Steglujan

Increased risk for volume depletion or hypotension in those with renal impairment (eGFR <60mL/min/1.73m²), elderly, low systolic BP, or on loop diuretics. Assess volume status, renal function before and after initiating therapy. Correct volume depletion before initiating. Assess for ketoacidosis in presence of signs/symptoms of metabolic acidosis, regardless of blood glucose levels; discontinue if suspected; evaluate and treat if confirmed. Monitor for resolution of ketoacidosis before restarting. Withhold (at least 4 days), if possible, prior to major surgery or procedures associated with prolonged fasting. Consider risks/benefits in patients with known risk factors for heart failure; monitor for signs/symptoms; evaluate and consider discontinuing if develops. Monitor for pancreatitis, serious hypersensitivity reactions, severe joint pain, or bullous pemphigoid; discontinue if suspected or occurs. Necrotizing fasciitis of the perineum (Fournier's gangrene); discontinue and treat immediately if suspected; use alternative antidiabetic. Increased risk of genital mycotic infections, UTIs (including urosepsis, pyelonephritis); monitor and treat appropriately. Prior to initiation, consider factors that may predispose the need for amputations (eg, history of prior amputation, peripheral vascular disease, neuropathy, diabetic foot ulcers). Monitor for infection (including osteomyelitis), new pain/tenderness, sores or ulcers of the lower limbs; discontinue if occur. History of angioedema to other DPP-4 inhibitors. Severe hepatic impairment: not recommended. Elderly. Pregnancy (during 2^nd & 3^rd trimesters), nursing mothers: not recommended.