Warfarin works by disrupting the role of vitamin K in a complex series of molecular events that cause blood clotting.
US Food and Drug Administration "FDA Drug Safety Communication: FDA warns that DPP-4 inhibitors for type 2 diabetes may cause severe joint pain. Feel Like Throwing Up 4. All rights reserved. ([2015, Aug 28]):Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.Some side effects may not be reported. Concomitant cardiovascular or Signs and symptoms of severe acidosis may include vomiting, abdominal pain, nausea, Long-term treatment with metformin has been associated with a decrease in vitamin B12 absorption. See below for a comprehensive list of adverse effects. Seek immediate medical care if you notice any sores, changes in skin color or temperature, or severe pain on your skin.Talk to your doctor about these less serious side effects:Some studies suggest that the risk of bleeding is generally higher in the first three months of warfarin treatment. Head Pain 6. If experienced, these tend to have a Less Severe expression 1. While the risk of major bleeding is low, you need to be aware of potential problems. Never take a double dose.If you follow your doctor's dosing instructions and tell all your health care providers that you take warfarin, you'll be at a much lower risk of dangerous interactions and side effects. For example, you might have trouble stopping the bleeding from a cut on your hand, or you have a nosebleed. Diarrhea 3. More-serious bleeding may be inside the body (internal).Seek immediate help if you have any of the following:Rarely, warfarin can cause the death of skin tissue (necrosis). If you have little vitamin K in your diet, a sudden spike can increase your risk of bleeding.Talk to your doctor about healthy choices you can make to get an adequate and consistent supply of vitamin K.To reduce the risk of a bleeding event from warfarin treatment, follow these guidelines:If you miss a dose, take it as soon as you remember. You may report them to the The easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records. Talk to your doctor, nurse or pharmacist if you have any concerns about warfarin.Mayo Clinic does not endorse companies or products. Taste Problems 9. "Product Information.

Gas 5. Acute Infection Of The Nose, Throat Or Sinus 2. If your doctor isn't available, skip the missed dose and resume your normal dosing schedule. The interaction might lower the effectiveness of warfarin or increase your risk of bleeding. In all cases, substantial reduction in prior activity level was reported, 10 patients were hospitalized due to disabling joint pain. Decreased levels of vitamin B12 appear to be reversible with discontinuation of metformin or vitamin B12 supplementation.Between October 2006 and December 2013, thirty-three cases of severe arthralgia have been reported to the FDA Adverse Event Reporting System Database. Each case involved the use of 1 or more dipeptidyl peptidase-4 (DPP-4) inhibitor. Inadequate Vitamin B12 7. Available from: URL: http://www.fda.gov/downloads/Drugs/DrugSafety/UCM460038.pdf." Rosiglitazone is another type of diabetes medicine. Although not all of these side effects may occur, if they do occur they may need medical attention.Some side effects of metformin / sitagliptin may occur that usually Check with your health care professional if any of the following side effects In metformin-treated patients, the incidence of lactic acidosis has been about 1.5 cases per 10,000 patient years. A positive rechallenge was reported in 8 cases, with 6 cases involving use of a different DPP-4 inhibitor. Mayo Clinic does not endorse any of the third party products and services advertised.A single copy of these materials may be reprinted for noncommercial personal use only. This complication occurs within a few days of starting warfarin treatment. Sitagliptin had the greatest number of cases reported (n=28) followed by Decreased serum vitamin B12 levels, without clinical manifestations (rarely megaloblastic anemia), has been reported in approximately 7% of patients. Available for Android and iOS devices.We comply with the HONcode standard for trustworthy health information - Mayo Clinic offers appointments in Arizona, Florida and Minnesota and at Mayo Clinic Health System locations.Our general interest e-newsletter keeps you up to date on a wide variety of health topics.Although commonly used to treat blood clots, warfarin (Coumadin, Jantoven) can have dangerous side effects and put you at risk of heavy bleeding. Merck & Company Inc, West Point, PA. 2. Weight Loss Other side effects include: nausea. Janumet (metformin-sitagliptin)."

If you take warfarin, it's important to have a consistent amount of vitamin K in your diet.

Swelling of the hands and legs can happen if you take Janumet XR in combination with rosiglitazone (Avandia ® ).

Megaloblastic anemia has occurred. "Mayo," "Mayo Clinic," "MayoClinic.org," "Mayo Clinic Healthy Living," and the triple-shield Mayo Clinic logo are trademarks of Mayo Foundation for Medical Education and Research.© 1998-2020 Mayo Foundation for Medical Education and Research (MFMER). Know the warning signs and how to prevent side effects.If you've been prescribed warfarin (Coumadin, Jantoven) to prevent blood clots, you probably already know that this powerful drug can save your life if you are at risk of or previously had blood clots. Any use of this site constitutes your agreement to the Terms and Conditions and Privacy Policy linked below. Medical conditions that increase the risk of bleeding include: Uncontrolled blood pressure A history of stroke Stomach ulcers, gastritis or peptic disease Kidney problems Cancer Alcoholism Liver disease Increased risk of falls The risk of lactic acidosis has been particularly high in patients with underlying renal insufficiency and rarely in patients with normal renal function. Your doctor may recommend a genetic test to guide decisions about appropriate dosing of the drug.Medical conditions that increase the risk of bleeding include:Like any other medication, warfarin can interact with drugs, foods, vitamins or herbal supplements.