Januvia (sitagliptin) is a prescription drug used to help manage blood sugar levels in adults with type 2 diabetes, along with a balanced diet and exercise. Januvia comes as an oral tablet.
If you have type 1 diabetes or you’ve ever had pancreatitis (inflammation of the pancreas), your doctor likely won’t prescribe Januvia for you.
For details about how Januvia is used, see the “What is Januvia used for?” section below.
Januvia basics
Januvia contains the active ingredient sitagliptin. It belongs to a group of drugs called dipeptidyl peptidase-4 (DPP-4) blockers.
Januvia is a brand-name drug. There isn’t currently a generic form.
Like most drugs, Januvia may cause mild or serious side effects. The lists below describe some of the more common side effects it may cause. These lists don’t include all possible side effects.
Keep in mind that side effects of a drug can depend on:
- your age
- other health conditions you have
- other medications you may be taking
Your doctor or pharmacist can tell you more about the potential side effects of Januvia. They can also suggest ways to help reduce side effects.
Mild side effects
Here’s a short list of some of the mild side effects that Januvia can cause. To learn about other mild side effects, talk with your doctor or pharmacist, or read Januvia’s prescribing information.
Mild side effects of Januvia that have been reported include:
- upper respiratory infection, such as a common cold or sinus infection
- headache
- upset stomach*
- diarrhea*
- mild hypoglycemia (low blood sugar level),* see “Side effect focus” below for details
Mild side effects of many drugs may go away within a few days or a couple of weeks. But if they become bothersome, talk with your doctor or pharmacist.
* This side effect was reported when Januvia was used by itself, but not when Januvia was used with certain other diabetes medications.
Serious side effects
Serious side effects from Januvia can occur, but they aren’t common. If you have serious side effects from this drug, call your doctor right away. But if you think you’re having a medical emergency, you should call 911 or your local emergency number.
Serious side effects of Januvia that have been reported include:
- edema (swelling), especially in the feet, ankles, or legs
- heart failure
- bullous pemphigoid (a condition that causes skin blisters or sores)
- pancreatitis (inflammation of the pancreas)*
- kidney problems, such as acute (sudden) kidney failure
- severe hypoglycemia (very low blood sugar level),* when Januvia is used with other diabetes medications
- severe and disabling joint pain*
- allergic reaction*
* For more information about this side effect, see the “Side effect focus” section below.
Side effects explained
Learn more about some of the side effects Januvia may cause. You can also refer to this in-depth Januvia side effects article for details.
Pancreatitis
Januvia can cause severe inflammation of the pancreas, which is also called pancreatitis.
With pancreatitis, you may have abdominal pain that spreads to your back. And it’s usually a sharp pain. Pancreatitis can also cause nausea and vomiting.
What might help
If you have symptoms of pancreatitis while you’re taking Januvia, seek emergency medical care right away.
If you have pancreatitis, your doctor may have you stop taking Januvia. But do not stop taking the drug without first talking with your doctor.
Hypoglycemia
You may have hypoglycemia (low blood sugar level) with Januvia.
If you’re taking Januvia with insulin or drugs that cause your pancreas to release insulin, your risk of having hypoglycemia is high. (Insulin helps lower your blood sugar levels.) Diabetes drugs that help release insulin include sulfonylurea drugs. Examples include glyburide (Glynase) and glimepiride (Amaryl).
Symptoms of hypoglycemia may include:
- shakiness, anxiety, or nervousness
- sweating and chills
- irritability or impatience
- confusion, dizziness, or lightheadedness
- fast heartbeat
- hunger or nausea
- pale skin
- sleepiness or weakness
- blurred vision
- tingling or numbness in the lips, tongue, or cheeks
- headache
- loss of balance or clumsiness
- nightmares
- seizures
If you have any of these symptoms, check your blood sugar level to see if it’s low.
What might help
If you’re taking insulin or drugs that cause its release together with Januvia, your doctor may lower your dosage of them. Do not lower the dosage of any medications or change how you take them without talking with your doctor.
To help prevent low blood sugar levels with Januvia, you’ll want to check your blood sugar level. Your doctor will tell you how often to do this. How often you’ll need to check depends on several factors. These include other diabetes drugs you’re taking and whether you’ve had low blood sugar levels in the past.
If you have hypoglycemia, you can safely increase your blood sugar level by eating something that contains sugar. The 15-15 rule can help get your blood sugar level to a level that’s in the preferred range. To follow this rule, you’ll eat 15 grams (g) of sugar, wait 15 minutes, then recheck your blood sugar. If your blood sugar is still too low, you’ll consume another 15 g of sugar.
Foods that give you 15 g of sugar include:
- 4 ounces (half a cup) of juice or regular (non-diet) soda
- 1 tablespoon of sugar, honey, or corn syrup
- hard candies, jellybeans, or gumdrops
- glucose tablets
Ask your doctor or pharmacist about the best way to increase your blood sugar to a safe level. Make sure you have sources of sugar available so you can quickly treat hypoglycemia if you have it.
Joint pain
Some people have severe and disabling joint pain with Januvia. Joint pain can start after the first dose of Januvia or after several years of treatment.
Drugs in the same group of medications as Januvia can also cause joint pain. These other drugs include saxagliptin (Onglyza) and linagliptin (Tradjenta).
What might help
If you have joint pain after starting Januvia, talk with your doctor right away. This can be a serious side effect.
Your doctor may have you stop taking Januvia if you have severe joint pain.
Once you stop the drug, your joint pain may go away. But do not stop taking Januvia without first talking with your doctor.
If you restart Januvia or take a drug from the same group of medications, your joint pain may come back.
Allergic reactionSome people may have an allergic reaction to Januvia.
Symptoms of a mild allergic reaction can include:
A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include swelling under your skin, typically in your face, eyelids, lips, hands, or feet. They can also include swelling of your tongue, mouth, or throat, which can cause difficulty breathing.
Call your doctor right away if you have an allergic reaction to Januvia. But if you think you’re having a medical emergency, call 911 or your local emergency number.
Januvia Images
Your doctor will will tell you how much Januvia to take. Below is the drug’s recommended daily dose, but always take the dosage your doctor prescribes.
Form and strengths
Januvia comes as tablets that you’ll take by mouth.
It’s available in strengths of:
- 100 milligrams (mg)
- 50 mg
- 25 mg
Recommended dosage
The recommended dosage of Januvia for type 2 diabetes is 100 mg once per day.
If you have kidney problems, you might need renal dosing of Januvia. Renal dosing is typically a lower dose than usual, such as 50 mg or 25 mg per day.
Your doctor will let you know the drug’s maximum dose.
Questions about Januvia’s dosage
Below are some common questions related to Januvia’s dosage.
What if I miss a dose of Januvia?
If you miss a dose of Januvia, take it as soon as you remember. But if it’s close to your next usual dose of Januvia, skip the missed dose and take your next scheduled dose. If you’re not sure when you should take your next dose of Januvia, ask your doctor or pharmacist.
Will I need to use Januvia long term?
Type 2 diabetes, which Januvia treats, is a long-lasting condition. And it cannot be cured. So you’ll likely need to take Januvia long term. Talk with your doctor to find out how long you should take this drug. Depending on how your condition progresses over time, your doctor may adjust your dosage or recommend other diabetes medications.
How long does Januvia take to work?
Januvia acts quickly to block a certain protein in your body. But you might not notice a difference in your blood sugar levels until several months have passed. In studies, some people had improvements in their blood sugar levels after 18 weeks of treatment.
Note: For details, you can refer to this Januvia dosage article.
If you have type 2 diabetes, your doctor might prescribe Januvia. It’s used together with diet and exercise to help manage blood sugar levels in adults with this condition.
With type 2 diabetes, your blood sugar levels are too high. This is because the insulin that your body naturally releases doesn’t work as well as usual. (Your body uses insulin to lower your blood sugar level.)
Januvia blocks a certain protein in your body that inactivates incretin hormones. These hormones help manage your blood sugar levels by affecting your pancreas and stimulating it to make and release insulin. By blocking the protein, more active incretin hormones are available to help manage your blood sugar levels.
Note: Januvia’s indication doesn’t include type 1 diabetes. In fact, this is a limitation of the drug, which means it cannot be used for the condition. Additionally, Januvia isn’t used for people who have had pancreatitis (inflammation of the pancreas). It’s not known if Januvia is safe for people who have had pancreatitis. This is another limitation of Januvia’s uses. (See the “What are Januvia’s side effects?” section above for more information about pancreatitis.)
Find answers below to some commonly asked questions about Januvia.
Is Januvia similar to alternatives, such as Jardiance, Trulicity, or glipizide?
Januvia is used to help manage blood sugar levels in adults with type 2 diabetes. Jardiance, Trulicity, and glipizide are also used for treating type 2 diabetes, but each of these drugs belongs to a different group of medications. And, they work differently than Januvia. Jardiance and Trulicity have other uses as well.
Certain diabetes drugs have benefits besides managing blood sugar levels in people with diabetes. For example, certain drugs can help reduce the risk of cardiovascular problems in certain people. But Januvia isn’t one of these drugs. Examples of diabetes drugs that reduce the risk of cardiovascular problems include:
- empagliflozin (Jardiance)
- dapagliflozin (Farxiga)
- canagliflozin (Invokana)
- dulaglutide (Trulicity)
- liraglutide (Victoza)
Like Januvia, glipizide is a diabetes drug that stimulates the pancreas to release insulin. (Insulin helps lower blood sugar levels.) It belongs to the same group of diabetes drugs as glyburide (Glynase) and glimepiride (Amaryl).
Unlike Januvia, which comes as tablets, Victoza and Trulicity come as injections. But similar to Januvia, they’re used to treat diabetes.
All the drugs mentioned here treat type 2 diabetes, but they don’t treat type 1 diabetes.
Sometimes your doctor may prescribe Januvia together with metformin. Depending on the dose of each drug you’re taking, you may be able to take Janumet. This medication contains both sitagliptin (the active drug in Januvia) and metformin.
To know which diabetes drug is best for you, talk with your doctor.
How does Januvia work?
Januvia is a dipeptidyl peptidase-4 (DPP-4) blocker.
DPP-4 is a protein that blocks the action of incretin hormones. Incretins help manage your body’s blood sugar levels. When you eat a meal, your digestive tract releases incretins. They affect your pancreas, stimulating it to make and release insulin. And insulin lowers your blood sugar levels.
By blocking DPP-4, more incretin hormones are available to help manage your blood sugar level. This is Januvia’s mechanism of action.
Is Januvia used for weight loss?
Januvia isn’t prescribed for weight loss. Instead, it’s prescribed together with diet and exercise for type 2 diabetes.
Like Januvia, diet and exercise can help manage your blood sugar levels.
Type 2 diabetes typically occurs in adults who have high blood sugar levels because of certain lifestyle and nutrition factors. Having a nutritious diet and exercise habits while taking Januvia may help you manage your weight. So you may notice changes in your weight during treatment.
Does Januvia cause cancer, such as pancreatic cancer?
It’s not known if Januvia causes cancer.
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If you have concerns about your risk of cancer with Januvia, talk with your doctor or pharmacist.
Will I have weight gain, hair loss, or erectile dysfunction with Januvia?
No, these aren’t side effects of Januvia.
This drug doesn’t affect your weight. But Januvia is meant to be used together with balanced diet and exercise habits. And these measures may lead to weight changes.
Hair loss isn’t a reported side effect of Januvia. But it
Erectile dysfunction hasn’t been reported as a side effect of Januvia. But this condition
If you’re concerned about these conditions, talk with your doctor or pharmacist.
Does Januvia treat type 1 diabetes?
No, Januvia does not treat type 1 diabetes. In fact, this is one of the drug’s limitations of use, which means it cannot be used for the condition.
Instead, Januvia is prescribed for people with type 2 diabetes. To learn more about this condition, see the “What is Januvia used for?” section above.
With type 1 diabetes, your body doesn’t make or release enough insulin. (Insulin is used to help lower your blood sugar levels.) With this condition, your immune system destroys the cells in your pancreas that make and release insulin. So, treatment for type 1 diabetes requires insulin therapy. But Januvia isn’t an insulin drug.
Costs of prescription drugs can vary depending on many factors. These factors include what your insurance plan covers and which pharmacy you use. For details, you can refer to this Januvia cost article.
Januvia isn’t available as a generic drug. Generics usually cost less than brand-name drugs.
You can visit Optum Perks to get price estimates of what you’d pay for Januvia when using coupons from the site. See the coupon options below. (Note: Optum Perks coupons cannot be used with any insurance copays or benefits.)
If you have questions about how to pay for your prescription, talk with your doctor or pharmacist. You can also visit the Januvia manufacturer’s website to see if they have support options. And, you can check out this article to learn more about saving money on prescriptions.
Your doctor will explain how you should take Januvia. They’ll also explain how much to take and how often. Be sure to follow your doctor’s instructions.
Taking Januvia
Januvia comes as a tablet that you’ll swallow once per day.
Taking Januvia with other drugs
Januvia is used to treat type 2 diabetes. This condition sometimes requires many different medications for treatment.
Different types of diabetes medications can help manage blood sugar levels in people with diabetes. Your doctor will recommend which drugs you’ll need to take for your blood sugar levels.
Examples of drugs that your doctor may prescribe with Januvia include:
- metformin
- insulin
- empagliflozin (Jardiance)
- dapagliflozin (Farxiga)
- glyburide (Glynase)
- glimepiride (Amaryl)
- pioglitazone (Actos)
- rosiglitazone (Avandia)
Questions about taking Januvia
Here’s a list of questions related to taking Januvia.
- Can Januvia be chewed, crushed, or split? No, you should not chew, crush, or split Januvia tablets. Instead, you must swallow them whole. If you’re having difficulty swallowing Januvia tablets whole, talk with your doctor or pharmacist.
- Should I take Januvia with food? You can take Januvia with or without food. But taking the drug with or without food may affect how much of it your body absorbs. To help keep your levels of Januvia consistent, take it the same way every day.
Questions for your doctorYou may have questions about Januvia and your treatment plan. It’s important to discuss all your concerns with your doctor.
Here are a few tips that might help guide your discussion:
- Before your appointment, write down questions such as:
- How will Januvia affect my body, mood, or lifestyle?
- Bring someone with you to your appointment if doing so will help you feel more comfortable.
- If you don’t understand something related to your condition or treatment, ask your doctor to explain it to you.
Remember, your doctor and other healthcare professionals are available to help you. And they want you to get the best care possible. So, don’t be afraid to ask questions or offer feedback on your treatment.
Januvia contains the active drug sitagliptin, and Tradjenta contains the active drug linagliptin.
These medications belong to the same group of diabetes medications. And they act in the same way to manage type 2 diabetes.
To learn about how Januvia and Tradjenta compare, see this article. Also, be sure to ask your doctor which medication is right for you.
Metformin is an active drug ingredient. It comes as a generic drug. Januvia is a brand-name drug that contains the ingredient sitagliptin.
Metformin is one of the most commonly prescribed drugs for type 2 diabetes. But it works differently than Januvia.
Sometimes, doctors prescribe both metformin and Januvia to manage diabetes. Depending on the prescribed doses of each drug, a doctor might prescribe the combination drug called Janumet. Janumet contains both metformin and sitagliptin.
If you’d like to learn about the similarities and differences between Januvia and metformin, see this article. Talk with your doctor to see which drug is better for you.
Some important things to discuss with your doctor when considering Januvia include your overall health and any conditions you have.
Also, tell your doctor if you’re taking any medications. This is important because some medications can interfere with Januvia.
These and other considerations are described below.
Interactions
Taking a medication with certain vaccines, foods, and other things can affect how the medication works. These effects are called interactions.
Before taking Januvia, be sure to tell your doctor about all medications you take, including prescription and over-the-counter types. Also describe any vitamins, herbs, or supplements you use. Your doctor or pharmacist can tell you about any interactions these items may cause with Januvia.
Interactions with drugs or supplements
Januvia can interact with several types of drugs, including:
- the diabetes drugs:
- glyburide (Glynase)
- glimepiride (Amaryl)
- insulin
This list does not contain all types of drugs that may interact with Januvia. Your doctor or pharmacist can tell you more about these interactions and any others that may occur with the use of Januvia. You can also refer to this Januvia interactions article for details.
Warnings
Januvia may not be right for you if you have certain medical conditions or other factors that affect your health. Talk with your doctor about your health history before you take Januvia. Factors to consider include:
- heart failure
- kidney problems
- previous allergic reaction to Januvia or any of its ingredients
- pregnancy
- breastfeeding
Januvia and alcohol
Some medications interact with alcohol, but Januvia isn’t one of them. However, before starting Januvia, ask your doctor or pharmacist if it’s safe for you to drink alcohol.
Tell your doctor if you drink alcohol. And let them know how much you drink. Your doctor can recommend whether drinking is safe for your blood sugar levels.
Pregnancy and breastfeeding
It’s not known if Januvia is safe to take during pregnancy. But having diabetes that’s not well managed during pregnancy is unsafe for both the pregnant person and the fetus.
Before taking Januvia, tell your doctor if you’re pregnant or considering pregnancy. They can help you safely manage your diabetes during pregnancy.
It’s also unknown if Januvia passes into breast milk or if it affects how your body makes breast milk. If you’re breastfeeding or considering doing so, talk with your doctor before starting Januvia. Your doctor will help you weigh the risks and benefits of taking this drug.
Do not take more Januvia than your doctor prescribes. Using more than this can lead to serious side effects. If you take too much Januvia, your doctor may closely monitor you for overdose.
What to do in case you take too much Januvia
Call your doctor if you think you’ve taken too much Januvia. You can also call 800-222-1222 to reach America’s Poison Centers or use its online resource. However, if you have severe symptoms, immediately call 911 (or your local emergency number) or go to the nearest emergency room.
If you have questions about taking Januvia, talk with your doctor or pharmacist. They can tell you about other treatments you can use for your condition.
Here’s an article about diabetes treatments you might find helpful. And here are some questions you can ask your doctor about Januvia:
- Can I take Januvia with natural diabetes remedies, such as apple cider vinegar?
- How often do I need to check my blood sugar levels when taking Januvia?
- Is Januvia better than other drugs, such as saxagliptin (Onglyza), linagliptin (Tradjenta), and alogliptin (Nesina)?
- Can I reduce the number of pills I take for diabetes by switching to Janumet?
- Does Januvia interact with birth control, such as birth control pills?
- Will Januvia make me constipated?
To get information on different conditions and tips for improving your health, subscribe to any of Healthline’s newsletters. You may also want to check out the online communities at Bezzy. It’s a place where people with certain conditions can find support and connect with others.
Q:
Should I take more Januvia than my prescribed dosage if I eat more sugar than usual?
AnonymousA:
No, it’s not recommended to take more than your prescribed dosage of Januvia if you eat more sugar than usual.
Taking more Januvia than your prescribed dosage can increase your risk for side effects. To learn more about this drug’s side effects, see the “What are Januvia’s side effects?” section above.
In general, it’s not recommended to change your dosage of Januvia without talking with your doctor. Always check with your doctor before changing the dosage of any of your medications.
The Healthline Pharmacist TeamAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.