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Inflammation of the pancreas: upper belly pain, nausea, vomiting Buildup of lactic acid in the body: sudden drop in blood pressure, low body temperature, slow heart rhythm, feeling weak, stomach pain, nausea Kidney problems: urinating less, itching, swelling of the ankles or feet Heart failure: shortness of breath, unusually fast weight gain, swelling of the legs or feet Severe allergic reaction: hives, blisters, trouble breathing, swelling of the face or throat Effects of other drugs, drug classes and over-the-counter products on Janumet XR The following medications may interact with Janumet XR: Carbonic anhydrase inhibitors may increase risk of lactic acidosis Consider more frequent monitoring Drugs that reduce metformin clearance (such as ranolazine vandetanib, dolutegravir, and cimetidine) may increase the accumulation of metformin

Dose adjustments are common, and your doctor should monitor blood pressure monthly during GLP-1 treatment, especially in the first 3-6 months when weight loss is most rapid

Before You Begin: Inspect your medication upon arrival for clarity and expiration date

2011), leading to increased excretion and decreased absorption (Harper et al