8 Januvia Side Effects and How to Manage Them

Januvia (sitagliptin) is one of many oral medications used to treat Type 2 diabetes. It belongs to the dipeptidyl peptidase-4 inhibitor class, also known as “gliptins.” Januvia controls your blood glucose (sugar) levels by causing a specific gut hormone involved in digestion and blood glucose control to stick around longer.

As with any medication, Januvia has possible side effects. Most of these, like cold symptoms, are generally mild and can be managed at home. But serious side effects, like pancreatitis and skin reactions, are also possible. Below we cover what you should know about eight Januvia side effects and how to manage them. 

1. Cold symptoms

The most commonly reported Januvia side effect is cold symptoms. This may include a stuffy nose, coughing, or general upper respiratory infections. Medications like Januvia may have certain immune system-related effects. But the evidence is mixed on whether they increase your risk of an infection.

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Most of the time, cold symptoms clear up quickly. But if they’re bothersome, over-the-counter (OTC) cold medications may help. Your pharmacist can recommend products that are safe for you to take. Home remedies, such as a saline rinse with a Neti Pot, may also provide relief.

If your cold symptoms don’t start getting better within 10 days, or if they’re severe or getting worse, contact your healthcare provider. Your infection may need further medical treatment.

2. Headache

Some people taking Januvia experience headaches. These are usually mild and tend to go away after your body gets used to Januvia. But if your headaches start interfering with your daily routine, ask your healthcare provider or pharmacist if OTC headache medications are right for you.

If your headache is persistent or severe, let your healthcare provider know. This isn’t typical and may require medical attention. 

3. Low blood glucose

Januvia has a low chance of causing low blood glucose (hypoglycemia) when taken on its own. This is because it mainly works in response to elevated blood glucose, such as after a meal. 

But if you take Januvia with other diabetes medications that have a higher hypoglycemia risk, such as insulin or sulfonylureas, the risk of hypoglycemia goes up. Your healthcare provider may adjust the dosage of these medications when you start taking Januvia.

Common hypoglycemia symptoms include:

• Shakiness

• Sweating

• Dizziness

• Weakness

• Fatigue

• Hunger

• Fast heart rate

• Confusion

If you experience any of these symptoms, check your blood glucose. If it’s below 70 mg/dL, you’ll need to eat or drink at least 15 g of fast-acting carbohydrates (four glucose tablets, for example). Blood glucose below 55 mg/dL may require immediate medical assistance. 

4. Joint pain

Joint pain has been reported in some people taking Januvia. This rare side effect is described as achiness in the fingers, hips, and knees. 

Keep in mind that sometimes joint pain is caused by arthritis or other health conditions. Let your healthcare provider know if you experience achy joints while taking Januvia. They may recommend a short trial off of Januvia to see if the pain goes away, but don’t try to do this on your own.

5. Pancreatitis

While rare, inflammation of the pancreas (pancreatitis) has been linked to medications like Januvia. Symptoms can include nausea and vomiting, severe abdominal pain, and yellowing of the skin and eyes (jaundice).

If you start experiencing these symptoms, you should seek medical attention right away. Pancreatitis can be life-threatening if it’s left untreated. You’ll typically need to receive treatment in a hospital.

If you’ve had pancreatitis in the past, let your healthcare provider know before they prescribe Januvia. They may recommend a different diabetes medication for you. 

6. Heart failure

Heart failure happens when your heart isn’t strong enough to pump blood throughout your body. Januvia can increase the risk of new or worsening heart failure, especially if you already have heart failure or kidney disease.  

You should be aware of the symptoms of heart failure. If they develop, report them to your healthcare provider right away. Common examples include: 

• Shortness of breath

• Unusual tiredness

• Swelling of arms or legs

• Sudden weight gain

If you have heart failure risk factors, your provider will consider Januvia’s benefits and risks for your specific situation. They may choose to use another medication to lower your blood glucose. 

7. Kidney problems

Januvia doesn’t usually affect your kidneys. But worsening kidney function has been reported as a rare side effect. In certain people, this has progressed to acute renal failure requiring dialysis. 

And if you already have kidney problems, Januvia can build up in your body. This can increase the likelihood of side effects. So, certain people with existing kidney problems may need to take a lower dose and have their kidney function monitored closely while taking Januvia. 

Your healthcare provider may check your kidney function through urine or blood tests before you start Januvia and periodically during treatment. Let them know if you have signs of worsening kidney function, such as changes in your urination frequency or ability to urinate.

8. Serious skin reactions

Rarely, people taking Januvia have reported serious skin reactions. Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), and drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome have occurred with Januvia.

Symptoms of these rare conditions include a rash, blisters, or peeling of the skin. Fever and widespread body aches may also occur. These skin reactions are considered an emergency and need immediate treatment.

When should you contact your healthcare provider about Januvia side effects?

Fortunately, most Januvia side effects are mild and will go away on their own. But if they persist or worsen, reach out to your healthcare provider.

Some Januvia side effects need medical attention right away. Contact your healthcare provider if you experience nausea and vomiting with severe abdominal pain, flu-like symptoms followed by a rash, or jaundice.

Check with your provider if you suspect worsening heart or kidney function. They can monitor these conditions and make changes as needed.

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Written by:

Julie Adkison, PharmD, BCACP, CDCES

Julie Adkison, PharmD, BCACP, CDCES, is a clinical pharmacist specializing in ambulatory care practice and diabetes care and education. She has worked in a faculty position in family medicine for many years.

Edited by:

Alyssa Billingsley, PharmD

Alyssa Billingsley, PharmD, is the director of pharmacy content for GoodRx. She has over a decade of experience as a pharmacist and has worked in clinical, academic, and administrative roles.

Reviewed by:

Austin Ulrich, PharmD, BCACP

Austin Ulrich, PharmD, BCACP, is a board-certified ambulatory care clinical pharmacist. In his early career, he provided direct patient care in a variety of settings, including hospital and community pharmacies, and in a primary care clinic as a clinical pharmacist.

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