Zituvimet (sitagliptin / metformin) is a combination medication that's used to manage blood sugar in adults living with Type 2 diabetes. This medication is used in addition to a balanced diet and exercise. Zituvimet (sitagliptin / metformin) is taken by mouth twice a day with meals. Diarrhea, upper respiratory tract infection, and headache are some potential side effects.
Type 2 diabetes
Zituvimet (sitagliptin / metformin) is a combination of two different diabetes medications.
Metformin is a biguanide. It works by lowering the amount of sugar your liver releases into your blood and the amount of sugar that gets absorbed into the body through your gut. It also helps your body respond better to insulin.
Sitagliptin is a dipeptidyl peptidase-4 (DPP-4) inhibitor. It blocks the action of DPP-4, a protein that normally breaks down hormones that tell the body to make insulin. By blocking DPP-4, the medication allows insulin to stick around in your body longer to help control your blood sugar levels.
Source: DailyMed
Side effects that you should report to your care team as soon as possible:
Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):
Combines two medications into one pill for convenience
Available in two strengths (either 500 mg or 1,000 mg of metformin, both in combination with sitagliptin)
Must take with meals
Might not be a good option for people with kidney or liver problems
Risk of lactic acidosis
Take Zituvimet (sitagliptin / metformin) with meals. This helps lower your risk of stomach side effects (upset stomach).
Swallow the Zituvimet (sitagliptin / metformin) tablets whole. Don't break or cut them. Contact your prescriber to talk about your options if you have trouble swallowing your pills.
Avoid alcohol while you're taking Zituvimet (sitagliptin / metformin). Drinking alcohol with this medication can put you at risk of having too much acid in your body (lactic acidosis) and low blood sugar.
Let your healthcare team know if you have a scheduled surgery or imaging procedure that will use contrast dye or if you've had one within the past 48 hours. Zituvimet (sitagliptin / metformin) can interact with the contrast, which can harm your kidneys. Follow your care team's instructions if you need to stop the medication before your procedure and restart it afterwards to protect your kidneys.
Check your blood sugar as instructed by your healthcare team and write down your results. Share your log with your primary care provider at your follow-up visits. This helps guide your diabetes treatment.
To get the most benefit from your diabetes treatment, take Zituvimet (sitagliptin / metformin) every day, have meals that are nutritious and balanced, and regularly exercise. Make a plan with your healthcare team for a routine that works best for you.
Zituvimet (sitagliptin / metformin) can make it easier for some people to become pregnant. Discuss the potential for an unintended pregnancy with your primary care provider.
Zituvimet (sitagliptin / metformin) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Risk factors: Kidney problems | Liver problems | Heart problems | Age 65 or greater | Alcohol use | Using contrast dye for surgery or other procedures
Zituvimet (sitagliptin / metformin) contains metformin, a medication that can rarely cause a condition called lactic acidosis (too much lactic acid in the blood). This condition can lead to other health problems that can be life-threatening. Let your prescriber know about any health conditions you have and the other medications you take before you start Zituvimet (sitagliptin / metformin). They can check your risk for lactic acidosis.
Tell your care team right away if you notice that you're breathing fast or short of breath or if you have irregular heartbeat, very upset stomach, or muscle pain. Also contact your care team if you feel very sleepy, tired, weak, dizzy, or cold. These can be signs that you have too much lactic acid in your blood.
Although rare, some people who took Zituvimet (sitagliptin / metformin) developed inflammation in their pancreas (pancreatitis). It's not clear whether people who already have problems with their pancreas are at higher risk during treatment. Stop Zituvimet (sitagliptin / metformin) and get medical help if you notice symptoms of having an inflamed pancreas, such as belly pain that won't go away or that spreads to your back, nausea, and vomiting.
Risk factors: History of heart failure | History of kidney issues
Some clinical studies suggest that there might be a link between treatment with a DPP-4 inhibitor (like sitagliptin) and heart failure. Since Zituvimet (sitagliptin / metformin) contains a DPP-4 inhibitor, it's important to be aware of the risk for heart failure. Make sure to let your care team know about your full medical history before you start this medication, especially if you have a history of heart failure. Contact your care team right away if you notice any symptoms related to heart failure, like shortness of breath, rapid or irregular heartbeat, swelling in ankles or feet, sudden weight gain, and chest pain.
Risk factors: Age 65 or older | History of kidney issues
There have been some reports of worsening kidney function, such as acute (sudden) kidney failure, that sometimes required dialysis during treatment with Zituvimet (sitagliptin / metformin). This medication might not be the best option if you have kidney issues, so be sure to tell your primary care provider about your full medical history. Older adults might be at greater risk for sudden kidney problems. Your care team will check your blood work at least once a year to check your kidney function while you're taking this medication.
Risk factors: Long-term use of Zituvimet (sitagliptin / metformin) | Lower than average calcium absorption | Lower than average vitamin B12 absorption
Zituvimet (sitagliptin / metformin) can lower how much vitamin B12 your body absorbs and drop your vitamin B12 levels. This can lead to anemia. Let your healthcare team know if you've had any low energy, muscle weakness, low appetite, or tingling or numbness on hands or feet that doesn't seem to go away. You might need to get blood tests done to check for vitamin B12 deficiency and related anemia. Your primary care provider might order these blood tests periodically (every 1 to 3 years) during treatment with Zituvimet (sitagliptin / metformin).
Risk factors: Changes in diet and exercise | Taking other medications for diabetes, especially insulin or glipizide | Drinking alcohol | Over age 65 | Liver or kidney problems
You're at risk of having low blood sugar if you take Zituvimet (sitagliptin / metformin) together with other diabetes medications, particularly insulin or a sulfonylurea. Very low blood sugar can be life-threatening. Symptoms of low blood sugar include feeling shaky, very hungry, confused, or weak; being nervous or anxious; having a fast heartbeat; or sweating. It's important to know how to recognize and treat low blood sugar. Talk to your healthcare team if you're concerned about having low blood sugar levels.
Some people who've taken medications containing a DPP-4 inhibitor like the sitagliptin in Zituvimet have reported severe and disabling joint pain. This joint pain can occur anytime after starting this medication, from one day to years. Talk to a healthcare professional if you have any discomfort in your joints.
Some people who took a DPP-4 inhibitor medication like the sitagliptin in Zituvimet have had an itchy, blistering rash called bullous pemphigoid. The blisters or sores usually go away with appropriate treatment and once you stop taking Zituvimet (sitagliptin / metformin). Stop taking this medication and speak to your care team right away if you have itchy skin, rash with blisters, or sores.
Severe allergic reactions to Zituvimet (sitagliptin / metformin) are rare but possible. Though allergic reactions can happen at any time during treatment, people have reported a reaction within the first 3 months of starting the medication. Get medical help right away if you experience hives, blisters, peeling skin, trouble breathing, or swelling in your face or throat.
The typical starting dose is 50 mg/500 mg (sitagliptin/metformin) by mouth twice a day with meals.
Your dose might differ if you were taking metformin by itself before you started Zituvimet.
People with Type 1 diabetes
Poor kidney function
Metabolic acidosis (including diabetic ketoacidosis)
Allergic reaction to sitagliptin or metformin
Type 2 diabetes in adults
By signing up, I agree to GoodRx's Terms and Privacy Policy, and to receive marketing messages from GoodRx.
Centers for Disease Control and Prevention. (2024). Diabetes during pregnancy.
Goldstein, B. J., et al. (2007). Effect of initial combination therapy with sitagliptin, a dipeptidyl peptidase-4 inhibitor, and metformin on glycemic control in patients with type 2 diabetes. DiabetesCare.
National Heart, Lung, and Blood Institute. (2022). Vitamin B12–Deficiency anemia.
Salawi, A. (2022). Pharmaceutical coating and its different approaches, a review. Polymers.
You and Your Hormones. (2021). Insulin.
Zydus Lifesciences Limited. (2024). Zituvimet- sitagliptin and metformin hydrochloride tablet, film coated [package insert]. DailyMed.
Research prescriptions and over-the-counter medications from A to Z, compare drug prices, and start saving.