Januvia

Medically Reviewed by Dr. Harshi Dhingra, M.D.

Last Reviewed: Jul 20, 2022

Warnings

Januvia Risks, Warnings, and Complications

Januvia can cause serious health problems, especially in certain high-risk patients. Some of the risks of Januvia therapy include:

HEART FAILURE: Clinical trials evaluated patients and found a possible link between treatment with DPP-4 inhibitors such as Januvia and heart failure. The risk is higher in people with a history of heart failure or kidney issues like severe renal impairment. Symptoms of heart failure may include shortness of breath, irregular or rapid heartbeat, fluid retention, weight gain, and chest pain. Talk with your doctor if you notice any such symptoms while taking Januvia.
KIDNEY PROBLEMS: Some patients treated with Januvia can experience worsening kidney problems. Tell your doctor if you have any history of kidney issues. Your healthcare provider may check your kidney function before starting Januvia and during treatment. Keep all appointments for blood tests and office visits while you are on this medication. Your doctor might want to perform dosage adjustment or stop this medication based on your kidney function.
HYPOGLYCEMIA (LOW BLOOD SUGAR): Patients taking Januvia drug therapy alone or with other diabetes medications are at increased risk of developing very low blood glucose, which can be life-threatening. Symptoms of low blood glucose include shakiness, anxiety, nervousness, fast heartbeat, chills or sweating, confusion, sleepiness, weakness, low energy, and excessive hunger. Talk with your doctor about what to do if you experience hypoglycemia (low blood glucose). The risk of this occurring is higher if you have had changes in diet and exercise levels or been drinking alcohol. The risk is also higher in people over the age of 65, those who take other medications for diabetes, and those with liver or kidney problems.
SEVERE JOINT PAIN: Januvia is a DPP-4 inhibitor, and it may cause severe and disabling arthralgia (joint pain) in some people. This can happen within days of starting the medicine or years later. Tell your doctor right away if you experience any joint discomfort.
SERIOUS HYPERSENSITIVITY REACTIONS: Rarely Januvia can cause an allergic reaction. Tell your doctor immediately or seek emergency medical care if you develop signs and symptoms of a serious hypersensitivity reaction such as rash, hives, swelling of the face, eyes, throat, tongue, and lips, or difficulty breathing or swallowing.

If you are at a high risk of complications from Januvia use, your doctor or pharmacist can discuss appropriate treatment with a dosage adjustment or institute alternative treatment.

Precautions Before Starting Januvia

Tell your healthcare provider if you have ever had an allergic reaction to Januvia, any of the ingredients in Januvia tablets, or any other medications. Your pharmacy can give you a list of ingredients.

Give your healthcare provider a complete medical history. Januvia may not be suitable for people with certain medical conditions such as pancreatitis, heart failure, kidney disease, gallstones, or high triglycerides. Also, tell your doctor if you have ever had diabetic ketoacidosis and if you drink or have ever drunk large amounts of alcohol.

Give your doctor a complete list of all your medications, including prescription drugs, over-the-counter medicines, vitamins, dietary supplements, and herbal products. This can help avoid serious interactions between Januvia and other drugs.

Tell your doctor if you are pregnant, could be pregnant, plan to get pregnant, or are breastfeeding.

Talk with your doctor about the symptoms of high and low blood sugar and what to do should they occur.

Precautions During Use of Januvia

Keep all your medical and lab appointments while on Januvia. Your doctor may want to check how well the medication is working to improve glycemic control (blood sugar levels). Your provider may order certain laboratory tests to monitor your kidney function during treatment with this medication.

Tell your doctor if there are any significant changes in your diet, exercise levels, or weight; if you become dehydrated or if you are eating or drinking less due to an illness that causes nausea, vomiting, and diarrhea; or if you are undergoing surgery, have an infection and/or fever, are experiencing unusual stress, or have suffered an injury. These conditions can lead to fluctuations in blood sugar levels and may affect the amount of Januvia you need.

Tell your health care professionals you are on Januvia before undergoing any surgery, including dental surgery.

Call your doctor if you become pregnant while on Januvia.

Januvia Drug Interactions

Taking Januvia together with some other medications can affect how the medications work. Interactions between medications can also increase the risk of serious adverse reactions. Your physician may choose different diabetes medications for you, change the dose or frequency of one or both medicines, and/or closely monitor you for side effects if there are known interactions between Januvia and your other medications.

There can be potential interactions between Januvia and the following medications:

Heart medications like digoxin (Lanoxicaps, Lanoxin)
Insulin
Oral diabetes medications such as acetohexamide, glimepiride (Amaryl), chlorpropamide (Diabinese), glipizide (Glucotrol, in Metaglip), glyburide (Diabeta, Glycron, Micronase), tolbutamide, and tolazamide (Tolinase).

This list does not describe all possible Januvia interactions. Give your healthcare professionals a complete list of your medications, including prescription drugs, over-the-counter medicines, vitamins, dietary supplements, and herbal products. Also, tell your health care provider if you smoke, drink alcohol, or use illegal drugs because some of these substances can cause serious health complications when used with prescription drugs.

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