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Sitagliptin and metformin is contraindicated in patients with: hypersensitivity to the active substances or to any of the excipients; any type of acute metabolic acidosis (such as lactic acidosis, diabetic ketoacidosis); diabetic pre-coma; severe renal failure (GFR <30 mL/min).
Acute conditions with the potential to alter renal function such as: dehydration; severe infection; shock; intravascular administration of iodinated contrast agents.
Acute or chronic disease which may cause tissue hypoxia such as: cardiac or respiratory failure, recent myocardial infarction, shock; hepatic impairment; acute alcohol intoxication, alcoholism; breast-feeding.
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