Januvia (sitagliptin) is a prescription medication used along with a healthy diet and exercise to treat Type 2 diabetes. It belongs to the drug class dipeptidyl peptidase-4 (DPP-4) inhibitor, also known as gliptins. Januvia (sitagliptin) is taken by mouth, typically once daily. Most people don't experience many side effects from this medication, but possible ones include stuffy or runny nose, sore throat, and headache.
Type 2 diabetes in adults
Typically, your body controls blood sugar by releasing certain hormones. These hormones tell your body to make more insulin and to produce less sugar. But a protein called dipeptidyl peptidase-4 (DPP-4) breaks down these hormones. As a result, you have higher levels of sugar in your blood.
Januvia (sitagliptin) is a DPP-4 inhibitor, which means that it blocks the action of DPP-4. In doing so, Januvia (sitagliptin) allows insulin to stick around longer in your body and tells your body to make less sugar. These actions lower your blood sugar levels.
Source: FDA
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
Less common
blurred vision
chills
cold sweats
confusion
cool, pale skin
dizziness
fast heartbeat
headache
increased hunger
loss of consciousness
nightmares
seizures
shakiness
slurred speech
unusual tiredness or weakness
Incidence not known
Blistering, peeling, loosening of the skin
hives or welts, itching, or skin rash
large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
loss of appetite
pains in the stomach, side, or abdomen, possibly radiating to the back
puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
red skin lesions, often with a purple center
redness of the skin
severe joint pain
sores, ulcers, or white spots in the mouth or on the lips
vomiting
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common
Body aches or pain
difficulty with breathing
ear congestion
loss of voice
muscle aches
stuffy or runny nose
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Only taken once a day
Can take with or without food
Not known to affect your body weight
Can cause severe joint pain
Not a first choice option for people with Type 2 diabetes and heart problems
Might cause sudden kidney injury in people with kidney problems
Take Januvia (sitagliptin) every day with or without food.
It's best to avoid alcohol when possible during treatment with Januvia (sitagliptin). Drinking alcohol with this medication can cause dangerously low blood sugar and raise your risk of an inflamed pancreas. If you drink alcohol regularly and it's difficult for you to cut it out completely, ask your provider what's a safer amount to drink.
Tell your provider right away if you experience severe stomach pain that doesn't go away. This can be a symptom of an inflamed pancreas (pancreatitis).
If you're taking Januvia (sitagliptin) with other diabetes medications that can lower your blood sugar levels, like insulin or glipizide, you might be at risk of having dangerously low blood sugar. Make sure to check your blood sugar if you feel shaky, confused, or have a fast heartbeat. Drink four ounces of fruit juice (about the amount in a typical juice box) or take four glucose tablets if your sugar levels are low (less than 70 mg/dL).
Tell your provider if you experience any changes in weight, trouble breathing, unusual tiredness, or swelling in the feet, ankles, or legs while taking Januvia (sitagliptin). Though rare, it's possible for this medication to cause or worsen heart failure. Let your provider know if you have a history of heart problems before starting Januvia (sitagliptin).
It's important to eat healthy and exercise regularly to keep your blood sugar under control. Make sure to work with your provider on a diet and exercise plan while taking Januvia (sitagliptin).
Januvia (sitagliptin) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Though rare, few people who took Januvia (sitagliptin) have reported having inflammation of the pancreas (pancreatitis). It's not known if this medication led to their pancreatitis or if they had other risk factors. Stop taking Januvia (sitagliptin) and let your provider know right away if you experience symptoms of an inflamed pancreas, such as pain in the upper stomach, fever, nausea, and vomiting.
Risk factors: Heart failure | Heart problems | Kidney problems
Though rare, people who took similar medications to Januvia (sitagliptin) have developed heart failure. But it's unclear whether Januvia (sitagliptin) carries this same risk and more research is needed in this area. To be safe, tell your provider if you have medical conditions that raise your risk for heart failure, including heart or kidney problems. let your provider know before starting Januvia (sitagliptin). Get medical help right away if you experience any symptoms of heart failure, such as trouble breathing, tiredness, swelling in your body, or sudden weight gain.
Risk factors: History of kidney problems | Taking a higher-than-recommended dose of Januvia (sitagliptin)
Few people who took Januvia (sitagliptin) reported developing sudden kidney injury, and at times, required dialysis. Your provider might order blood work done before you start treatment and while you take Januvia (sitagliptin) to check your kidney health, especially if you already have kidney problems. If you develop any kidney problems, you might need to stop taking this medication. Talk with your provider if you're urinating less than usual while taking Januvia (sitagliptin).
Risk factor: History of allergy to DPP-4 inhibitors (also called "gliptins")
Rarely, Januvia (sitagliptin) can cause serious allergic reactions, such as rash, peeling or blistering skin, swelling, trouble breathing, and dizziness. This is more likely to happen within the first three months you start this medication. Let your provider know if you've had an allergic reaction to other DPP-4 inhibitors or "gliptins", such as Tradjenta (linagliptin) or alogliptin (Nesina). Though unclear, it's possible that taking Januvia (sitagliptin) might cause you to have another allergic reaction. If you experience an allergic reaction to Januvia (sitagliptin), stop the medication and get medical care right away.
People who take diabetes medications similar to Januvia (sitagliptin) have experienced severe joint pain. This can happen anytime from a day to many years after starting the medication. For most people, the pain goes away after they stop the medication. If you experience any discomfort in your joints, speak to your provider right away.
Some people taking Januvia (sitagliptin) have experienced an itchy, blistering rash (bullous pemphigoid). Typically, the blisters or sores go away once you stop taking the medication. If you have itchy skin, rash with blisters, or sores, talk to a provider right away and stop taking Januvia (sitagliptin).
The typical dose is 100 mg by mouth once daily.
Your dose might differ if you have kidney problems.
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
Improve blood sugar levels in adults with Type 2 diabetes (as an add-on to a nutritious diet and exercise routine)
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Kasina, S. V. S. K., et al. (2023). Dipeptidyl Peptidase IV (DPP IV) Inhibitors. StatPearls.
Merck Sharp & Dohme LLC. (2023). JANUVIA- sitagliptin tablet, film coated [package insert]. DailyMed.
National Kidney Foundation. (n.d.). Acute Kidney Injury (AKI).
Weiss, F. U., et al. (2019). Etiology and Risk Factors of Acute and Chronic Pancreatitis. Visceral Medicine.
White, W. B., et al. (2013). Alogliptin after Acute Coronary Syndrome in Patients with Type 2 Diabetes. The New England Journal of Medicine.
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