What is Januvia Uses, warnings & interactions
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Januvia is a medicine prescribed to adults with type 2 diabetes to help them lower their blood sugar.
If your doctor has prescribed Januvia medication to you, you may want to know more about what it is and how it works. Here we’ll explain what Januvia is used for, how it works, its side effects, and more. We’ll also answer some of the most frequently asked questions about Januvia.
- Treatment of type 2 diabetes
What is Januvia used for?
Januvia is used to treat type 2 diabetes in adults 18 years and over. It can help to lower your blood sugar levels when used alongside exercise and changes to your diet.
You take Januvia as a pill you swallow once a day. When your blood sugar is high, Januvia encourages your pancreas to produce more insulin, a hormone that helps your cells absorb sugar from your blood. It also makes your pancreas produce less of a hormone called glucagon that makes your liver release sugar into your blood. This combined action helps to lower your blood sugar levels.
When your blood sugar is low, Januvia stops working as hard. This means it can help keep your blood sugar in a healthy range. Not too high, not too low.
Januvia can be used alone, or it can be taken alongside other diabetes medications like a sulfonylureas. The medication is also not a type of insulin, so it can be taken with insulin, if your condition requires it.
How does Januvia work?
Type 2 diabetes is a disorder that causes you to have high levels of sugar (glucose) in your blood. When you digest food and drink, sugar is released into your bloodstream so it can be carried around your body and taken to the cells that use it for energy. A hormone called insulin helps your cells absorb the sugar from your blood.
But if you have type 2 diabetes, your body becomes resistant to insulin over time, meaning it works less effectively. Your body may also produce less insulin than it should. Together, this means your cells can’t absorb enough sugar, and your blood sugar levels remain too high. High blood sugar levels can cause a range of health problems, including nerve damage, heart disease, strokes, kidney failure, blindness, and can lead to amputations of parts of your body.
Januvia can treat type 2 diabetes by helping to lower your blood sugar. It contains the active ingredient sitagliptin. This belongs to a class of drugs called dipeptidyl peptidase-4 inhibitors (DPP-4 inhibitors) that can increase how much insulin you produce and reduce how much sugar your liver secretes into your blood.
When you digest food, your stomach and gut produce digestive hormones, called incretins, that signal your pancreas to secrete insulin. But as you continue to digest, these hormones are broken down by an enzyme called DPP-4. The sitagliptin in Januvia blocks the DPP-4 enzyme, stopping it from working. This keeps your digestive hormones active for longer, making your pancreas produce more insulin and your liver less sugar, lowering your blood sugar level.
Januvia works when you digest food, helping to ensure your blood sugar doesn’t rise too high. But when you stop digesting food and your blood sugar falls, Januvia is less active, meaning it doesn’t lower your blood sugar when it’s not needed, reducing your risk of hypoglycemia (your blood sugar falling to low).
How long does it take for Januvia to work?
Januvia is a medication you take every day to help give you a prolonged and lasting reduction in blood sugar. Januvia will work at different speeds in different people, but it can take one or two weeks to build up and have a noticeable effect on your blood sugar. It may take several months for you to see the full benefits of the medication.
How much does Januvia lower A1C?
In a 24-week study of Januvia in patients with type 2 diabetes, Januvia was found to lower A1C an average of 0.7%, from a starting A1C of 8%.
In the same study, 47% of the patients who took Januvia lowered their A1C below 7% (the American Diabetes Association recommends an A1C goal of lower than 7%).
Januvia and other drugs
Januvia can be used alone or can be taken alongside other drugs to treat your type 2 diabetes. These can include:
- Glucophage, Glucophage XR, Fortamet, and Glumetza (metformin)
- Actos (pioglitazone)
- Avandia (rosiglitazone)
- Amaryl (glimepiride)
As Januvia is not a type of insulin, it can often be used alongside different forms of insulin, including:
- Long-acting insulin, like:
Is there a generic equivalent to Januvia?
No. There is no generic version of Januvia available in the United States.
Alternatives to Januvia
Januvia is a non-insulin medication used to treat type 2 diabetes. Other alternative non-insulin medications are available, including:
- Janumet (sitagliptin and metformin hydrochloride)
- Jardiance (empagliflozin)
- Invokana (canagliflozin)
- Onglyza (saxagliptin)
- Victoza (liraglutide)
- Trulicity (dulaglutide)
- Farxiga (dapagliflozin)
- Ozempic (semaglutide)
How much does Januvia cost?
Without insurance, prices for Januvia will depend on the dose you buy (25 mg, 50 mg, or 100 mg) and the number of tablets you buy (30, 90, or 100). Prices can also vary by retailer. As a guide, 30, 25 mg Januvia tablets will cost around $625.
Januvia side effects
The most common side effects of Januvia include:
- A stuffy or runny nose
- A sore throat
- An increase in upper respiratory tract infections, like colds, sinus infections, and the flu
Often these side effects disappear after a few weeks of use. Occasionally, Januvia can cause more serious side effects. These include:
- Heart failure
- Inflammation of the pancreas (pancreatitis) that can be fatal in severe cases
- Severe allergic reactions to the medication that can cause anaphylaxis – a potentially life-threatening condition where your immune system overreacts, causing swelling in your face, mouth, and throat that can make it hard to breathe
- Kidney problems that can reduce kidney function or cause kidney failure in severe cases
- Joint pain that can become severe
- A serious skin reaction called bullous pemphigoid that can cause large, fluid filled blisters
- Dangerously low blood sugar levels (hypoglycemia)
Your doctor will assess your risk of side effects versus the benefits of taking Januvia.
Does Januvia cause weight loss?
Weight loss wasn’t a side effect reported in clinical trials for Januvia. However, two small clinical studies did find subjects who took Januvia also lost weight.
Not enough research has been conducted on Januvia weight loss to say more, however. It’s not known with certainty how Januvia could cause this weight loss, and if it does, if it could help with weight loss in different groups of people. Januvia has also not been approved by the FDA for weight loss.
Januvia should not be used to help you lose weight. Talk to your doctor if you want to discuss options for losing weight.
How to take Januvia?
Always take your Januvia exactly as directed by the doctor who prescribed it to you.
Januvia comes as a tablet that you swallow. You typically take Januvia once a day, at the same time each day. You have to swallow Januvia tablets whole, don’t break or crush them up. You can take Januvia tablets with or without food or water.
What is the best time of day to take Januvia?
There is no recommended best time of the day to take Januvia. Just make sure you take Januvia at the same time each day, at a time convenient to you.
What if I miss a Januvia dose?
If you miss a Januvia dose, take the dose as soon as you remember.
If you don’t remember until it’s time for your next dose, skip the missed dose and don’t take a double dose, as you may take too much Januvia and risk a Januvia overdose.
If you take too much Januvia (a Januvia overdose), you increase your risk of side effects, including serious side effects.
Symptoms of a Januvia overdose include:
- Chest pain
- A rapid heartbeat
- Feeling shaky and nervous
- Excessive sweating
- Changes in your thinking and reasoning
If you’ve taken too much Januvia, you should seek emergency medical attention.
What should I avoid while taking Januvia?
There are no specific foods or drinks you need to avoid when taking Januvia, although you should make sure you stick to your diabetes diet whilst taking the medication. You should also be careful about drinking alcohol with Januvia (see Januvia and alcohol below).
Birth control pills can make Januvia less effective. Talk to your doctor about the best forms of contraception for you when taking Januvia.
There are also certain medications you should avoid when taking Januvia, as they can interact with it.
Januvia can interact with other medications. This can change how Januvia and the other medications work and can make some side effects more likely. You should tell your prescribing physician about all the drugs you’re taking, particularly:
- Any other medications you’re taking to treat your diabetes like insulin or a sulfonylurea medicine
- Any other medications that can lower your blood sugar levels, like beta-blockers and some antibiotics
- Digoxin, a medication used to treat a range of heart conditions
If you’re unsure if you’re taking any of these, take the packaging of all your medications and supplements to your doctor or pharmacist.
Januvia and alcohol
Although alcohol doesn’t interact directly with Januvia, it can lower your blood sugar and make hypoglycemia (very low blood sugar) more likely if you’re taking diabetes medications. Drinking alcohol can also increase your risk of pancreas damage.
Drink any alcohol in moderation when taking Januvia if your diabetes is well controlled and you have no problems with your pancreas. Avoid alcohol when taking Januvia if your diabetes is not well controlled and/or you have any problems with your pancreas.
Januvia isn’t suitable for everyone. You should not take Januvia if you:
- Are allergic to the active ingredient sitagliptin
- Are allergic to any of the other ingredients in Januvia (listed in the leaflet which comes with the medication)
- Have type 1 diabetes (Januvia is for type 2 diabetes only)
- Have diabetic ketoacidosis – a condition where high blood sugar causes high levels of ketones to build up in your body
- Are under 18 years of age
Talk to your doctor before taking Januvia if you:
- Have or have had any pancreas problems, such as pancreatitis (inflammation of the pancreas)
- Have a heart condition
- Have or have had any kidney problems
- Have gallstones
- Have high levels of triglycerides (a type of fat) in your blood
- Are over 65 years of age
- Are pregnant or are planning to become pregnant
- Are breastfeeding or are planning to breastfeed
Can Januvia affect pregnancy?
There’s no research on how Januvia can affect your unborn baby. There is a registry that monitors pregnant women taking Januvia, but there isn’t sufficient data yet to judge the drug’s safety during pregnancy.
In animal studies (rats and rabbits), no adverse effects on pregnancy were found, even with high doses of Januvia, but animal studies don’t always predict how a drug will affect human biology. If you’re taking Januvia and fall pregnant, or are trying for a baby, talk to your doctor.
For breastfeeding, there’s no data on whether or not Januvia can pass into breast milk in humans. This was found to be the case in animal studies however, so there is a possibility Januvia could pass into your breast milk. Talk to your doctor about taking Januvia if you are breastfeeding or plan to breastfeed, or if you express milk in another way, such as with a breast pump.
Januvia expiration and storage
Januvia doesn’t need to be stored in any special conditions although avoid extremes of temperature. It should be kept in the original packaging it came in or a pill organizer. Keep your Januvia out of sight and reach of children.
Don’t use your Januvia after the expiry date on the packaging. The expiry date refers to the last day of that month.
Are Januvia and metformin the same?
No, Januvia and metformin are different medications. Both are used to treat type 2 diabetes, and both are taken as tablets, but they contain different active ingredients and work in different ways. Januvia can reduce your blood sugar levels by making your pancreas produce more insulin and making your liver secrete less sugar into your blood. Metformin instead makes your cells absorb more blood sugar in the presence of insulin.
What does Januvia do to the body?
Januvia makes your digestive hormones work for longer when you digest food by slowing the rate at which the hormones are broken down. This encourages your pancreas to release more insulin and stops your liver from releasing sugar into your blood, both of which can lower your blood sugar levels.
Does Januvia cause weight gain?
Weight gain is not a reported side effect of Januvia, but there has been some limited evidence in two small studies that it may help with weight loss. There’s not enough research to fully understand the effects of Januvia on weight loss though, and Januvia is not approved by the FDA for weight loss. Talk to your doctor if you want to lose weight.
Is Januvia bad for your kidneys?
Januvia can cause kidney problems in some people as a side effect of the medication, but most people will experience no kidney problems. Januvia can still be used if you have kidney problems, although usually at a lower dose. Talk to your doctor if you’re worried about any Januvia side effects.
Does Januvia cause frequent urination?
Januvia is not known to cause more frequent urination. Urinating more frequently is more likely to be a sign that you have high blood sugar and that your Januvia isn’t working. Contact your doctor if you’re urinating more frequently.
Should Januvia be taken in the morning or at night?
There is no recommended time of day to take Januvia. It’s usually taken once a day, at the same time, so choose a time that’s convenient for you. Always make sure you take your Januvia exactly as directed by the doctor who prescribed it to you.
What is the Januvia drug class?
Januvia is a class of drug called a dipeptidyl peptidase-4 inhibitor (DPP-4 inhibitor). It works by stopping DPP-4 enzymes breaking down the digestive hormones you release when you digest food. This keeps the digestive hormones working for longer, making your pancreas produce more insulin and your liver less sugar.
What drug is comparable to Januvia?
There are a range of other oral medications you can take to help lower your blood sugar if you have type 2 diabetes. They include Janumet (sitagliptin and metformin hydrochloride), Jardiance (empagliflozin), Invokana (canagliflozin), Victoza (liraglutide), Trulicity (dulaglutide), and Farxiga (dapagliflozin).
What are the side effects of Januvia?
Like all medications, Januvia can cause side effects. The most common side effects caused by Januvia include headaches, a stuffy or runny nose, a sore throat, and an increase in upper respiratory tract infections. In rare instances, Januvia can cause more serious side effects, like heart failure and inflammation of the pancreas (pancreatitis). Talk to your doctor if you’re concerned about Januvia side effects.
What drugs interact with Januvia?
Some drugs can interact with each other, altering how they work and increasing the risk of some side effects. Januvia can interact with other medications taken for type 2 diabetes, like insulin or a sulfonylurea medicine; other medications that can lower your blood sugar levels, like beta-blockers; and digoxin, a medication used to treat a range of heart conditions.