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If duloxetine is contraindicated, not tolerated or ineffective, consider amitriptyline, gabapentin, or pregabalin as alternatives
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(5.1) If lactic acidosis is suspected, discontinue JANUMET XR and institute general supportive measures in a hospital setting
If you need to dispose of medication and do not have a take-back program or instructions, mix the residual drug with an unpalatable substance (like coffee grounds or cat litter), seal it in a bag, and discard in the trash, per FDA guidelines, to prevent accidental exposure
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