sitagliptin
Brand names: Januvia
Zituvimet is a combination of two medicines, sitagliptin and metformin. It helps lower blood sugar in adults with type 2 diabetes, along with diet and exercise.
Drug Pricing (NADAC)
Brand Price
$18.33/unit
Generic Available
No
MERCK SHARP DOHME
Pricing data from NADAC (CMS), effective December 18, 2024. Compare all drug costs →
What it does
Zituvimet is used to treat type 2 diabetes.
Common side effects
Diarrhea, Upper respiratory tract infection (like a cold), Headache
Key warnings
Zituvimet can cause a serious condition called lactic acidosis.
How It Works
Zituvimet contains sitagliptin, which increases insulin release after you eat and decreases sugar production in your liver. It also contains metformin, which helps your body use insulin better and reduces sugar released from the liver. Together, they help lower your blood sugar levels.
How to Take It
Take Zituvimet twice a day with meals. Your doctor will adjust your dose based on how well it works for you. The maximum daily dose is 100 mg of sitagliptin and 2,000 mg of metformin. Do not split or divide Zituvimet tablets.
Pregnancy & Breastfeeding
Talk to your doctor if you are pregnant or plan to become pregnant. It is not known if Zituvimet will harm your unborn baby. Talk to your doctor if you are breastfeeding.
Missed Dose
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and take your next dose at the regular time.
Storage
Store Zituvimet at room temperature, between 68°F and 77°F. Protect it from moisture.
Side Effects (from patient reports)
Based on 29,861 FDA adverse event reports.
FDA Adverse Event Report Analysis
Detailed analysis of 70,292 reports from the FDA Adverse Event Reporting System (FAERS). Reports span 2006–2025.
Total Reports
70,292
Death-Related Reports
6,655
Hospitalization Reports
24,338
Top Indication
Diabetes Mellitus
Gender Distribution
Age Distribution
Most Reported Adverse Reactions (FAERS)
| # | Reaction | Reports |
|---|---|---|
| 1 | BLOOD GLUCOSE INCREASED | 4,453 |
| 2 | NAUSEA | 3,790 |
| 3 | DIARRHOEA | 3,470 |
| 4 | DRUG INEFFECTIVE | 3,469 |
| 5 | FATIGUE | 2,885 |
| 6 | HEADACHE | 2,508 |
| 7 | DIZZINESS | 2,435 |
| 8 | DYSPNOEA | 2,340 |
| 9 | VOMITING | 2,317 |
| 10 | PANCREATITIS | 2,205 |
| 11 | DEATH | 2,160 |
| 12 | ACUTE KIDNEY INJURY | 2,158 |
| 13 | ASTHENIA | 2,077 |
| 14 | MALAISE | 1,898 |
| 15 | WEIGHT DECREASED | 1,893 |
Reactions in Death Reports
Reactions in Hospitalization Reports
Source: FDA FAERS (Adverse Event Reporting System) FDA FAERS (Adverse Event Reporting System) Reports are voluntary and do not establish causation
Serious Warnings
Zituvimet can cause a serious condition called lactic acidosis. This is a buildup of lactic acid in your blood. It can be life-threatening. Get medical help right away if you have symptoms like weakness, muscle pain, trouble breathing, sleepiness, or stomach pain.
Known Drug Interactions
Drugs that Reduce Metformin Clearance Clinical Impact: Concomitant use of drugs that interfere with common renal tubular transport systems involved in the renal elimination of metformin (e.g., organic cationic transporter-2 [OCT 2 ] / multidrug and toxin extrusion [MATE] inhibitors) could increase systemic exposure to metformin and may increase the risk for lactic acidosis [see Clinical Pharmacology ( 12.3 )]. Alcohol Clinical Impact: Alcohol is known to potentiate the effect of metformin on lactate metabolism. ( 7 ) Drugs that reduce metformin clearance (such as ranolazine, vandetanib, dol...
Mechanism: This combination can interfere with how the kidneys remove metformin from the body, which can cause the drug to build up to unsafe levels.
What to do: Your doctor may need to monitor you closely for side effects like a dangerous buildup of acid in the blood.
Examples: Topiramate, zonisamide, acetazolamide or dichlorphenamide.
Mechanism: This drug can interfere with how your body manages acid and how your kidneys remove the diabetes medicine. This may lead to a buildup of the medication in your system.
What to do: Your doctor should monitor your kidney health and check for side effects while you are taking both medications.
Examples: Ranolazine, vandetanib, dolutegravir, and cimetidine. ( 7 ) Drugs that reduce metformin clearance (such as ranolazine, vandetanib, dolutegravir, and cimetidine) may increase the accumulation of metformin.
Mechanism: Dolutegravir slows down the process of removing the diabetes medicine from your body. This can cause the medicine to build up to higher levels in your blood, which may increase the risk of side effects.
What to do: Your doctor may need to adjust your dosage or monitor you more frequently for side effects.
Examples: Ranolazine, vandetanib, dolutegravir, and cimetidine. ( 7 ) Drugs that reduce metformin clearance (such as ranolazine, vandetanib, dolutegravir, and cimetidine) may increase the accumulation of metformin.
Mechanism: Ranolazine reduces how quickly your body gets rid of the diabetes medicine. This can cause the medicine to stay in your body longer and reach higher levels than intended.
What to do: Your doctor may need to adjust your medication dose and monitor you closely for any side effects.
Examples: Ranolazine, vandetanib, dolutegravir, and cimetidine. ( 7 ) Drugs that reduce metformin clearance (such as ranolazine, vandetanib, dolutegravir, and cimetidine) may increase the accumulation of metformin.
Mechanism: Cimetidine slows down how quickly your body removes metformin, which can cause the medicine to build up in your blood.
What to do: Your doctor may need to adjust your dose or monitor you more closely for side effects.
Common Questions
What should I do if I experience severe stomach pain?
Can Zituvimet cause low blood sugar?
Will Zituvimet affect my kidneys?
Can I drink alcohol while taking Zituvimet?
What if I need to have an X-ray with contrast dye?
Does Zituvimet interact with other medications?
How often will my doctor check my kidney function?
Can Zituvimet cause joint pain?
What are the symptoms of lactic acidosis?
Can Zituvimet cause an allergic reaction?
What are the common side effects of sitagliptin?
Does sitagliptin interact with other medications?
What drug class is sitagliptin?
Is sitagliptin safe during pregnancy?
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bromocriptine
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What the FDA Data Shows for sitagliptin
The FDA label for sitagliptin (sold under brand names such as Januvia) classifies it as a prescription-only medication in the DPP-4 Inhibitor class. Zituvimet is used to treat type 2 diabetes. Official labeling lists 3 commonly reported side effects, including Diarrhea, Upper respiratory tract infection (like a cold), Headache.
Post-market surveillance from the FDA Adverse Event Reporting System (FAERS) captures real-world experience. For this drug, FAERS contains 29,861 voluntary reports. The database also lists 8 documented drug interactions derived from FDA labeling, with the top-flagged interaction rated moderate severity. NADAC pricing from CMS.
Report counts do not establish causation — a FAERS entry documents a temporal association, not proof that the drug produced the outcome. Widely prescribed medications naturally accumulate more reports than niche therapies, so raw totals must be interpreted alongside total exposure. Shortage status, recall history, and patent information further shape supply and switching decisions. This page summarizes public FDA data for educational purposes only and is not a substitute for professional medical advice — always consult a licensed healthcare provider before starting, stopping, or changing any medication.
Data Sources
Drug labeling: FDA Drug Labels (SPL/DailyMed). Adverse events: FDA Adverse Event Reporting System (FAERS). Pricing: CMS National Average Drug Acquisition Cost (NADAC).
FAERS reports are voluntary and do not establish causation. Drug interactions are derived from FDA labeling and clinical references. Always consult a healthcare professional before making medication decisions.
Last updated: June 9, 2025
Read our methodology — how this data is sourced, computed, and verified.
All federal data sources used on this page
- FDA Orange Book — approved drug products with therapeutic equivalence. accessdata.fda.gov/cder/ob
- FDA DailyMed — NIH-hosted drug labeling for FDA-approved meds. dailymed.nlm.nih.gov
- FDA Adverse Event Reporting System (FAERS) — post-marketing safety surveillance. fda.gov/drugs/faers
- NLM RxNorm — standardized clinical drug nomenclature. nlm.nih.gov/research/umls/rxnorm
- CMS Medicare Part B Drug Average Sales Price Files — federal drug pricing data. cms.gov/medicare/part-b-drugs/asp
- FDA Drug Shortages Database — current and resolved drug shortage tracking. accessdata.fda.gov/drugshortages