Januvia is a prescription oral medication for type 2 diabetes. It is used as part of a diabetes management plan in adults alongside exercise and diet.

Diabetics have a difficult time controlling blood sugar. In particular, type 2 diabetes patients do not make enough insulin, making the body insulin-resistant and unable to use insulin efficiently to control blood sugar.

This medication contains the active substance sitagliptin, a DPP-4 inhibitor.

How Does Januvia Work?

Januvia works by slowing the inactivation of the incretin hormones in the intestines. When you take the medication, more incretin is released by the intestine which raises the levels of insulin in the body. Increased insulin levels reduce the amount of body sugar.

In addition, Januvia blocks dipeptidyl peptidase 4 (DPP-4), resulting in increased production of GLP-1 and GIP in the body. GLP-1 causes the body to release less glucagon hence reducing blood sugar levels.

Precautions and Warnings With Januvia

Januvia has precautions and warnings that you must follow to prevent any potential side effects.

  • Pancreatitis: Januvia may cause pancreatitis. As such, patients should be aware of symptoms like nausea and abdominal pain when taking the medication as they could indicate pancreatitis. Discontinue the medication immediately, and seek medical attention if you notice these symptoms.
  • Allergic Reaction: Januvia has been associated with severe allergic reactions such as angioedema and anaphylaxis, which can be life-threatening. Disclosing any allergic reactions to your doctor might help prevent adverse reactions.
  • Heart Failure: Patients having a pre-history of conditions like heart failure or renal impairment may experience worsening of their conditions. Stop using Januvia if you notice signs and symptoms of heart failure, and promptly inform your doctor.
  • Disabling Arthralgia: Januvia causes disabling or severe arthralgia. In case you experience severe joint pain when taking the medication, discontinuing the medication might be necessary.
  • Bullous Pemphigoid: Bullous Pemphigoid, which is characterized by symptoms like blisters or erosions, may occur with the use of Januvia. In case you notice these symptoms, seek medical attention as soon as possible.
  • Kidney Conditions: Kidney conditions such as kidney failure can become fatal with Januvia use. People with kidney problems should talk to their doctor before using Januvia to avoid the risk of encountering adverse side effects.

Januvia Side Effects

While Januvia is an effective medication for managing type 2 diabetes, it has potential side effects that may occur during treatment. Recognizing these side effects is important to ensure proper monitoring and management throughout the treatment.

Common Side Effects

  • Headache
  • Stomach pain
  • Constipation
  • Diarrhea
  • Blurred vision
  • Profuse sweating
  • Irregular heartbeats

Severe Side Effects

  • Kidney disease
  • Gallstones
  • Swelling of the feet, legs, or ankles
  • Confusion
  • Skin reaction
  • Joint pain
  • Unusual tiredness

Drug Interactions With Januvia

Drug interactions occur when Januvia is taken with other medications or substances, potentially affecting its effectiveness or increasing the risk of adverse effects. Knowing potential drug interactions is vital when considering the use of Januvia.

Drug Interaction
DigoxinCombining Januvia with digoxin may increase the concentration of digoxin in your bloodstream, causing the toxicity of digoxin.
RifampinThe interaction between rifampin (Rifadin) and Januvia decreases the effectiveness of Januvia, causing its metabolism to increase.
Beta-blockers (propranolol)Co-administration of these medications increases symptoms of hypoglycemia such as tachycardia.
CYP3A4 inducers and inhibitors (carbamazepine)


Drugs that induce or inhibit the activity of the CYP3A4 enzyme system in the liver may affect the metabolism of Januvia, potentially affecting its efficacy or increasing the risk of adverse effects.
SulfonylureasCombining Januvia and sulfonylureas may potentiate the risk of having hypoglycemic effects of insulin. Dosage adjustment may be necessary to prevent low blood sugar levels.

Strengths and Dosages of Januvia

Januvia is available in tablet form for oral consumption. It can be taken with or without food at any time of the day. Monitor your blood sugar levels as advised by the doctor before taking Januvia.

Age Dosage   No. of Times a Day
 Starting Dosage Minimum Dosage Maximum Dosage  
25mg50mg100mgOnce per day

The dosage of Januvia prescribed by your doctor will vary depending on any other medical condition you have. Patients suffering from kidney functions may require a lower dosage of Januvia compared to those without kidney issues.

Januvia should be used alongside exercise and a balanced diet for effective management of type 2 diabetes.

Cost of Januvia in America

On average, Januvia’s 100 mg oral tablet usually goes for $613 for a 30-day supply, but the price can change depending on the pharmacy you buy them. These prices are for individuals who pay with cash and may not apply to medical insurance coverage.

Only the brand name of Januvia is currently available, there is no generic version yet.

Why is Januvia Expensive?

Januvia is quite an expensive medication for several reasons. They include:

  • Research and Development: Developing Januvia involves extensive research and testing to ensure that it is safe for use. This may take a long time and it requires substantial financial investment, which contributes to the high cost of the medication.
  • Brand-Name: Januvia is a brand-name drug with no generic version. Typically, brand-name drugs are much more expensive than generics.

Januvia Alternatives

There are several alternative medications to Januvia and each of them works through different mechanisms to help lower sugar levels and manage type 2 diabetes. The drugs may be used alone or in combination with other medications, depending on the patient’s treatment goals and needs. They include:

  • Metformin: Metformin is a first-line treatment drug for type 2 diabetes. It works by inhibiting fructose-1-6-bisphosphatase hence decreasing glucose production in the liver and improving insulin sensitivity in the body’s tissue to allow better uptake of glucose from the blood.
  • Dapagliflozin: It works by blocking glucose reabsorption in the kidney, leading to increased glucose excretion in the urine.
  • Nateglinide: Nateglinide is a meglitinide medication that stimulates insulin release from the pancreas in response to meals. This helps to lower blood sugar levels after eating.
  • Other Medication: Other alternative medications include acarbose, empagliflozin (Jardiance), liraglutide, glyburide, and glipizide.

FAQs of Januvia

What is Januvia used for?

Januvia is a type of medication used in the treatment of type 2 diabetes by helping to lower blood sugar levels.

How does Januvia work?

It slows the inactivation of incretin hormones in the intestines hence increasing the release of insulin and decreasing the secretion of glucagon. This helps regulate blood sugar levels in patients with type 2 diabetes.

When will generic Januvia be available?

The earliest potential release date for a generic version of Januvia could be after October 2026, based on the expiration of its patent at that time.

Who makes Januvia?

Januvia is manufactured by Merk and Co., a global pharmaceutical company.

What are the side effects of Januvia?

The side effects of Januvia include nausea, headache, stomach pain, diarrhea, profuse sweating, skin reaction, joint pain, and swelling of the ankles, feet, and legs.

How to take Januvia

Take the medication orally, once per day, with or without food, as directed by your doctor. Swallow the tablet as a whole with a glass of water.

How long does it take for Januvia to work

After taking Januvia, you may notice an improvement in your blood glucose levels within 1-2 weeks of starting the medication.

How long does Januvia stay in your system?

The terminal half-life of Januvia is approximately 12.5 hours. Essentially, this means your body should completely eliminate a full dose of Januvia in 2 days.

IMPORTANT NOTE: The information provided here is for educational purposes only and is not intended to serve as medical advice, diagnosis, or treatment recommendations. It should not be taken as an endorsement of any specific medication or treatment. Individual health conditions and responses to treatment can vary greatly; therefore, this information should not be seen as a guarantee of safety, suitability, or effectiveness for any particular individual. Always consult with a healthcare professional for personalized medical advice and before making any decisions regarding your health or treatment plans.

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