{"id":20563,"date":"2021-03-08T13:00:11","date_gmt":"2021-03-08T18:00:11","guid":{"rendered":"https:\/\/www.singlecare.com\/blog\/?p=20563"},"modified":"2024-06-11T12:48:29","modified_gmt":"2024-06-11T16:48:29","slug":"januvia-side-effects","status":"publish","type":"post","link":"https:\/\/www.singlecare.com\/blog\/januvia-side-effects\/","title":{"rendered":"Januvia side effects and how to avoid them"},"content":{"rendered":"<p><span style=\"font-weight: 400;\"><a href=\"#side-effects\">Januvia side effects<\/a> | <a href=\"#weight-loss\">Weight loss<\/a> | <a href=\"#hypoglycemia\">Hypoglycemia<\/a> | <a href=\"#how-long-do-side-effects-last\">How long do side effects last?<\/a> | <a href=\"#warnings\">Warnings<\/a> | <a href=\"#interactions\">Interactions<\/a> | <a href=\"#how-to-avoid-side-effects\">How to avoid side effects<\/a><\/span><\/p>\n<p><span style=\"font-weight: 400;\">Januvia (active ingredient: sitagliptin) is a brand-name medication that helps reduce blood sugar in adults with Type 2 diabetes mellitus. Januvia should be used along with diet and exercise. Sitagliptin belongs to a family of drugs called dipeptidyl peptidase-4 inhibitors (DPP-4 inhibitors), but they\u2019re usually just called \u201cgliptins.\u201d When blood sugar rises in the body after a meal, <\/span><a href=\"https:\/\/www.accessdata.fda.gov\/drugsatfda_docs\/label\/2018\/021995s042lbl.pdf#page=9\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400;\">sitagliptin increases the body\u2019s secretion of insulin<\/span><\/a><span style=\"font-weight: 400;\">, the hormone that triggers cells in the body to absorb sugar from the bloodstream. Sitagliptin also lowers the production of glucagon, a hormone that stimulates the liver to make glucose. Combined, these two effects help to reduce blood sugar after eating.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Some patients may take Januvia as a stand-alone treatment for diabetes. More frequently, however, people take Januvia along with one or two other diabetes drugs such as metformin, pioglitazone, glimepiride, or insulin. In fact, Merck markets two combination drugs containing sitagliptin: <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/janumet\/what-is\"><span style=\"font-weight: 400;\">Janumet<\/span><\/a><span style=\"font-weight: 400;\"> (sitagliptin and metformin) and Steglujan (sitagliptin and ertugliflozin).\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Januvia, like other <\/span><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK542331\/\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400;\">gliptins<\/span><\/a><span style=\"font-weight: 400;\">, has a low incidence of side effects. Still, anyone considering taking Januvia should be aware of possible side effects, drug interactions, and other reasons this drug may not be a good fit.<\/span><\/p>\n<p><strong>RELATED: <a href=\"https:\/\/www.singlecare.com\/prescription\/januvia\/what-is\">Learn more about Januvia<\/a> | <a href=\"https:\/\/www.singlecare.com\/prescription\/januvia\">Get Januvia discounts<\/a><\/strong><\/p>\n<h2 id=\"side-effects\"><span style=\"font-weight: 400;\">Common side effects of Januvia<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">The most common side effects of Januvia are:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Upper respiratory tract infection<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Stuffy, runny nose, or sore throat (nasopharyngitis)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Headache<\/span><\/li>\n<\/ul>\n<h2><span style=\"font-weight: 400;\">Serious side effects of Januvia<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Januvia can cause side effects and some rare but serious side effects such as:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Low blood sugar\u2014interactions between Januvia with other diabetes medications increase changes of hypoglycemia.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Swelling of the pancreas (pancreatitis)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Kidney dysfunction or failure<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Severe and disabling joint pain<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Heart failure<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Large, fluid-filled blisters (bullous pemphigoid)<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Severe allergic reactions have also been reported including:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Anaphylaxis, a condition marked by skin rash, shortness of breath, and shock<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Angioedema, whose symptoms include facial swelling, rash, dizziness, and possible trouble breathing<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Stevens-Johnson syndrome, a severe skin reaction marked by blistering, rash, and skin peeling<\/span><\/li>\n<\/ul>\n<h3 id=\"weight-loss\"><span style=\"font-weight: 400;\">Januvia and weight loss<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Unlike some other Type 2 diabetes medications, Januvia and other gliptins are not associated with weight gain as a side effect. Weight loss, unfortunately, is also not a side effect of Januvia. Instead, Januvia is considered weight-neutral. However, some studies suggest Januvia <\/span><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC3047989\/\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400;\">may promote weight loss<\/span><\/a><span style=\"font-weight: 400;\"> when combined with metformin, but <\/span><a href=\"https:\/\/www.tandfonline.com\/doi\/abs\/10.1185\/030079908X260925\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400;\">other studies<\/span><\/a><span style=\"font-weight: 400;\"> do not. An analysis of Januvia <\/span><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC5665259\/\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400;\">studies<\/span><\/a><span style=\"font-weight: 400;\"> determined that patients taking Januvia had a modest but clinically insignificant drop in weight of just a few pounds.<\/span><\/p>\n<h3 id=\"hypoglycemia\"><span style=\"font-weight: 400;\">Januvia and hypoglycemia<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">As with all diabetes medications, Januvia may cause blood sugar levels to drop too low. However, Januvia carries a lower risk of hypoglycemia than other blood sugar-reducing drugs. <\/span><a href=\"https:\/\/www.accessdata.fda.gov\/drugsatfda_docs\/label\/2018\/021995s042lbl.pdf#page=9\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400;\">In initial clinical studies<\/span><\/a><span style=\"font-weight: 400;\">, healthy patients treated only with Januvia did not experience hypoglycemia.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">The risk of hypoglycemia depends on the <\/span><i><span style=\"font-weight: 400;\">other<\/span><\/i><span style=\"font-weight: 400;\"> diabetes drugs being taken along with Januvia. <\/span><a href=\"https:\/\/www.accessdata.fda.gov\/drugsatfda_docs\/label\/2018\/021995s042lbl.pdf\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400;\">About 1\u20134% of patients<\/span><\/a><span style=\"font-weight: 400;\"> in the initial clinical studies experienced hypoglycemia symptoms when taking Januvia with metformin, pioglitazone, or rosiglitazone. Januvia is most likely to cause hypoglycemia when combined with insulin or sulfonylureas, drugs that cause the body to secrete more insulin. <\/span><a href=\"https:\/\/www.accessdata.fda.gov\/drugsatfda_docs\/label\/2018\/021995s042lbl.pdf#page=6\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400;\">In a 24-week trial<\/span><\/a><span style=\"font-weight: 400;\">, about 12\u201315% of patients taking Januvia with a sulfonylurea or insulin experienced hypoglycemia symptoms.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">When taking diabetes medications, always be on guard for telltale signs of low blood sugar such as:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Headache<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Drowsiness<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Irritability<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Dizziness\/lightheadedness<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Hunger<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Weakness<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Jitteriness or feeling \u201cshaky\u201d<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Anxiety<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Sweating\u00a0<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Fast heartbeat<\/span><\/li>\n<\/ul>\n<h2 id=\"how-long-do-side-effects-last\"><span style=\"font-weight: 400;\">How long do Januvia side effects last?<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Minor side effects of Januvia such as headache and cold symptoms are temporary and usually fade after a while, or when the drug is discontinued. If symptoms persist or get worse contact your healthcare provider. Severe joint pain may usually resolve <\/span><a href=\"https:\/\/www.fda.gov\/drugs\/drug-safety-and-availability\/fda-drug-safety-communication-fda-warns-dpp-4-inhibitors-type-2-diabetes-may-cause-severe-joint-pain\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400;\">within a month<\/span><\/a><span style=\"font-weight: 400;\"> after the drug is stopped. Hypoglycemia is a temporary problem that can be quickly resolved by taking fast-acting carbohydrate foods, glucose tablets, or an emergency glucagon injection. Other serious side effects such as kidney problems, pancreatitis, and heart failure will take longer to resolve even after Januvia is discontinued. Your healthcare provider will discuss side effects with you, and how to address them.<\/span><\/p>\n<h2 id=\"warnings\"><span style=\"font-weight: 400;\">Januvia contraindications &amp; warnings<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Januvia is <\/span><a href=\"https:\/\/www.accessdata.fda.gov\/drugsatfda_docs\/label\/2018\/021995s042lbl.pdf\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400;\">effective at reducing blood sugar<\/span><\/a><span style=\"font-weight: 400;\"> and generally has minimal side effects. The FDA has not recalled the drug or issued any <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/black-box-warning\/\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400;\">black box warnings<\/span><\/a><span style=\"font-weight: 400;\">. The use of Januvia does not result in dependency or abuse. Not everyone, though, may be an appropriate candidate for this medication.<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">Allergies<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Anyone with allergies or a history of serious hypersensitivity reactions to Januvia, other DPP-4 inhibitors, or any of the inactive ingredients in Januvia should not take Januvia.<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">Type 1 diabetes<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Januvia is not used to treat Type 1 diabetes.<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">Diabetic ketoacidosis<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Januvia does not treat diabetic ketoacidosis.<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">Kidney disease<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Healthcare professionals are advised to perform kidney function tests before prescribing Januvia and periodically while you take Januvia. In rare cases, sitagliptin has led to kidney impairment and even kidney failure severe enough to require dialysis. Patients with moderate or severe renal impairment or end-stage kidney disease requiring dialysis require a lower dose of Januvia.<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">Heart failure risk<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">The good news is that Januvia has <\/span><a href=\"https:\/\/www.nejm.org\/doi\/10.1056\/NEJMoa1501352\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400;\">never been linked to heart failure<\/span><\/a><span style=\"font-weight: 400;\">. The bad news is that <\/span><a href=\"https:\/\/www.fda.gov\/drugs\/drug-safety-and-availability\/fda-drug-safety-communication-fda-adds-warnings-about-heart-failure-risk-labels-type-2-diabetes\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400;\">two other DPP-4 inhibitors have<\/span><\/a><span style=\"font-weight: 400;\">, so the FDA has determined that all DPP-4 inhibitors, including Januvia, should be used cautiously in patients at risk for heart failure. A doctor will discuss the risk with people who have heart problems before prescribing Januvia.<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">Inflammation of the pancreas<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Januvia has been associated with sometimes fatal pancreatitis, or inflammation of the pancreas, the organ that produces insulin and glucagon. It\u2019s uncertain if Januvia is a risk in people who have a history of pancreatitis. However, it is advised that all patients taking Januvia are monitored for pancreatitis when they start taking Januvia.<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">Children<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Januvia is not FDA approved for use in children younger than 18.<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">Seniors<\/span><\/h3>\n<p><a href=\"https:\/\/www.accessdata.fda.gov\/drugsatfda_docs\/label\/2018\/021995s042lbl.pdf\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400;\">In clinical trials<\/span><\/a><span style=\"font-weight: 400;\">, Januvia was as effective and safe among people older than 65 as among younger patients.<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">Pregnancy and breastfeeding<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">There is not enough research or information on pregnant women to determine if Januvia is safe to use during pregnancy. <\/span><a href=\"https:\/\/www.accessdata.fda.gov\/drugsatfda_docs\/label\/2018\/021995s042lbl.pdf\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400;\">Animal studies<\/span><\/a><span style=\"font-weight: 400;\"> show that sitagliptin does cross the placenta, but other animal studies show no increased risk of birth defects. On the other hand, uncontrolled blood sugar caused by gestational diabetes may cause a number of complications to the mother and baby, including birth defects or miscarriage. Pregnant women with gestational diabetes will need to discuss the relative risks and benefits of taking Januvia. Pregnant women who take Januvia will be asked by their healthcare provider to join the <\/span><a href=\"http:\/\/www.merckpregnancyregistries.com\/januvia.html\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400;\">Merck Pregnancy Registry<\/span><\/a><span style=\"font-weight: 400;\"> that monitors pregnancy outcomes.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">There are no studies on whether sitagliptin is present in human milk or on its effects on nursing babies. Animal studies suggest that Januvia may be present in human milk. Nursing mothers should discuss the risks with a healthcare provider or consider another way to feed their infant.<\/span><\/p>\n<h2 id=\"interactions\"><span style=\"font-weight: 400;\">Januvia interactions<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Like all diabetes medications, Januvia has significant drug interactions that may require therapies to be monitored or modified.\u00a0<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">Diabetes medications<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Understandably, the most significant Januvia drug interactions involve blood sugar. Combined with medications that lower blood sugar\u2014particularly other diabetes medications\u2014Januvia can have an add-on effect and raise the risk of low blood sugar.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">For this reason, other gliptins are to be avoided outright. These include:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Nesina (alogliptin)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Tradjenta (linagliptin)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Onglyza (saxagliptin)<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">However, Januvia is normally prescribed along with at least one other diabetes medication (in a different diabetes drug class) that reduces blood sugar. Some diabetes drug combinations with Januvia only minimally raise the risk of hypoglycemia.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">However, when Januvia is taken with sulfonylureas or insulin, the <\/span><a href=\"https:\/\/www.accessdata.fda.gov\/drugsatfda_docs\/label\/2018\/021995s042lbl.pdf\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400;\">risk of hypoglycemia rises significantly.<\/span><\/a><span style=\"font-weight: 400;\"> Combinations with these medications will require regular blood sugar monitoring and may require lowering the doses:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Insulin<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Glimepiride<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Glyburide<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Glipizide<\/span><\/li>\n<\/ul>\n<h3><span style=\"font-weight: 400;\">Drugs that lower blood sugar<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Other prescription drugs may also reduce blood sugar. When taken with Januvia, there\u2019s a small chance the combination might lead to hypoglycemia or even severe hypoglycemia. Therapy with the following drugs may need to be monitored:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Antidepressants <\/b><span style=\"font-weight: 400;\">such as SSRIs\u00a0<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Testosterone<\/b><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Some anti-parasite drugs <\/b><span style=\"font-weight: 400;\">such as hydroxychloroquine, quinine, or pentamidine<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Many people don\u2019t know that some foods and supplements can also lower blood sugar, such as:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Alcohol (excess consumption)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Garlic<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Ginseng<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Horse chestnut<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Flaxseed<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Fenugreek<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Aloe<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Ashwagandha<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">These foods and herbs may need to be put on hold for a while. Excess consumption of alcohol, in particular, should be avoided when taking Januvia.<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">Drugs that raise blood sugar<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">All diabetes medications lower blood sugar, but a surprisingly large number of medications <\/span><i><span style=\"font-weight: 400;\">raise <\/span><\/i><span style=\"font-weight: 400;\">blood sugar.\u00a0 Combining these drugs with Januvia or other diabetes medications could essentially cancel out the beneficial effects of taking diabetes medications. The most common drugs that might raise blood sugar include:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Corticosteroids<\/b><span style=\"font-weight: 400;\">\u00a0<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Birth control pills<\/b><span style=\"font-weight: 400;\">\u00a0<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Stimulants <\/b><span style=\"font-weight: 400;\">(for ADHD)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Oral decongestants<\/b><span style=\"font-weight: 400;\"> such as Sudafed (pseudoephedrine)\u00a0<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Systemic bronchodilators<\/b><span style=\"font-weight: 400;\"> such as terbutaline or epinephrine<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Fluoroquinolone antibiotics<\/b><span style=\"font-weight: 400;\"> such as ciprofloxacin<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Thiazide diuretics (water pills)<\/b><span style=\"font-weight: 400;\"> commonly used to treat high blood pressure<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Antipsychotic medications<\/b><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Some anticonvulsants<\/b><span style=\"font-weight: 400;\">\u00a0<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Some immunotherapy anticancer drugs<\/b><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Some immune-suppressing drugs<\/b><span style=\"font-weight: 400;\"> such as tacrolimus<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Some HIV and hepatitis C antiviral medications<\/b><span style=\"font-weight: 400;\">\u00a0<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Thyroid hormones<\/b><span style=\"font-weight: 400;\">\u00a0<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Growth hormones<\/b><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">None of these drugs are to be avoided outright, but blood sugar needs to be monitored carefully when mixing these drugs with Januvia. Doses or therapies may need to be changed if blood sugar can\u2019t be controlled.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Nicotine and niacin (vitamin B3) can also raise blood sugar, particularly in people with diabetes.<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">Beta blockers<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Beta blockers are a special problem for people taking diabetes medications and can potentially interact with Januvia. Even worse, beta-blockers mask many of the symptoms of low blood sugar such as shakiness, irritability, and anxiety, raising the risk that a hypoglycemic episode will evolve into something more serious. Combining Januvia with beta blockers will require careful monitoring of blood sugar levels. Doses may need to be adjusted.<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">Januvia and digoxin<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Digoxin is used to treat heart failure. When combined with Januvia, the concentration of digoxin in the blood increases slightly, possibly raising the risk of adverse effects. The prescribing information, however, does not recommend any dose adjustments. Therapy will have to be monitored.<\/span><\/p>\n<p><strong>RELATED: <a href=\"https:\/\/www.singlecare.com\/blog\/januvia-and-jardiance\/\">Is it safe to take Januvia and Jardiance together?<\/a><\/strong><\/p>\n<h2 id=\"how-to-avoid-side-effects\"><span style=\"font-weight: 400;\">How to avoid Januvia side effects<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Although Januvia is generally considered a safe medication with relatively minimal side effects, the likelihood of experiencing side effects can be reduced by a few helpful suggestions:<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">1.\u00a0 Take Januvia as directed<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Take the dose prescribed, usually 100 mg once daily. Januvia is taken every day, often with other medications. Don\u2019t take extra medicine, cut the dose, or skip a day or two. If the medicine does not seem to be working or side effects are a problem, talk to the prescribing physician about changing the dose or switching to a new medication.\u00a0<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">2.\u00a0 Tell your doctor about all your medical conditions and medications<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Because of the risk of side effects, you should tell your doctor about all your physical conditions you have as well as all prescription and over-the-counter medications, supplements, and herbal remedies you take. They may not seem important, but this information could make treatment with Januvia safer.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Make sure you tell your doctor about any of the following physical conditions you might have:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Kidney problems<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Pancreas problems<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Gallstones<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Heart problems<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">High blood triglyceride levels<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">A history of alcoholism<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Type 1 diabetes<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Diabetic ketoacidosis<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Any allergic reaction to Januvia<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Before prescribing Januvia, the doctor will need to know if the patient is pregnant, nursing, or planning on becoming pregnant or breastfeeding a baby.<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">3.\u00a0 Monitor blood sugar<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Januvia can be used alone or with other diabetes medications. Combining two or more diabetes drugs may require that you regularly monitor blood sugar. Your healthcare provider will instruct you on blood glucose monitoring, if applicable. Watch for signs of low blood sugar and always have a rapid source of sugar (such as glucose tablets or Smarties) and a glucagon emergency injection kit or nasal spray handy.<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">4.\u00a0 Keep a list of medicines being taken<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Because so many medications can affect blood sugar, <\/span><span style=\"font-weight: 400;\">be sure to keep an up-to-date medication list at all times.<\/span><span style=\"font-weight: 400;\"> Be ready to share that list whenever consulting with a doctor, pharmacist, or other healthcare provider.\u00a0<\/span><\/p>\n<h2><span style=\"font-weight: 400;\">Resources:<\/span><\/h2>\n<ul>\n<li><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK542331\/\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400;\">Dipeptidyl Peptidase IV (DPP IV) Inhibitors<\/span><\/a><span style=\"font-weight: 400;\">, StatPearls<\/span><\/li>\n<li><a href=\"https:\/\/online.epocrates.com\/drugs\/442110\/Januvia\/Monograph\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400;\">Januvia<\/span><\/a><span style=\"font-weight: 400;\">, Epocrates<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC3047989\/\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400;\">Clinical utility of fixed combinations of sitagliptin-metformin in treatment of Type 2 diabetes<\/span><\/a><span style=\"font-weight: 400;\">, <\/span><i><span style=\"font-weight: 400;\">Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy<\/span><\/i><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/www.tandfonline.com\/doi\/abs\/10.1185\/030079908X260925\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400;\">Efficacy and safety of sitagliptin added to ongoing metformin therapy in patients with Type 2 diabetes<\/span><\/a><span style=\"font-weight: 400;\">, <\/span><i><span style=\"font-weight: 400;\">Current Medical Research and Opinion<\/span><\/i><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/my.clevelandclinic.org\/health\/symptoms\/17679-elevated-liver-enzymes\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400;\">Elevated Liver Enzymes<\/span><\/a><span style=\"font-weight: 400;\">, Cleveland Clinic<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/www.fda.gov\/drugs\/drug-safety-and-availability\/fda-drug-safety-communication-fda-adds-warnings-about-heart-failure-risk-labels-type-2-diabetes\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400;\">FDA Drug Safety Communication: FDA adds warnings about heart failure risk to labels of Type 2 diabetes medicines containing saxagliptin and alogliptin<\/span><\/a><span style=\"font-weight: 400;\">, Food and Drug Administration (FDA)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/www.medicines.org.uk\/emc\/files\/pil.7887.pdf\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400;\">Januvia Information Sheet<\/span><\/a><span style=\"font-weight: 400;\">, Merck<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/ascpt.onlinelibrary.wiley.com\/doi\/epdf\/10.1016\/j.clpt.2005.09.002\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400;\">Pharmacokinetics and pharmacodynamics of sitagliptin, an inhibitor of dipeptidyl peptidase IV, in healthy subjects: Results from two randomized, double-blind, placebo-controlled studies with single oral doses<\/span><\/a><span style=\"font-weight: 400;\">, <\/span><i><span style=\"font-weight: 400;\">Clinical Pharmacology &amp; Therapeutics<\/span><\/i><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/HYPERTENSIONAHA.117.09259\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400;\">Risk of cardiovascular events in patients with diabetes mellitus on <\/span><span style=\"font-weight: 400;\">\u03b2-blockers<\/span><\/a><span style=\"font-weight: 400;\">, <\/span><i><span style=\"font-weight: 400;\">Hypertension<\/span><\/i><\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"<p>Januvia side effects | Weight loss | Hypoglycemia | How long do side effects last? | Warnings | Interactions | How to avoid side effects Januvia (active ingredient: sitagliptin) is a brand-name medication that helps reduce blood sugar in adults with Type 2 diabetes mellitus. Januvia should be used along with diet and exercise. Sitagliptin [&hellip;]<\/p>\n","protected":false},"author":15,"featured_media":20641,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[4589],"tags":[10298,12752],"coauthors":[8861],"class_list":["post-20563","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-drug-info","tag-diabetes","tag-medication-side-effects","wpautop"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v27.4 (Yoast SEO v27.4) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>Januvia side effects and how to avoid them | SingleCare<\/title>\n<meta name=\"description\" content=\"Stuffy, runny nose, and sore throat are some Jardiance side effects that can occur while adjusting to the medication. 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