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Precautions

Do NOT use Duetact if:

• you are allergic to any ingredient in Duetact

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• you have moderate to severe heart failure, liver problems or abnormal liver function tests, certain severe problems related to diabetes (eg, diabetic ketoacidosis, diabetic coma), moderate to severe burns, or quite high blood acid levels (acidosis)

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• you have type 1 diabetes
• you consider bosentan.

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Contact your physician or physician straight away if all of these connect with you.

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Some health conditions may interact with Duetact. Tell a medical expert or pharmacist in case you have any medical conditions, in particular when any with the following apply to you:

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• in the event you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement

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• if you have allergies to medicines, foods, or other substances

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• if you have had an intense hypersensitive reaction (eg, severe rash, hives, breathing difficulties, dizziness) to your other sulfonamide medicine such as acetazolamide, celecoxib, certain diuretics (eg, hydrochlorothiazide), glipizide, probenecid, sulfamethoxazole, valdecoxib, or zonisamide

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• in case you have a good reputation for kidney, thyroid, heart, or circulation system problems; anemia, stroke; certain hormonal problems (eg, adrenal or pituitary problems, syndrome of inappropriate secretion of antidiuretic hormone [SIADH]); low blood sodium levels; or 'abnormal' amounts of an enzyme called glucose 6-phosphate dehydrogenase (G6PD)

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• if you have stomach or bowel problems (eg, stomach or bowel blockage, stomach paralysis), are drinking alcoholic beverages, or experienced poor nutrition

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• for those who have bad health, a high fever, a severe infection, severe diarrhea, high blood acid levels, or brain or nerves problems, or experienced an intense injury

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• if you have a good reputation for bladder cancer, bone fracture, low calcium intake, or weak bones (eg, osteoporosis)

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Some medicines may interact with Duetact. Tell your medical provider should you consider every other medicines, especially any from the following:

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• Bosentan because liver problems may occur, and also the effectiveness of both medicines could possibly be decreased

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• Beta-blockers (eg, propranolol) for the reason that likelihood of low blood sugar could be increased. They may also hide certain signs of low blood glucose making it more challenging to notice

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• Angiotensin-converting enzyme (ACE) inhibitors (eg, enalapril), azole antifungals (eg, miconazole, ketoconazole), chloramphenicol, clarithromycin, clofibrate, disopyramide, fenfluramine, fluoxetine, insulin, monoamine oxidase inhibitors (MAOIs) (eg, phenelzine), nonsteroidal anti-inflammatory drugs (NSAIDs) (eg, ibuprofen), phenylbutazone, probenecid, quinolone antibiotics (eg, ciprofloxacin), salicylates (eg, aspirin), and sulfonamides (eg, sulfamethoxazole) as the probability of low blood glucose levels could possibly be increased
• Calcium channel blockers (eg, diltiazem), corticosteroids (eg, prednisone), decongestants (eg, pseudoephedrine), diazoxide, diuretics (eg, furosemide, hydrochlorothiazide), estrogens, hormonal contraceptives (eg, contraceptive pills), isoniazid, niacin, phenothiazines (eg, promethazine), phenytoin, rifamycins (eg, rifampin), sympathomimetics (eg, albuterol, epinephrine), or thyroid supplements (eg, levothyroxine) since they may decrease Duetact's effectiveness, causing high blood sugar
• Gemfibrozil because blood glucose could be increased or decreased
• Anticoagulants (eg, warfarin) because their effectiveness could be decreased or perhaps the chance of their unwanted effects may be increased by Duetact.

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This will not be a total list of all interactions that could occur. Ask your health care provider if Duetact may connect to other medicines which you take. Check with your doctor prior to starting, stop, or change the dose of the medicine.

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Important safety information:

• Duetact may cause drowsiness, dizziness, blurred vision, or lightheadedness. These effects may be worse if you get it with alcohol or certain medicines. Use Duetact with caution. Do not drive or perform other possible unsafe tasks before you know how you answer it.

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• Do not are drinking alcohol while you take Duetact; it might boost the chance of low blood sugar. Rarely, alcohol may interact with Duetact and cause a serious reaction with symptoms including flushing, nausea, vomiting, dizziness, or stomach pain. Discuss any questions or concerns using your doctor.

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• Carry an ID card all the time saying you might have diabetes.

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• Proper exercise and dieting are very important to be able to shed weight and keep them back. Follow the dieting and exercise program provided to you by your health care provider.

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• Check your blood glucose levels as directed through your doctor. If they are often higher or less than they should be and you also take Duetact the same manner prescribed, tell your medical professional.
• It might be harder to regulate your blood glucose during periods of stress including fever, infection, injury, or surgery. Talk along with your doctor about how exactly to regulate your blood sugar levels if any of these occur. Do not change the dose of your respective medicine without checking along with your doctor.

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• Do not take over the recommended dose without checking using your doctor.

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• Duetact may cause low blood sugar levels. Low blood sugar could make you anxious, sweaty, weak, dizzy, drowsy, or faint. It may also build your heart rhythm faster; make your vision change; give you a headache, chills, or tremors; or allow you to more hungry. It can be a good plan to hold a trusted method to obtain glucose (eg, tablets or gel) to take care of low blood glucose. If this is not available, you should eat or drink a simple way to obtain sugar like white sugar, honey, candy, orange juice, or non-diet soda. This will lift up your blood glucose level quickly. Tell a medical expert straight away should this happen. To prevent low blood sugar, eat meals as well on a daily basis and never skip meals.

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• Risk of low blood sugar levels may be increased by severe or prolonged exercise, alcohol consumption, or skipping meals.

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• Duetact has a sulfonylurea. It may increase the likelihood of death from heart problems. Talk together with your doctor regarding the benefits and risks of this or any other therapies to help remedy your problem.

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• Duetact may cause ovulation in ladies that have not reached menopause but don't ovulate. To avoid pregnancy, be sure to make use of effective contraceptive while using Duetact.

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• Duetact might cause you to become sunburned more easily. Avoid the sun, sunlamps, or tanning booths before you know how you react to Duetact. Use a sunscreen or wear protective clothing in the event you must be outside for more than a short period of time.

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• Duetact may be connected with an increased chance of bladder cancer. Discuss questions or concerns with your doctor.
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• Lab tests, including fasting blood sugar, hemoglobin A_1c, liver function, and eye exams, could possibly be performed whilst you use Duetact. These tests could possibly be used to monitor your problem or pay attention to side effects. Be sure to keep all doctor and lab appointments.

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• Use Duetact with caution within the elderly; they could be more sensitive to its effects, particularly the likelihood of heart related illnesses or low blood glucose.

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• Duetact mustn't be employed in children; safety and effectiveness in children are not confirmed.

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• Pregnancy and breast-feeding: Duetact could potentially cause injury to the fetus or newborn. If you think you could possibly be pregnant, speak to your doctor. You will need to discuss the advantages and perils of using Duetact while you are pregnant. It is not known if Duetact can be found in breast milk. Do not breastfeed while taking Duetact.

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When employed for a long Duetact might not exactly be well. If your blood glucose levels continues to be in order then becomes hard to manage, speak to your doctor. Do not customize the dose of the medicine without checking with your doctor.

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