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Sitagliptin is an orally-active inhibitor of the dipeptidyl peptidase-4 (DPP-4) enzyme. Sitagliptin is present in JANUMET tablets in the form of sitagliptin phosphate monohydrate. Sitagliptin phosphate monohydrate is described chemically as 7-[(3R)-3-amino-1-oxo-4-(2,4,5-trifluorophenyl)butyl]-5,6,7,8tetrahydro-3-(trifluoromethyl)-1,2,4-triazolo[4,3-a]pyrazine phosphate (1:1) monohydrate with an empirical formula of C16H15F6N5OH3PO4H2O and a molecular weight of 523.32. The structural formula is:Bacterial, viral and other infections due to opportunistic pathogens, including

HOW TO USE: Read the Patient Information Leaflet provided by your pharmacist before you start using this medication and each time you get a refill. If you have any questions, ask your doctor, diabetes educator, or pharmacist. Learn all preparation and usage instructions from your health care professional and the product package. Before using, check this product visually for particles or discoloration. If either is present, do not use the insulin. Insulin regular should be clear and colorless. Before injecting each dose, clean the injection site with rubbing alcohol. Change the injection site each time to lessen injury under the skin and to avoid developing problems under the skin (lipodystrophy). Insulin regular may be injected in the stomach area, the thigh, the buttocks, or the back of the upper arm. Do not inject into a vein or muscle because very low blood sugar (hypoglycemia) may occur. Do not rub the area after the injection. Do not inject into skin that is red, swollen, or itchy. Do not inject cold insulin because this can be painful. The insulin container you are currently using can be kept at room temperature (see also Storage section). Inject this medication under the skin as directed by your doctor, usually 30 minutes before meals. Because this insulin is fast-acting, not eating right after a dose of this insulin may lead to low blood sugar (hypoglycemia). Giving insulin regular into a vein should only be done by a health care professional. Very low blood sugar may result. Do not use insulin regular in an insulin pump. This product may be mixed only with certain other insulin products such as NPH insulin. Always draw the insulin regular into the syringe first, then follow with the longer-acting insulin. Never inject a mixture of different insulins into a vein. Consult your health care professional about which products may be mixed, the proper method for mixing insulin, and the proper way to inject mixtures of insulin. Do not change brands or types of insulin without directions on how to do so from your doctor. Learn how to store and discard medical supplies safely. The dosage is based on your medical condition and response to treatment. Measure each dose very carefully because even small changes in the amount of insulin may have a large effect on your blood sugar levels. Check your urine/blood sugar level as directed by your doctor. Keep track of your results and share them with your doctor. This is very important in order to determine the correct insulin dose. Use this medication regularly to get the most benefit from it. To help you remember, use it at the same times each day.

Nursing mothers should not use most Generic Ovral, since it can appear in breast milk and may cause jaundice and enlarged breasts in nursing infants. In this situation, your doctor may advise you to use a different form of contraception while you are nursing your baby. Uncommon (0.1% to 1%): Blurred visionInvasive fungal infections, including hislasmosis, coccidioidomycosis, candidiasis, aspergillosis, blastomycosis, and pneumocystosis. Patients with hislasmosis or other invasive fungal infections may present with disseminated, rather than localized, disease. Antigen and antibody testing for hislasmosis may be negative in some patients with active infection. Empiric anti-fungal therapy should be considered in patients at risk for invasive fungal infections who develop severe systemic illness.

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