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Kazano Warnings and Precautions

If you are taking Kazano for type 2 diabetes and have an upcoming surgery or medical procedure planned, you may need to stop taking this medicine temporarily. Other warnings and precautions with Kazano apply to women who are pregnant or breastfeeding, people with certain allergies, and people with liver or kidney conditions.


What Should I Tell My Healthcare Provider?

You should talk with your healthcare provider prior to taking Kazano® (alogliptin and metformin) if you have:
  • Liver disease, such as hepatitis, cirrhosis, or liver failure
  • Kidney disease, such as kidney failure (renal failure)
  • Had pancreatitis (inflammation of the pancreas)
  • Gallstones 
  • Congestive heart failure (CHF) or other heart problems
  • Plans for a surgery or medical procedure, including x-rays or procedures where you will be given an injection of dye or contrast agent
  • A condition called metabolic acidosis or have had diabetic ketoacidosis (increased ketones in your blood or urine)
  • Low vitamin B12 levels (pernicious anemia)
  • A history of alcoholism or drink alcohol often
  • Any allergies, including to foods, dyes, or preservatives.
Also, let your healthcare provider know if you are:
  • Pregnant or thinking of becoming pregnant
  • Breastfeeding.
You should also tell your healthcare provider about all other medications you are taking, including prescription and nonprescription medicines, vitamins, and herbal supplements.

Specific Precautions and Warnings for Kazano

Some warnings and precautions to be aware of prior to taking this medication include the following:
  • Very preliminary data suggests incretin mimetics, such as Kazano, may increase the risk of precancerous cellular changes (called pancreatic duct metaplasia) in people with type 2 diabetes. Researchers are continuing to study the possibility that incretin mimetics might increase the risk of pancreatic cancer, although at this time there is not enough information to know for sure if there is any increased risk.
  • Kazano contains the medication metformin, which can cause a rare but life-threatening condition known as lactic acidosis (a buildup of lactic acid in the bloodstream). People with certain health conditions have a higher risk for this complication, including those who have kidney disease, liver disease, or heart failure.

    Lactic acidosis is a medical emergency that requires hospital treatment. Let your healthcare provider know immediately if you develop signs of this condition, such as:
    • Fatigue or tiredness
    • Muscle pain
    • Difficulty breathing
    • Unexplained abdominal (stomach) problems with nausea, vomiting, and diarrhea.
(Click Metformin and Lactic Acidosis to learn more.)
  • Other things can increase your risk for lactic acidosis, such as:
    • Drinking a lot of alcohol regularly or large amounts in a short period ("binge drinking"). Do not drink large amounts of alcohol during Kazano treatment (see Metformin and Alcohol).
    • Getting dehydrated, which can happen if you don't drink enough fluids; get sick with fever, diarrhea, or vomiting; or sweat a lot. Let your healthcare provider know if you may be dehydrated.
    • Having certain medical procedures, including surgery or x-ray tests with contrast media or injectable dyes. Let your healthcare provider know if you will be having a medical procedure. You may need to temporarily stop taking Kazano.
  • This medication has been reported to cause inflammation of the pancreas (known medically as pancreatitis), which can be severe enough to be life-threatening. Contact your healthcare provider right away if you have signs of pancreatitis, such as nausea, vomiting, and severe abdominal (stomach) pain that may radiate to your back. 

    People who have kidney or liver problems or those with a history of pancreatitis, gallstones, or alcoholism are at a higher risk for pancreatitis. Let your healthcare provider know if any of these conditions apply to you.  
  • Although generally rare, some people may have a severe allergic reaction to this medication. Stop taking Kazano and contact your healthcare provider right away if you have signs of an allergic reaction, such as:
    • An unexplained skin rash, itching, flaking, or peeling
    • Hives
    • Difficulty breathing or swallowing
    • Swelling of the face, lips, or throat.
  • There have been reports of liver problems occurring in people treated with Kazano. Your healthcare provider may want to test your liver function before starting treatment. Let him or her know if you develop any signs of liver problems, such as:
    • Upper-right abdominal (stomach) pain
    • Loss of appetite
    • Fatigue or unusual tiredness
    • Dark urine
    • Yellowing of the skin or whites of the eyes (jaundice).
  • People who have kidney disease have a higher risk for potentially serious Kazano side effects and should not be treated with this drug. Your healthcare provider will check your kidney function (renal function) before you start Kazano and then at least once a year during treatment. Because certain medical procedures may temporarily affect how well your kidneys function, you may need to temporarily stop taking this medicine before a surgical procedure or a procedure where you will be given contrast dye.
  • This medication may decrease the amount of B12 in your body. Your healthcare provider will check your B12 levels (with a simple blood test) during treatment.
  • Kazano is not likely to cause dangerously low blood sugar (hypoglycemia). However, if you take it in combination with other diabetes medicines that lower blood sugar, such as insulin or a sulfonylurea medicine, your risk for hypoglycemia may be higher. You may also be at a higher risk for hypoglycemia if you are older, do not eat enough, exercise strenuously without eating enough, have pituitary or adrenal problems, or drink large amounts of alcohol.
  • Although this medication is quite effective at controlling blood glucose levels, it is not known whether treatment actually lowers the risk for coronary artery disease, strokes, or other heart and blood vessel problems associated with diabetes.
  • Your healthcare provider may need to change the dose of your diabetes medications if your body is under stress, such as from an infection, fever, accident, or surgery. Let your healthcare provider know right away if any of these things happen to you.
  • Kazano is a pregnancy Category B medication, which means it is probably safe for use during pregnancy, although the full risks are currently unknown. Talk to your healthcare provider before using this medication when pregnant (see Kazano and Pregnancy).
  • It is unknown whether Kazano passes through breast milk. Therefore, if you are breastfeeding or plan to start, discuss this with your healthcare provider prior to taking the drug (see Kazano and Breastfeeding).
Common Symptoms of Diabetic Neuropathy

Kazano Medication Information

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