Key takeaways:
Januvia (sitagliptin) is an oral medication that helps lower blood glucose (blood sugar) levels in adults living with Type 2 diabetes.
The most common Januvia side effect is symptoms of the common cold. These are generally mild and tend to go away on their own. Headaches, hypoglycemia (low blood sugar), and joint pain are also possible.
If you have heart failure or kidney problems, make sure to let your healthcare team know. These can raise your risk of more serious side effects from Januvia.
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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 manages your blood glucose (blood sugar) levels by causing a specific gut hormone involved in digestion and blood sugar 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.
Januvia side effects at a glance
Common and/or mild side effects of Januvia include:
Upper respiratory tract infections, such as the common cold
Headache
Low blood sugar
Joint pain
Diarrhea
Rare but serious risks include:
Pancreatitis (pancreas inflammation)
New or worsening heart failure
Worsening kidney function
Severe joint pain
Bullous pemphigoid, a skin condition that causes large blisters
Serious skin reactions
Anaphylaxis
Below, we’ll cover what you should know about eight notable 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 tract 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.
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 team. 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 prescriber or pharmacist if OTC headache medications are right for you.
If your headaches are persistent or severe, let your healthcare team know. This isn’t typical and may require medical attention.
3. Low blood sugar
Januvia has a low chance of causing low blood sugar (hypoglycemia) when taken on its own. This is because it mainly works in response to elevated blood sugar, such as after a meal.
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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 prescriber 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 sugar. If it’s below 70 mg/dL, you should eat or drink at least 15 g of fast-acting carbohydrates (four glucose tablets, for example). Blood sugar below 55 mg/dL may require immediate medical assistance.
4. Joint pain
Joint pain has been reported by some people taking Januvia. This rare side effect is described as achiness in the fingers, hips, and/or knees.
Keep in mind that sometimes joint pain is caused by arthritis or other health conditions. Let your healthcare team know if you experience achy joints while taking Januvia. They may recommend a short trial away from 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 team 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. Gliptins such as Januvia may 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 team right away. Common examples include:
Shortness of breath
Unusual tiredness
Swelling of arms or legs
Sudden weight gain
If you have any heart failure risk factors, your prescriber should consider Januvia’s benefits and risks for your specific situation. They may choose to use another medication to lower your blood sugar.
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 team 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 or symptoms 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.
Frequently asked questions
No, Januvia isn’t considered a high-risk medication. But, like many medications, it can still cause serious side effects in certain situations. Some of the biggest concerns include pancreatitis, heart failure, and kidney problems. For most people, though, side effects tend to be mild, such as a runny nose or headache.
There aren’t any specific foods you have to avoid with Januvia. But it’s smart to limit alcohol. Drinking frequently or in large amounts can raise your risk of low blood sugar and pancreatitis — especially if you’re also taking other diabetes medications, such as insulin or a sulfonylurea. Also try to limit how much sugary foods, drinks, and refined carbohydrates you consume.
Eating regular, balanced meals can help keep your blood sugar steady. And if you’re not sure what to eat, your prescriber or a dietitian can help you build a meal plan that works with your medications and lifestyle.
Januvia isn’t known for causing kidney problems. But, in rare cases, it’s been linked to sudden kidney injury. To be safe, your healthcare team will usually check your kidney function before you start taking Januvia. They may also keep an eye on it while you’re taking the medication. For most people with normal kidney function, serious kidney problems from Januvia are uncommon.
No, Januvia isn’t considered a high-risk medication. But, like many medications, it can still cause serious side effects in certain situations. Some of the biggest concerns include pancreatitis, heart failure, and kidney problems. For most people, though, side effects tend to be mild, such as a runny nose or headache.
There aren’t any specific foods you have to avoid with Januvia. But it’s smart to limit alcohol. Drinking frequently or in large amounts can raise your risk of low blood sugar and pancreatitis — especially if you’re also taking other diabetes medications, such as insulin or a sulfonylurea. Also try to limit how much sugary foods, drinks, and refined carbohydrates you consume.
Eating regular, balanced meals can help keep your blood sugar steady. And if you’re not sure what to eat, your prescriber or a dietitian can help you build a meal plan that works with your medications and lifestyle.
Januvia isn’t known for causing kidney problems. But, in rare cases, it’s been linked to sudden kidney injury. To be safe, your healthcare team will usually check your kidney function before you start taking Januvia. They may also keep an eye on it while you’re taking the medication. For most people with normal kidney function, serious kidney problems from Januvia are uncommon.
The bottom line
Common Januvia (sitagliptin) side effects include cold symptoms and headache. Hypoglycemia (low blood sugar) and joint pain are also possible. While rare, pancreatitis, kidney problems, and serious skin reactions have been reported with Januvia. Several Januvia side effects can be managed at home. But others may require immediate medical attention. Contact your healthcare team if you have any questions about Januvia side effects.
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References
Labib, A. M., et al. (2023). Toxic epidermal necrolysis. StatPearls.
Merck Sharp & Dohme. (2024). Januvia- sitagliptin tablet, film coated [packet insert].
National Kidney Foundation. (2024). Acute kidney injury (AKI).
Pathak, R., et al. (2010). Dipeptidyl peptidase-4 (DPP-4) inhibitors in the management of diabetes. Pharmacy and Therapeutics.
Yang, W., et al. (2015). DPP-4 inhibitors and risk of infections: A meta-analysis of randomized controlled trials. Diabetes Metabolism Research and Reviews.
