Januvia’s Side Effects: What to Know

Medically Reviewed By Victor Nguyen, PharmD, MBA

Januvia: Introduction

Januvia is a brand-name prescription drug. It’s a type of medication called a dipeptidyl peptidase-4 (DDP-4) blocker, and it contains the active drug sitagliptin. It comes as a tablet and is taken by mouth.

Januvia is approved by the Food and Drug Administration (FDA) to treat type 2 diabetes in adults. It’s prescribed in combination with diet and exercise. If Januvia works to treat your type 2 diabetes, your doctor will likely recommend that you take the drug long term. At this time, Januvia is not approved for use in children with type 2 diabetes.

Similar to other drugs, Januvia may cause side effects. Read below for information about possible side effects, including common, mild, and serious ones.

For a general overview of Januvia, including details about its uses, see this article.

If you’d like to take Januvia, search here to find a healthcare professional who might prescribe it.

Januvia: More common side effects

Some of Januvia’s side effects may be more common than others. These side effects may last only a few days to weeks. However, some side effects may last longer or become severe or bothersome. Tell your doctor or pharmacist if you have concerns about any side effects with Januvia.

In Januvia’s clinical studies, these were some side effects that occurred more often:

  • infections, such as upper respiratory infections
  • runny nose or congestion
  • headache*

* For more information about this side effect, see “Januvia: Side effects explained” below.

Januvia: Mild side effects

Januvia can cause mild side effects, which are listed below. However, this list doesn’t include all possible mild side effects. To learn more about Januvia’s side effects, view the drug’s prescribing information.

Januvia’s mild side effects include:

  • infections, such as upper respiratory infections
  • runny nose or congestion
  • headache*

The side effects listed above may last only a few days to weeks. However, some side effects may last longer or become severe or bothersome. Tell your doctor or pharmacist if you have concerns about side effects with Januvia.

Note: After the Food and Drug Administration (FDA) approves a drug, it tracks side effects of the medication. If you develop a side effect while taking Januvia and want to tell the FDA about it, visit MedWatch.

* For more information about this side effect, see “Januvia: Side effects explained” below.

Januvia: Serious side effects

It’s possible to have serious side effects with Januvia. Serious side effects are listed below, but this list may not include all possibilities. To learn more about Januvia’s side effects, view the drug’s prescribing information.

Call your doctor right away if you have serious side effects with Januvia. However, if you think you’re having a medical emergency or life threatening side effects, call 911 or your local emergency number.

Serious side effects of Januvia and their possible symptoms include:

  • Kidney problems. Symptoms can include:
    • swelling, especially in the legs or feet
    • nausea or vomiting
    • urinating more or less often than normal
  • Pancreatitis (inflammation of the pancreas). Symptoms can include:
    • abdominal pain
    • nausea or vomiting
    • fever
  • Bullous pemphigoid (a rare, blistering skin condition). Symptoms can include:
    • large blisters on the skin
    • rash
    • itching
  • Heart failure.*
  • Hypoglycemia.*
  • Severe and disabling joint pain.*
  • Allergic reaction.†

* For more information about this side effect, see “Januvia: Side effects explained” below.
† An allergic reaction is possible after taking Januvia. However, it’s not clear whether this side effect occurred in clinical studies. For more information about this side effect, see “Januvia: Side effects explained” below.

Januvia: Common questions about side effects

Here are some common questions about the drug’s side effects and answers to them. Talk with your doctor if you have other questions about this drug.

Does stopping Januvia cause withdrawal symptoms?

No, you probably won’t experience withdrawal symptoms if you stop taking Januvia. Withdrawal happens when you stop taking a drug that your body has become dependent on. (With dependence, your body needs a medication to feel as you usually do.)

Stopping Januvia shouldn’t cause withdrawal symptoms, but it may worsen your diabetes symptoms. (Januvia is prescribed to treat type 2 diabetes in adults.)

It’s important that you always talk with your doctor before stopping any medications. They can determine the best way for you to stop treatment and advise whether you should try another medication. If you have questions about stopping Januvia, talk with your doctor.

Do 100-mg doses of Januvia cause different side effects than 50-mg or 25-mg doses?

You may have an increased risk of side effects when taking 100-milligram (mg) doses of Januvia compared with 50-mg or 25-mg doses. This is because when there’s more medication in your body, you may be at an increased risk of side effects. However, the actual side effects themselves don’t vary with different doses of the drug.

If your doctor increases your dose of Januvia and you notice a difference in side effects, be sure to discuss it with them. In some cases, they may recommend decreasing your dose of the drug.

Is weight loss or weight gain a side effect of Januvia?

No, weight loss and weight gain were not side effects of Januvia reported in clinical studies.

However, changes in your weight may be due to other diabetes medications you’re taking in combination with Januvia. Other diabetes medications can cause weight loss or weight gain. For example, insulin can cause you to gain weight, while metformin may cause you to lose weight.

Januvia has been studied in weight loss research involving people who don’t have diabetes. In one study, the drug helped people lose some body weight. However, more studies are needed to determine whether Januvia is a safe and effective weight loss option. At this time, the drug is only approved for treating type 2 diabetes. Januvia is not currently approved for weight loss.

If you’re concerned about weight changes while taking Januvia, talk with your doctor. They can help you determine what may be causing your weight gain or weight loss.

Are certain side effects more likely if Januvia and metformin are taken together?

Yes, it’s possible that you may have an increased risk of side effects if you take metformin in combination with Januvia. In a clinical study, people who took both Januvia and metformin experienced more upper respiratory infections and headaches than people who took Januvia by itself.

In addition, you may experience some other side effects from metformin. To learn about side effects of metformin, see this article.

If you’re concerned about possible side effects of Januvia and metformin, talk with your doctor. They can discuss the side effects of these drugs and what you can expect. In addition, they may be able to recommend ways to decrease side effects or options for treating them.

Januvia: Side effects explained

Here’s detailed information about some of Januvia’s side effects.

Joint pain

It’s possible to develop joint pain from taking Januvia. Although this was not a common side effect reported by people taking Januvia, it is possible.

Joint pain was not reported in clinical studies of Januvia. However, people have reported joint pain with Januvia since the drug was approved for use. In some cases, people taking Januvia reported severe and disabling joint pain.

It’s possible for joint pain to occur at any time during treatment with Januvia. Some people reported pain only 1 day after starting treatment, while others didn’t experience joint pain until years after taking the drug.

Joint pain may cause other symptoms including:

  • joint swelling
  • joint stiffness

What to do

If you experience joint pain while taking Januvia, talk with your doctor. They may be able to determine whether Januvia is the cause. In some cases, your doctor may recommend stopping Januvia to see if your joint pain resolves.

Headache

You may develop a headache from taking Januvia. Headaches were one of the most common side effects reported in people taking this medication during clinical studies.

What to do

If you have headaches during treatment with Januvia, especially if they are severe or frequent, talk with your doctor. They may recommend an over-the-counter pain (OTC) medication, such as acetaminophen (Tylenol) or ibuprofen (Advil) to help relieve your symptoms. Talk with your doctor before taking OTC medications with Januvia.

Hypoglycemia

It’s possible for Januvia to increase your risk of hypoglycemia (low blood sugar). However, this risk is very low if you are taking Januvia by itself.

If you’re taking Januvia in combination with other diabetes medications, you may have a higher risk of hypoglycemia. For example, taking insulin or a sulfonylurea (another type of diabetes medication) with Januvia may increase this risk.

Examples of sulfonylureas include:

Examples of insulins include:

You should be aware of the symptoms of hypoglycemia so you can treat it right away if it develops. Symptoms may include:

  • sweating
  • fatigue
  • irritability or anxiousness

What to do

Before you start diabetes treatment, your doctor will discuss how best to treat low blood sugar. They’ll also advise how often you should test your blood sugar level.

Tell your doctor if you have hypoglycemia while taking Januvia. If you are taking Januvia with insulin or other diabetes medication, your doctor may recommend decreasing your dose of that medication. This can help decrease your risk of hypoglycemia.

Heart failure

Heart failure was not seen in clinical studies of Januvia. However, it was reported in studies of medications similar to Januvia. So it is possible that Januvia may increase your risk of heart failure.

With heart failure, your heart doesn’t pump blood throughout your body as well as usual.

Due to this possible risk, you should be aware of the symptoms of heart failure. This way, you can tell your doctor right away if you develop symptoms. These may include:

  • swelling of the legs or feet
  • shortness of breath
  • fatigue
  • cough
  • weight gain

Tell your doctor if you have or have had heart failure or conditions such as kidney problems. These may increase your risk of heart failure.

What to do

If you develop symptoms of heart failure, call your doctor. They can help determine the cause of your heart failure and advise the best ways to treat it. In some cases, they may recommend that you stop taking Januvia, and they’ll prescribe a different medication to treat your diabetes.

Allergic reaction

As with most drugs, some people can have an allergic reaction after taking Januvia. A more severe allergic reaction is rare but possible.

An allergic reaction is possible after taking Januvia. However, it’s not clear whether this side effect occurred in clinical studies.

Possible symptoms of mild and serious allergic reactions are listed in the table below.

Mild allergic reaction symptoms Serious allergic reaction symptoms
• itching trouble breathing
rash • swelling in your throat or mouth
flushing • swelling under your skin, possibly in your hands, feet, lips, or eyelids

If you have an allergic reaction to Januvia, call your doctor right away. This is important to do because the reaction could become severe.

However, if you’re having a medical emergency or your symptoms feel life threatening, call 911 or a local emergency number.

Januvia: Precautions

Be sure to talk with your doctor about your health history before you take Januvia. This drug may not be the right treatment option for you if you have certain medical conditions or other factors that affect your health.

The conditions and factors to consider include those described below.

Heart failure. If you have or have had heart failure, Januvia may make your condition worse. Your doctor may monitor you for symptoms of worsening heart failure throughout your treatment with Januvia. If your condition worsens, your doctor may recommend treatment with a diabetes medication other than Januvia.

Kidney problems. If you have kidney problems, tell your doctor before starting Januvia. This medication may increase your risk of kidney problems. If you already have kidney problems, Januvia may make your condition worse. In some cases, if you have kidney problems, your doctor may recommend a lower dosage of Januvia than usual.

Pancreatitis. Tell your doctor if you have or have had pancreatitis. This drug may increase your risk of pancreatitis. If you’ve had pancreatitis before, Januvia may increase your risk of this condition occurring again. If you develop symptoms of pancreatitis, tell your doctor right away. Symptoms of pancreatitis include abdominal pain, nausea, and vomiting. Your doctor will recommend treatment for your pancreatitis. They may also recommend stopping treatment with Januvia.

Allergic reaction. If you’ve had an allergic reaction to Januvia or any of its ingredients, your doctor will likely not prescribe Januvia. Ask your doctor what other medications may be better options for you.

Consuming alcohol during Januvia treatment

There are no known interactions between alcohol and Januvia.

However, alcohol can increase your risk of hypoglycemia (low blood sugar). Hypoglycemia is also a possible side effect of Januvia.

In addition, drinking too much alcohol can increase your risk of pancreatitis. Because Januvia may also cause pancreatitis, alcohol may increase your risk of this condition.

If you are taking Januvia and would like to drink alcohol, talk with your doctor about how much alcohol, if any, may be safe to drink.

Pregnancy and breastfeeding during Januvia treatment

It’s not known for sure whether it’s safe to take Januvia while pregnant or breastfeeding. Read below for more information about using Januvia during these times.

If you’re pregnant, planning a pregnancy, or breastfeeding, talk with your doctor before taking Januvia.

Januvia and pregnancy

At this time, it’s not clear whether Januvia is safe to take during pregnancy.

In animal studies, there was no increased risk of congenital anomalies (commonly known as birth defects). However, animal studies don’t always indicate what may happen in humans.

It’s important to note that diabetes that’s not well managed during pregnancy can increase risks to a pregnant person and their fetus. Talk with your doctor about the best way to treat your diabetes during pregnancy.

In addition, there is a registry for people who’ve taken Januvia during pregnancy. The purpose of a pregnancy exposure registry is to collect information about side effects that a drug may have caused during pregnancy. This information can help doctors determine whether the medication may be safe for pregnant people. To join the registry, talk with your doctor or call 800-986-8999.

Januvia and breastfeeding

No studies have been done to evaluate Januvia use in people who are breastfeeding. So it’s not known whether the drug passes into breast milk. It’s also not clear whether it has any effects on a breastfed child or the production of breast milk.

In animal studies, Januvia did pass into breast milk. However, it’s important to note that animal studies do not always indicate what may happen in humans.

Januvia: What to discuss with your doctor

Talk with your doctor or pharmacist to find out more information about Januvia. If you have questions about the drug’s side effects, your pharmacist or healthcare professional can help answer them for you.

In addition to discussing Januvia with your doctor, you may find the following articles helpful in learning more.

  • Overview of Januvia. To read an overview of Januvia, see this article.
  • Drug comparison. To learn how Januvia compares with Tradjenta, read this article.
  • Details about type 2 diabetes. To learn more about type 2 diabetes, which Januvia is used to treat, see this article.

Disclaimer: Healthgrades has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.

Medical Reviewer: Victor Nguyen, PharmD, MBA
Last Review Date: 2022 May 23
THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.