Nesina

Assess renal function prior to therapy and periodically thereafter. Monitor for signs/symptoms of pancreatitis, serious hypersensitivity reactions, severe joint pain, or bullous pemphigoid; discontinue if suspected or occurs. Consider risks/benefits in patients with known risk factors for heart failure; monitor for signs/symptoms; evaluate and consider discontinuing if develops. History of angioedema to other DPP-4 inhibitors. Hepatic impairment. Obtain LFTs before starting therapy; interrupt and evaluate if liver enzymes elevated or abnormal tests persist; do not restart if liver injury is confirmed and no other etiology can be found. Pregnancy. Nursing mothers.