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Patients should be advised to discontinue Janumet immediately and to promptly notify their health practitioner if unexplained hyperventilation, myalgia, malaise, unusual somnolence, dizziness, slow or irregular heart beat, sensation of feeling cold (especially in the extremities) or other nonspecific symptoms occur

When your chart needs adjustment: renal impairment, age, and drug interactions The standard dosing chart assumes normal renal function, age under 65, and no interacting medications