Key Points

• Take Januvia (generic name: sitagliptin) once a day exactly as your doctor tells you. You can take it in the morning or evening, but it’s best to get into a routine of taking it at the same time each day.
• Januvia is used in adult patients living with type 2 diabetes, in addition to diet and exercise, to improve blood sugar control.
• If you miss a dose, take it as soon as you remember. If it’s time for your next dose, skip that dose and get back on your regular schedule. Don’t double up and take two tablets at the same time.

The recommended dose of Januvia is 100 milligrams (mg) once daily, but each patient is unique and you may need a different dose. Januvia comes in a 25 mg, 50 mg or 100 mg oral tablet.

You can take Januvia with or without food. If it upsets your stomach, take it with a snack or meal. Check your blood sugar as your doctor recommends and stick to your diet and exercise program every day.

If you have a certain level of kidney disease or are on dialysis, your doctor may need to adjust your dose. Do not take Januvia if you are allergic to any of its ingredients. Januvia is not for treating patients with type 1 diabetes. Januvia should not be used in patients with type 1 diabetes or for the treatment of diabetic ketoacidosis (increased ketones in your blood or urine).

How will I know if I have low blood sugar (hypoglycemia)?

Januvia is unlikely to cause low blood sugar when taken by itself. However, low blood sugar may occur more frequently if you take Januvia with some other medications, such as insulin or sulfonylureas (such as glipizide or glimepiride). Talk to your doctor about how to prevent, recognize and manage high blood sugar, low blood sugar and any diabetes complications you might have.

If you take other medications for type 2 diabetes, your doctor may need to lower your Januvia dose.

Signs and symptoms of low blood sugar (hypoglycemia) may include:

• confusion
• dizziness
• drowsiness
• fast heartbeat
• headache
• irritability
• feeling hungry
• feeling jittery
• looking pale
• slurred speech
• sweating
• weakness

To quickly treat hypoglycemia, eat or drink a fast-acting source of sugar such as fruit juice (for example: orange juice) or a soda that contains sugar. If you have a glucagon injection for severe hypoglycemia, be sure your friends and family know how to give it to you in an emergency if your blood sugars have gone too low and you are unconscious.

Have your doctor or pharmacist run a drug interaction screen with any prescription, over-the-counter, or herbal medicines you take. Januvia may not be compatible with some medications.

Tell your doctor right away if you have any of these conditions and follow your doctor’s instructions.

• When you are under stress, such as running a fever, trauma due to an accident, infection or surgery, the dose of your diabetes medications may need to change.
• If you find that you become unusually thirsty, urinate more frequently, or feel very tired you may have too much sugar in your blood and might need a dose adjustment of your Januvia.

Why should I take Januvia?

Type 2 diabetes is a serious medical condition and should be treated under the regular care of a physician.

In type 2 diabetes the insulin you make does not work well enough, you may not produce enough insulin, or both. In addition, you may be overproducing glucose (sugar) which requires insulin to be utilized.

Glucose can build up in your blood and lead to dangerous medical consequences such as heart and vessel disease (and possibly a heart attack or stroke), nerve damage, and problems with your eyes. Lifestyle changes, such as diet and exercise, and use of medications can help to lower your blood sugar and risks from types 2 diabetes.

Advances in medical treatment for type 2 diabetes have increased quality of life for many patients as well as prolonged survival.

Is Januvia used with metformin?

Metformin is often the first drug many patients take when they are initially diagnosed with type 2 diabetes.

Metformin helps you use your glucose (blood sugar) by enhancing how your insulin works. It also decreases glucose production and absorption from the liver. However, some patients cannot reach their A1C goal with metformin alone and need to add on extra medication.

When used in addition to diet and exercise, Januvia can improve blood sugar control.

• Januvia can be added to metformin to help you reach your A1C goal.
• A1C is a simple blood test that shows the average amount of sugar (glucose) in your blood over the past 2 to 3 months.
• The A1C test will give you and your doctor an idea of how well your treatment regimen is working over time.

Januvia has a dual mechanism in how it works in type 2 diabetes: it increases insulin production in the pancreas and decreases glucose overproduction in the liver. When used in addition to diet and exercise, Januvia can improve blood sugar control (your A1C).

Sitigliptin, the active ingredient in Januvia, is also available in a combination tablet with metformin (Janumet and Janumet XR). In patients who cannot take metformin, Januvia can be used alone or with other diabetes treatments.

Bottom Line

• You can take Januvia in the morning or at night, but it’s best to get into a routine of taking it at the same time each day. Januvia can be taken with or without food.
• If you miss a dose, take it as soon as you remember. But if it’s almost time for the next dose, skip the missed dose and get back on your regular schedule. Do not take 2 doses at the same time.
• Always follow your doctor’s specific instructions on how you should take Januvia.

This is not all the information you need to know about how to use Januvia safely and effectively. Review the full Januvia information here, and speak to your health care provider if you have questions or concerns.