Do NOT use Duetact if:

• you are allergic to any ingredient in Duetact
• you have moderate to severe heart failure, liver problems or abnormal liver function tests, certain severe problems associated with diabetes (eg, diabetic ketoacidosis, diabetic coma), moderate to severe burns, or very high blood acid levels (acidosis)
• you have type 1 diabetes
• you are taking bosentan

• if you are pregnant, planning to become pregnant, or are breast-feeding
• if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
• if you have allergies to medicines, foods, or other substances
• if you have had a severe allergic reaction (eg, severe rash, hives, breathing difficulties, dizziness) to any other sulfonamide medicine such as acetazolamide, celecoxib, certain diuretics (eg, hydrochlorothiazide), glipizide, probenecid, sulfamethoxazole, valdecoxib, or zonisamide
• if you have a history of kidney, thyroid, heart, or blood vessel problems; stroke; certain hormonal problems (eg, adrenal or pituitary problems, syndrome of inappropriate secretion of antidiuretic hormone [SIADH]); or low blood sodium levels
• if you have stomach or bowel problems (eg, stomach or bowel blockage, stomach paralysis), drink alcohol, or have had poor nutrition
• if you have very poor health, a high fever, a severe infection, severe diarrhea, or high blood acid levels, or if you have had a severe injury
• if you have swelling problems (edema) or certain eye problems (macular edema)
• if you will be having surgery

• Bosentan because liver problems may occur, and the effectiveness of both medicines may be decreased
• Beta-blockers (eg, propranolol) because the risk of low blood sugar may be increased. They may also hide certain signs of low blood sugar and make it more difficult to notice
• Angiotensin-converting enzyme (ACE) inhibitors (eg, enalapril), azole antifungals (eg, miconazole, ketoconazole), chloramphenicol, clofibrate, fenfluramine, insulin, metformin, monoamine oxidase inhibitors (MAOIs) (eg, phenelzine), nonsteroidal anti-inflammatory drugs (NSAIDs) (eg, ibuprofen), phenylbutazone, probenecid, quinolone antibiotics (eg, ciprofloxacin), salicylates (eg, aspirin), and sulfonamides (eg, sulfamethoxazole) because the risk of low blood sugar may be increased
• Calcium channel blockers (eg, diltiazem), corticosteroids (eg, prednisone), decongestants (eg, pseudoephedrine), diazoxide, diuretics (eg, furosemide, hydrochlorothiazide), estrogens, hormonal contraceptives (eg, birth control pills), isoniazid, niacin, phenothiazines (eg, promethazine), phenytoin, rifamycins (eg, rifampin), sympathomimetics (eg, albuterol, epinephrine), or thyroid supplements (eg, levothyroxine) because they may decrease Duetact 's effectiveness, resulting in high blood sugar
• Gemfibrozil because blood sugar may be increased or decreased
• Anticoagulants (eg, warfarin) because their effectiveness may be decreased or the risk of their side effects may be increased by Duetact

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

• Diarrhea; headache; limb pain; muscle aches; nausea; upper respiratory tract infection; weight gain.

• Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); blurred vision or other vision changes; chest pain; confusion; fever, chills, or sore throat; increased or painful urination; irregular heartbeat; symptoms of heart failure (eg, shortness of breath; sudden unexplained weight gain; swelling of the hands, ankles, or feet); symptoms of liver problems (eg, dark urine, severe or persistent nausea, stomach pain, unexplained vomiting or loss of appetite, yellowing of the skin or eyes); symptoms of low blood sugar (eg, anxiety, chills, dizziness or drowsiness, headache, increased hunger, increased sweating, tremors); unusual bone pain; unusual bruising or bleeding; unusual tiredness or weakness.

If you have any questions about Duetact , please talk with your doctor, pharmacist, or other health care provider.

Duetact is to be used only by the patient for whom it is prescribed. Do not share it with other people.

If your symptoms do not improve or if they become worse, check with your doctor.