Simvastatin (sim-va-STAT-in), Sitagliptin Phosphate (sit-a-GLIP-tin FOS-fate)
Treats type 2 diabetes. Also lowers high cholesterol and triglyceride levels in the blood. Lowers risk of heart attack, stroke, and certain blood vessel problems. This medicine contains an HMG-CoA inhibitor (statin).
JuvisyncThere may be other brand names for this medicine.
When This Medicine Should Not Be Used
Do not use this medicine if you have had an allergic reaction to sitagliptin or simvastatin. Do not use this medicine if you have severe kidney disease, liver disease, type 1 diabetes, or diabetic ketoacidosis or if you are pregnant or breastfeeding. Do not use this medicine if you also use any of the following: boceprevir (Victrelis®), cyclosporine (Gengraf®, Neoral®, Sandimmune®), danazol (Danocrine®), gemfibrozil (Lopid®), nefazodone (Serzone®), telaprevir (Incivek®), medicine to treat infections (such as clarithromycin, erythromycin, itraconazole, ketoconazole, posaconazole, telithromycin, voriconazole, Nizoral®), or medicine to treat HIV/AIDS (such as atazanavir, indinavir, nelfinavir, ritonavir, saquinavir, tipranavir, Crixivan®, Kaletra®, Lexiva®, Norvir®, Prezista®, Reyataz®).
How to Use This Medicine
- Take your medicine as directed. Your dose may need to be changed several times to find what works best for you.
- Swallow the tablet whole. Do not break, crush, or chew it.
- Take the medicine in the evening, unless your doctor tells you otherwise.
- Carefully follow your doctor's instructions about diet and exercise. This medicine is part of a complete plan for lowering cholesterol and triglycerides in your blood.
- This medicine should come with a Medication Guide. Ask your pharmacist for a copy if you do not have one.
If a dose is missed:
- If you miss a dose or forget to use your medicine, use it as soon as you can. If it is almost time for your next dose, wait until then to use the medicine and skip the missed dose. Do not use extra medicine to make up for a missed dose.
How to Store and Dispose of This Medicine
- Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light.
- Ask your pharmacist, doctor, or health caregiver about the best way to dispose of any outdated medicine or medicine no longer needed.
- Keep all medicine out of the reach of children. Never share your medicine with anyone.
Drugs and Foods to Avoid
Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.
- Make sure your doctor knows if you also use amiodarone (Cordarone®), colchicine (Colcrys®), digoxin (Lanoxin®), dronedarone (Multaq®), niacin (Vitamin B3), ranolazine (Ranexa®), certain blood pressure medicines (such as amlodipine, diltiazem, verapamil, Caduet®, Lotrel®), other medicines for lowering cholesterol (such as fenofibrate, Tricor®), or a blood thinner (such as warfarin, Coumadin®, Jantoven®).
- Make sure your doctor knows about all medicine you use to treat diabetes.
- Tell your doctor if you usually drink more than 2 glasses of alcohol per day.
- Avoid drinking grapefruit juice while taking this medication.
Warnings While Using This Medicine
- It is not safe to take this medicine during pregnancy. It could harm an unborn baby. Tell your doctor right away if you become pregnant.
- Make sure your doctor knows if you have kidney disease, low blood pressure, an underactive thyroid, or a muscle disorder. Tell your doctor if you have a history of liver disease, epilepsy, gallstones, heart disease, pancreas problems, or stroke or if you drink alcohol regularly.
- Your medicine dose may need to be changed or stopped when your body is under stress. Make sure your doctor knows if you are injured or sick or if you have an infection, severe vomiting, diarrhea, or fever. Make sure any doctor or dentist who treats you knows that you use this medicine. Tell your doctor if you plan to have surgery.
- Stop using this medicine and tell your doctor right away if you have sudden and severe stomach pain that may spread to your back, nausea, vomiting, fever, or lightheadedness. These may be symptoms of pancreatitis.
- You may develop low blood sugar while you are taking this medicine. The risk for low blood sugar is higher if you also take other medicine for diabetes. Tell your doctor if you have symptoms of low blood sugar, such as shaking, increased hunger, a headache, or drowsiness. Low blood sugar may be caused by exercising more than normal or waiting too long to eat.
- Talk to your doctor if you are Chinese or have Chinese ancestry and take large amounts of niacin (Niacor®, Niaspan®). Chinese patients who take large amounts of niacin (greater than or equal to 1 gram or 1000 milligrams per day) together with this medicine may have an increased risk for muscle injury.
- Call your doctor right away if you have unexplained muscle pain, tenderness, or weakness. You may also have a fever and unusual tiredness. These could be symptoms of a serious muscle problem called myopathy.
- Call your doctor right away if you have dark-colored urine, fever, muscle cramps or spasms, muscle pain or stiffness, or unusual tiredness or weakness. These could be symptoms of a serious muscle problem called rhabdomyolysis, which can cause kidney problems.
- Your doctor will do lab tests at regular visits to check on the effects of this medicine. Keep all appointments. Check your blood sugar at home as directed by your doctor.
Possible Side Effects While Using This Medicine
Call your doctor right away if you notice any of these side effects:
- Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
- Blistering, peeling, red skin rash
- Change in how much or how often you urinate
- Dark-colored urine or pale stools, loss of appetite, pain in your upper stomach, yellow skin or eyes
- Muscle pain, tenderness, or weakness
- Shaking, sweating, fast or pounding heartbeat, faintness, increased hunger, confusion
- Sudden and severe stomach pain, nausea, vomiting, fever, lightheadedness
If you notice these less serious side effects, talk with your doctor:
- Constipation, stomach pain
- Cough, stuffy or runny nose, or sore throat
- Problems with memory