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A total of 641 patients with type 2 diabetes participated in a 24-week, randomized, double-blind, placebo-controlled study designed to assess the efficacy of januvia as add-on to insulin therapy with or without metformin .

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Treatment for diabetes is usually for lifeHoweverif your kidneys are not working properlyyour doctor will tell you to stop taking metformin.

If you’ve taken too many metformin tablets go to your nearest hospital accident and emergencyA&Edepartment straight away.

You may need to stop taking metformin before having surgery and certain medical testsTell your doctor if you need to have:

Taking nicotinic acid with metformin may make metformin less effective in lowering your blood sugar.

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they may also hide certain signs of low blood sugar and make it more difficult to notice anticoagulants eg, warfarin , azole antifungals eg, miconazole, ketoconazole , chloramphenicol, clarithromycin, clofibrate, fenfluramine, insulin, metformin, monoamine oxidase inhibitors maois eg, phenelzine , nonsteroidal anti-inflammatory drugs nsaids eg, ibuprofen , phenylbutazone, probenecid, quinolone antibiotics eg, ciprofloxacin , salicylates eg, aspirin , or sulfonamides eg, sulfamethoxazole because the risk of low blood sugar may be increased corticosteroids eg, prednisone , decongestants eg, pseudoephedrine , diazoxide, diuretics eg, furosemide, hydrochlorothiazide , estrogens, hormonal contraceptives eg, birth control pills , isoniazid, niacin, phenothiazines eg, promethazine , phenytoin, rifamycins eg, rifampin , sympathomimetics eg, albuterol, epinephrine, terbutaline , or thyroid supplements eg, levothyroxine because they may decrease amaryl s effectiveness, resulting in high blood sugar gemfibrozil because blood sugar may be increased or decreased.

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