this may increasingly sitagliptin and simvastatin (Oral route) sit-a-GLIP-tin FOS-fate, sim-va-STAT-in Overview Side Effects Interactions Pregnancy Reviews More Support Group Q & A Commonly used brand name(s) In the U.S. Juvisync Available Dosage Forms: Tablet Therapeutic Class: Antihyperlipidemic Pharmacologic Class: Sitagliptin Slideshow Cholesterol. Get Your Fats Straight! Uses For sitagliptin and simvastatin Sitagliptin and simvastatin combination is used together with a proper diet and exercise to treat type 2 diabetes. It is also used together with a proper diet to treat high cholesterol and triglyceride (fats) levels in the blood. sitagliptin and simvastatin may help prevent medical problems caused by clogged blood vessels such as heart attacks and strokes. Sitagliptin is a dipeptidyl peptidase-4 (DPP-4) inhibitor. It helps to control blood sugar levels by increasing substances in the body that make the pancreas release more insulin. It also signals the liver to stop producing sugar (glucose) when there is too much sugar in the blood. Simvastatin belongs to the group of medicines called statins. It works to reduce the amount of cholesterol in the blood by blocking the production of cholesterol. sitagliptin and simvastatin was available only with your doctor's prescription. The Juvisync product will no longer be marketed in the United States as of September 26, 2013, but may be available in other countries. Before Using sitagliptin and simvastatin In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For sitagliptin and simvastatin, the following should be considered: Allergies Tell your doctor if you have ever had any unusual or allergic reaction to sitagliptin and simvastatin or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully. Pediatric Appropriate studies have not been performed on the relationship of age to the effects of sitagliptin and simvastatin combination in the pediatric population. Safety and efficacy have not been established. Geriatric Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of sitagliptin and simvastatin combination in the elderly. However, elderly patients are more likely to have age-related kidney or muscle problems, which may require caution and an adjustment in the dose for patients receiving sitagliptin and simvastatin combination. Pregnancy Pregnancy Category Explanation All Trimesters X Studies in animals or pregnant women have demonstrated positive evidence of fetal abnormalities. This drug should not be used in women who are or may become pregnant because the risk clearly outweighs any possible benefit. Breast Feeding Studies in women breastfeeding have demonstrated harmful infant effects. An alternative to this medication should be prescribed or you should stop breastfeeding while using sitagliptin and simvastatin. Interactions with Medicines Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking sitagliptin and simvastatin, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive. Using sitagliptin and simvastatin with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take. Amprenavir Atazanavir Boceprevir Clarithromycin Cobicistat Cyclosporine Danazol Darunavir Erythromycin Fosamprenavir Gemfibrozil Idelalisib Indinavir Itraconazole Ketoconazole Lopinavir Mibefradil Mifepristone Nefazodone Nelfinavir Paritaprevir Posaconazole Ritonavir Saquinavir Telaprevir Telithromycin Tipranavir Voriconazole Using sitagliptin and simvastatin with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines. Acenocoumarol Amiodarone Amlodipine Azithromycin Balofloxacin Besifloxacin Bezafibrate Carbamazepine Ceritinib Ciprofibrate Ciprofloxacin Clofibrate Colchicine Conivaptan Dabigatran Etexilate Dalfopristin Daptomycin Delavirdine Diltiazem Eliglustat Eltrombopag Enoxacin Eslicarbazepine Acetate Fenofibrate Fenofibric Acid Fleroxacin Fluconazole Flumequine Fusidic Acid Gatifloxacin Gemifloxacin Lanreotide Levofloxacin Lomefloxacin Lomitapide Lumacaftor Moxifloxacin Nadifloxacin Niacin Norfloxacin Octreotide Ofloxacin Pasireotide Pazopanib Pazufloxacin Pefloxacin Prulifloxacin Quinupristin Ranolazine Risperidone Rufloxacin Simeprevir Sparfloxacin Tadalafil Thioctic Acid Tosufloxacin Verapamil Warfarin Using sitagliptin and simvastatin with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines. Acebutolol Albiglutide Alitretinoin Atenolol Betaxolol Bisoprolol Bosentan Carteolol Carvedilol Celiprolol Clopidogrel Dasatinib Digoxin Dronedarone Efavirenz Esmolol Fosphenytoin Interferon Beta Labetalol Levobunolol Levothyroxine Metipranolol Metoprolol Nadolol Nebivolol Oat Bran Oxcarbazepine Oxprenolol Pectin Penbutolol Phenytoin Pindolol Practolol Propranolol Rifampin Sotalol St John's Wort Ticagrelor Timolol Interactions with Food/Tobacco/Alcohol Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive. Using sitagliptin and simvastatin with any of the following is usually not recommended, but may be unavoidable in some cases. If used together, your doctor may change the dose or how often you use sitagliptin and simvastatin, or give you special instructions about the use of food, alcohol, or tobacco. Cranberry Juice Grapefruit Juice Other Medical Problems The presence of other medical problems may affect the use of sitagliptin and simvastatin. Make sure you tell your doctor if you have any other medical problems, especially: Alcohol use, excessive or history of or Chinese ancestry or Gallbladder stones or Hypothyroidism (an underactive thyroid), uncontrolled or Kidney disease or Liver disease, history of or Pancreas problems, history of Use with caution. May cause side effects to become worse. Angioedema (swelling of the face, lips, tongue, throat, arms, or legs) with sitagliptin or other DPP-4 inhibitors, history of Use with caution. May increase the risk of this condition occurring again. Diabetic ketoacidosis (high ketones and acid in the blood) or Kidney disease, severe or Liver disease, active or Type 1 diabetes Should not be used in patients with these conditions. Electrolyte disorders, severe or Endocrine disorders, severe or Epilepsy (seizures), not well-controlled or Hypotension (low blood pressure) or Major surgery or trauma, recent or Metabolic disorders, severe or Sepsis (severe infection in the blood) Patients with these conditions may be at risk for muscle or kidney problems. Muscle pain, tenderness, or weakness, history of Use with caution. May make these conditions worse. Proper Use of sitagliptin and simvastatin Take sitagliptin and simvastatin only as directed by your doctor . Do not use more of it, do not use it more often, and do not use it for a longer time than your doctor ordered. sitagliptin and simvastatin should come with a Medication Guide. It is very important that you read and understand this information. Be sure to ask your doctor about anything you do not understand. Your doctor will give you instructions about diet, exercise, testing your blood sugar, and adjusting your dose when you are sick. Carefully follow your doctor's instructions . Swallow the tablet whole. Do not break, crush, or chew it. If you are taking diltiazem (Cardizem ), dronedarone (Multaq ), or verapamil (Calan , Isoptin , Verelan ) together with sitagliptin and simvastatin, your dose of Juvisync should not be higher than 100 milligrams (mg) of sitagliptin and 10 mg of simvastatin per day, unless otherwise directed by your doctor. Do not use more than 100 mg of sitagliptin and 20 mg of simvastatin per day together with amiodarone (Cordarone ), amlodipine (Norvasc ), lomitapide (Juxtapid ), or ranolazine (Ranexa ) . When used together with higher doses of Juvisync , these medicines may increase your risk of muscle injury and could result in kidney problems. Avoid drinking grapefruit juice while you are taking sitagliptin and simvastatin. Grapefruit juice may increase your risk of muscle injury and could result in kidney problems. Do not drink large amounts of alcohol with sitagliptin and simvastatin. This could cause unwanted effects on the liver. Dosing The dose of sitagliptin and simvastatin will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of sitagliptin and simvastatin. If your dose is different, do not change it unless your doctor tells you to do so. The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine. For oral dosage form (tablets): For type 2 diabetes and high cholesterol: For patients who are not taking sitagliptin or simvastatin: Adults At first, 100 milligrams (mg) of sitagliptin and 40 mg of simvastatin combination once a day in the evening. Your doctor may adjust your dose as needed. Children Use and dose must be determined by your doctor. For patients who are already taking simvastatin: Adults At first, 100 milligrams (mg) of sitagliptin and the dose of simvastatin you are already taking. It is taken once a day in the evening. Your doctor may adjust your dose as needed. Children Use and dose must be determined by your doctor. Missed Dose If you miss a dose of sitagliptin and simvastatin, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses. Storage Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing. Keep out of the reach of children. Do not keep outdated medicine or medicine no longer needed. Ask your healthcare professional how you should dispose of any medicine you do not use. Precautions While Using sitagliptin and simvastatin It is very important that your doctor check your progress at regular visits . This will allow your doctor to see if the medicine is working properly and to decide if you should continue to take it. Blood and urine tests may be needed to check for unwanted effects. Using sitagliptin and simvastatin while you are pregnant can harm your unborn baby. Use an effective form of birth control to keep from getting pregnant. If you think you have become pregnant while using the medicine, tell your doctor right away. Do not use sitagliptin and simvastatin if you are also taking any of the following medicines: boceprevir (Victrelis ), cobicistat-containing products (Stribild ), cyclosporine (Gengraf , Neoral , Sandimmune ), danazol (Danocrine ), gemfibrozil (Lopid ), nefazodone (Serzone ), telaprevir (Incivek ), certain antibiotics (such as clarithromycin, erythromycin, itraconazole, ketoconazole, posaconazole, telithromycin, voriconazole, Nizoral ), or medicines to treat HIV/AIDS (such as atazanavir, indinavir, nelfinavir, ritonavir, saquinavir, tipranavir, Crixivan , Kaletra , Lexiva , Norvir , Prezista , Reyataz ). Using these medicines together with sitagliptin and simvastatin combination may increase your risk of muscle injury and could result in kidney problems . Chinese patients who are taking large amounts of niacin (greater than or equal to 1 gram or 1000 milligrams per day) together with sitagliptin and simvastatin may have an increased risk for muscle injury. Talk to your doctor if you are Chinese or have Chinese ancestry and take large amounts of niacin (Niacor , Niaspan ). You may need a different dose of sitagliptin and simvastatin. Call your doctor right away if you have unexplained muscle pain, tenderness, or weakness, especially if you also have unusual tiredness or a fever. These could be symptoms of serious muscle problems, such as myopathy or immune-mediated necrotizing myopathy (IMNM). Myopathy is more common when high doses of simvastatin (eg, 80 milligrams) are used, but some people get myopathy with lower doses. Call your doctor right away if you have dark-colored urine, diarrhea, a fever, muscle cramps or spasms, muscle pain or stiffness, or unusual tiredness or weakness. These could be symptoms of a serious muscle problem called rhabdomyolysis, which can cause kidney problems. Call your doctor right away if you have dark-colored urine, a general feeling of tiredness or weakness, a headache, light-colored stools, loss of appetite, stomach pain, upper right stomach pain, vomiting, weight loss, or yellow eyes or skin. These could be symptoms of liver damage. Tell your doctor right away if you have sudden and severe stomach pain, nausea, vomiting, fever, or lightheadedness. These may be symptoms of pancreatitis (swelling and inflammation of the pancreas). sitagliptin and simvastatin may cause serious allergic reactions, including anaphylaxis, angioedema, or certain skin conditions (Stevens-Johnson syndrome). These reactions can be life-threatening and require immediate medical attention. Call your doctor right away if you have a rash, itching, blistering, peeling, or loosening of the skin, fever or chills, trouble breathing or swallowing, or any swelling of your hands, face, mouth, or throat while you are using sitagliptin and simvastatin. sitagliptin and simvastatin may cause hypoglycemia (low blood sugar). Low blood sugar can also occur if you delay or miss a meal or snack, exercise more than usual, drink alcohol, cannot eat because of nausea or vomiting, take certain medicines, or take sitagliptin with another type of diabetes medicine (eg, insulin, glimepiride, metformin, or pioglitazone). Symptoms of low blood sugar must be treated before they cause you to pass out (unconsciousness). People feel different symptoms with low blood sugar . It is important that you learn which symptoms you usually have so you can treat it quickly. Symptoms of low blood sugar include anxiety, behavior changes similar to being drunk, blurred vision, cold sweats, confusion, cool, pale skin, difficulty with thinking, drowsiness, excessive hunger, a fast heartbeat, headaches that continue, nausea, nervousness, nightmares, restless sleep, shakiness, slurred speech, or unusual tiredness or weakness. If symptoms of low blood sugar occur, check your blood sugar level. If you have low blood sugar, eat glucose tablets or gel, corn syrup, honey, or sugar cubes, or drink fruit juice, non-diet soft drinks, or sugar dissolved in water. Glucagon is a medicine that is used in emergency situations when severe symptoms, such as seizures (convulsions) or unconsciousness occur. Have a glucagon kit available, along with a syringe and needle, and know how to use it. The members of your family should also know how to use glucagon. There may be a time when you need emergency help for a problem caused by your diabetes. You need to be prepared for these emergencies. It is a good idea to wear a medical identification (ID) bracelet or neck chain at all times. Also, carry an ID card in your wallet or purse that says you have diabetes with a list of all your medicines. Make sure any doctor or dentist who treats you knows that you are using sitagliptin and simvastatin. You may need to stop using sitagliptin and simvastatin if you have major surgery, a major injury, or you develop other serious health problems. Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements. sitagliptin and simvastatin Side Effects Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention. Check with your doctor immediately if any of the following side effects occur: More common Anxiety blurred vision chills cold sweats confusion cool, pale skin depression dizziness fainting fast or irregular heartbeat headache increased hunger nausea nightmares seizures shakiness slurred speech unusual tiredness or weakness Less common Bladder pain bloody or cloudy urine difficult, burning, or painful urination dry mouth flushed, dry skin frequent urge to urinate fruit-like breath odor increased thirst increased urination loss of consciousness lower back or side pain stomachache sweating swelling troubled breathing unexplained weight loss vomiting Rare Bloating constipation dark-colored urine fever indigestion loss of appetite muscle cramps or spasms muscle pain, tenderness, wasting, or weakness pains in the stomach, side, or abdomen, possibly radiating to the back yellow eyes or skin Incidence not known Agitation black, tarry stools bleeding gums blistering, peeling, or loosening of the skin burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings chest pain decreased urine output diarrhea difficulty with moving difficulty with swallowing feeling of warmth hives increased sensitivity of the skin to sunlight irritability joint or muscle pain large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs lethargy pinpoint red spots on the skin rapid weight gain red, irritated eyes red, sore, or itching skin red skin lesions, often with a purple center redness of the face, neck, arms, and occasionally, upper chest seizures severe sunburn skin rash sore throat sores, ulcers, or white spots on the lips or in the mouth sores, welts, or blisters on the skin swollen glands swollen joints tightness in the chest unsteadiness or awkwardness unusual bleeding or bruising weakness in the arms, hands, legs, or feet Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them: More common Body aches or pain cough that produces mucus ear congestion loss of voice runny or stuffy nose sneezing Less common Burning feeling in the chest or stomach dizziness or lightheadedness feeling of constant movement of self or surroundings pain or tenderness around the eyes and cheekbones sensation of spinning skin rash that is encrusted, scaly, and oozing tenderness in the stomach area trouble with sleeping Incidence not known Acid or sour stomach being forgetful belching decreased interest in sexual intercourse excess air or gas in the stomach or intestines full feeling hair loss heartburn inability to have or keep an erection loss in sexual ability, desire, drive, or performance passing gas problems with memory stomach discomfort, upset, or pain thinning of the hair Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional. Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088. Side Effects (complete list) The information contained in the Truven Health Micromedex products as delivered by Drugs.com is intended as an educational aid only. It is not intended as medical advice for individual conditions or treatment. It is not a substitute for a medical exam, nor does it replace the need for services provided by medical professionals. Talk to your doctor, nurse or pharmacist before taking any prescription or over the counter drugs (including any herbal medicines or supplements) or following any treatment or regimen. Only your doctor, nurse, or pharmacist can provide you with advice on what is safe and effective for you. The use of the Truven Health products is at your sole risk. 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Next Side Effects Print this page Add to My Med List More about simvastatin/sitagliptin Side Effects During Pregnancy Drug Interactions Support Group 0 Reviews Add your own review/rating Drug class: antidiabetic combinations Consumer resources Other brands: Juvisync Professional resources Related treatment guides Cardiovascular Risk Reduction Diabetes, Type 2 High Cholesterol High Cholesterol, Familial Heterozygous High Cholesterol, Familial Homozygous} Drug Status Availability Discontinued X Pregnancy Category Not for use in pregnancy N/A CSA Schedule Not a controlled drug Approval History Drug history at FDA Drug Class Antidiabetic combinations Antihyperlipidemic combinations Related Drugs Cardiovascular Risk Reduction simvastatin , Zocor , ramipril , Victoza , telmisartan , Altace , More... High Cholesterol atorvastatin , simvastatin , Crestor , Lipitor , Zocor , Zetia , More... Diabetes, Type 2 metformin , insulin aspart , glipizide , glimepiride , Januvia , pioglitazone , More... High Cholesterol, Familial Homozygous atorvastatin , simvastatin , Crestor , Lipitor , Zocor , rosuvastatin , More... 1 more conditions... Simvastatin / sitagliptin Rating No Reviews - Be the first! No Reviews - Be the first! Not Rated - Be the first! Help and Support Looking for answers? Ask a question or go join the simvastatin / sitagliptin support group to connect with others who have similar interests.} } among the best
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