin / sitagliptin). Be sure to follow up with your care team for foot exams.

Tell your care team if you have any new pain, tenderness, sores, infections, or ulcers in your legs or feet. If this happens, you might need to stop taking Steglujan (ertugliflozin / sitagliptin). Your care team can help you manage foot problems or treat them before they get worse.

• Risk factors: Heart failure | Heart problems | Kidney problems

Some studies suggest that there might be a connection between medications like sitagliptin (which is in Steglujan) and a risk of heart failure for people with Type 2 diabetes and heart disease. It's not clear if Steglujan carries this risk.

Before starting Steglujan (ertugliflozin / sitagliptin), tell your prescriber your full medical history. This is especially important if you have heart or kidney problems. They can check your risk of heart failure.

Get medical help right away if you have signs of heart failure. Watch for shortness of breath, tiredness, sudden weight gain, or swelling in the feet.

• Risk factors: Using insulin | Taking sulfonylureas or glinides

Your blood sugar can drop too much if you take Steglujan (ertugliflozin / sitagliptin) with some other diabetes medications. Insulin is one common example. Others include sulfonylureas like glipizide and glinides like repaglinide. Your prescriber might lower the dose of these medications to prevent low blood sugar.

To be safe, be sure you know how to recognize the signs of low blood sugar. Watch for signs like feeling hungry, shaking, cranky, weak, dizzy, or confused. You might also sweat a lot if have a fast heartbeat. If this happens, eat or drink something sugary (like juice or hard candy) right away to get your sugar back up. Tell your care team if your sugar gets too low.

Some people who take DPP-4 inhibitors, like the sitagliptin in Steglujan, have had severe joint pain. It can show up anytime from a day to many years after starting the medication. Most times, the pain goes away after stopping the medication. If you have any pain in your joints, let your care team know right away.

Although rare, some people taking DDP-4 inhibitors, like the sitagliptin in Steglujan, got a skin problem called bullous pemphigoid. It can cause itchy skin, blistering rash, or sores. These symptoms usually go away once you stop taking the medication and get treated.

If you notice a rash with blisters or itchy skin, speak to a healthcare professional. You might need to stop taking Steglujan (ertugliflozin / sitagliptin) and see a dermatologist.

• Risk factors: Allergy to DPP-4 inhibitors (also called "gliptins")

Some people can have a serious allergic reaction to Steglujan (ertugliflozin / sitagliptin). This can include a rash, peeling or blistering skin, swelling of the face or lips, or trouble breathing. Other signs of anaphylaxis are also possible. Allergic reactions can happen within the first 3 months of taking the medication. If this happens, stop taking Steglujan (ertugliflozin / sitagliptin) and get medical help right away.

Tell your prescriber if you've had an allergic reaction to other DPP-4 inhibitors. This includes medications like Tradjenta (linagliptin) or alogliptin (Nesina). You might be more likely to react to Steglujan because it contains a similar medication called sitagliptin.