Sitagliptin, Oral Tablet

• Pancreatitis warning: Sitagliptin may increase your risk of pancreatitis (inflammation of the pancreas). This can be severe and sometimes fatal. Before you start taking this drug, tell your doctor if you’ve ever had:
  • pancreatitis
  • gallstones (stones in your gallbladder)
  • alcoholism
  • high triglyceride levels
  • kidney problems
• Joint pain warning: This drug may cause severe and disabling joint pain. Tell your doctor right away if you have joint pain while taking this drug. Your doctor may switch you to another medication to control your diabetes.

Sitagliptin is a prescription drug. It comes as an oral tablet.

Sitagliptin oral tablet is available as the brand-name drug Januvia. It’s not available as a generic drug.

Sitagliptin may be used as part of a combination therapy. That means you may need to take it with other drugs.

Why it’s used

Sitagliptin is used to treat high blood sugar levels caused by type 2 diabetes. It’s used along with lifestyle changes such as improved diet and exercise, and avoiding smoking.

How it works

Sitagliptin belongs to a class of drugs called dipeptidyl peptidase-4 (DPP-4) inhibitors. A class of drugs is a group of medications that work in a similar way. These drugs are often used to treat similar conditions.

Insulin is a chemical in your body that helps remove sugar from your blood and moves it to cells, where it can be used for energy. Hormones in your body called incretins regulate the production and release of insulin. Sitagliptin works by protecting incretin hormones so they aren’t broken down too quickly. This helps your body use insulin better and lowers your blood sugar.

Sitagliptin oral tablet doesn’t cause drowsiness, but it can cause other side effects.

More common side effects

The more common side effects that can occur with sitagliptin include:

• upset stomach
• diarrhea
• stomach pain
• upper respiratory infection
• stuffy or runny nose and sore throat
• headache

If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.

Serious side effects

Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

• Pancreatitis. Symptoms can include:
  • severe pain in your stomach that won’t go away, and that can be felt from your stomach through your back
  • vomiting
• Low blood sugar.* Symptoms can include:
  • intense hunger
  • nervousness
  • shakiness
  • sweating, chills, and clamminess
  • dizziness
  • fast heart rate
  • lightheadedness
  • sleepiness
  • confusion
  • blurred vision
  • headache
  • depression
  • irritability
  • crying spells
  • nightmares and crying out in your sleep
• Severe allergic reaction. Symptoms can include:
  • skin rash
  • hives
  • swelling of your face, lips, tongue, and throat
  • trouble breathing or swallowing
• Kidney problems. Symptoms can include:
  • swelling of your feet, ankles, or legs
  • drowsiness
  • tiredness
  • chest pain
  • nausea
  • shortness of breath
  • producing less urine than usual
• Bullous pemphigoid. Symptoms can include:
  • large, fluid-filled blisters
  • skin erosion
  • itchy skin

*Treating low blood sugar

Sitagliptin will decrease your blood sugar levels. It could cause hypoglycemia, which is when your blood sugar level drops too low. If this happens, you need to treat it.

For mild hypoglycemia (55–70 mg/dL), treatment is 15–20 grams of glucose (a type of sugar). You need to eat or drink one of the following:

• 3–4 glucose tablets
• a tube of glucose gel
• ½ cup of juice or regular, non-diet soda
• 1 cup of nonfat or 1% cow’s milk
• 1 tablespoon of sugar, honey, or corn syrup
• 8–10 pieces of hard candy, such as lifesavers

Test your blood sugar 15 minutes after you treat the low sugar reaction. If your blood sugar is still low, then repeat the above treatment.

Once your blood sugar level is back in the normal range, eat a small snack if your next planned meal or snack is more than 1 hour later.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.

An interaction is when a substance changes the way a drug works. This can be harmful or prevent the drug from working well. To help prevent interactions, your doctor should manage all of your medications carefully. Be sure to tell your doctor about all medications, vitamins, or herbs you’re taking.

To find out how sitagliptin might interact with something else you’re taking, talk to your doctor or pharmacist.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.

Other diabetes medications

When you take sitagliptin with certain other diabetes drugs, your blood sugar can drop too low. Your doctor will check your blood sugar more closely when you’re taking one of these drugs with sitagliptin. Examples of these drugs include:

• insulin
• sulfonylureas
• glipizide
• glimepiride
• glyburide

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.

This drug comes with several warnings.

Allergy warning

Sitagliptin can cause a severe allergic reaction. Symptoms include:

• skin rash
• hives
• swelling of your face, lips, tongue, and throat
• trouble breathing or swallowing

If you develop these symptoms, call 911 or go to the nearest emergency room.

Don’t take this drug again if you’ve ever had an allergic reaction to it. Taking it again could be fatal (cause death).

Warnings for people with certain health conditions

For people with pancreatitis: Sitagliptin may increase your risk of pancreatitis. If you have pancreatitis already, your doctor may choose another medication to treat your diabetes.

For people with kidney problems: Your dosage of this drug will depend on your kidney function. If your kidneys don’t work as well as they should, you may need a lower dosage of this drug so that you don’t experience side effects.

For people with diabetic ketoacidosis: You shouldn’t use sitagliptin to treat diabetic ketoacidosis.

Warnings for other groups

For pregnant women: Studies of this drug in pregnant animals haven’t shown risk to the fetus. However, there aren’t enough studies done in pregnant women to show whether the drug poses a risk to the fetus.

Tell your doctor if you’re pregnant or plan to become pregnant. Sitagliptin should be used during pregnancy only if the potential benefit justifies the potential risk.

If you do use this drug during pregnancy, talk to your doctor about taking part in the Pregnancy Registry for this drug. It tracks the effects of using sitagliptin in pregnant women.

For women who are breastfeeding: It isn’t known if sitagliptin passes through breast milk or if it causes side effects in a child who is breastfed.

You and your doctor may need to decide if you’ll take sitagliptin or breastfeed. If your doctor decides that it’s okay for you to take sitagliptin while you’re breastfeeding, your child should be monitored for side effects of the medication.

For seniors: As you age, your kidneys may not work as well as they did when you were younger. Your doctor should monitor your kidney function before starting and during treatment with this medication to limit your risk of side effects.

For children: It hasn’t been established that this drug is safe and effective for use in children younger than 18 years.

All possible dosages and forms may not be included here. Your dose, form, and how often you take it will depend on:

• your age
• the condition being treated
• how severe your condition is
• other medical conditions you have
• how you react to the first dose

Drug form and strengths

Brand: Januvia

• Form: oral tablet
• Strengths: 25 mg, 50 mg, 100 mg

Dosage for type 2 diabetes

Adult dosage (ages 18–64 years)

• Typical dosage: 100 mg taken once per day.

Child dosage (ages 0–17 years)

This drug hasn’t been studied in children. It shouldn’t be used in children younger than 18 years.

Senior dosage (ages 65 years and older)

As you age, your kidneys may not work as well as they once did. Your dosage of sitagliptin will depend on your kidney function. Your doctor will check your kidneys before and during treatment with this medication.

Special dosage considerations

For people with kidney problems:

• Mild kidney impairment (creatinine clearance greater than or equal to 45 mL/min but less than 90 mL/min): No dosage change is needed.
• Moderate kidney impairment (creatinine clearance greater than or equal to 30 mL/min but less than 45 mL/min): 50 mg per day.
• Severe kidney impairment (creatinine clearance less than 30 mL/min): 25 mg per day.
• End-stage kidney disease (requiring dialysis): 25 mg per day.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always speak with your doctor or pharmacist about dosages that are right for you.

Sitagliptin oral tablet is used for long-term treatment. It comes with serious risks if you don’t take it as prescribed.

If you don’t take it at all: Your symptoms of type 2 diabetes may not improve or may even get worse.

If you stop taking it suddenly: If your condition improved while you were taking sitagliptin and then you suddenly stop taking it, your symptoms of type 2 diabetes may come back.

If you take too much: If you double up your dose or take it too close to your next scheduled time, you may be at higher risk of serious side effects such as severe gastrointestinal problems or a low blood sugar reaction.

If you think you’ve taken too much of this drug, call your doctor or local poison control center. If your symptoms are severe, call 911 or go to the nearest emergency room right away.

What to do if you miss a dose: If you forget to take your dose, take it as soon as you remember. If it’s just a few hours before the time for your next dose, then only take one dose at that time.

Never try to catch up by taking two doses at once. This could result in dangerous side effects.

How to tell if the drug is working: Your blood sugar should be near your target range as determined by your doctor. Your symptoms of diabetes should also get better.

Keep these considerations in mind if your doctor prescribes sitagliptin for you.

General

• Sitagliptin can be taken with or without food.

Storage

• Store sitagliptin at room temperature between 68°F and 77°F (20°C and 25°C). It can be stored briefly at a temperature between 59°F and 86°F (15°C and 30°C).
• Store this drug away from light.
• Don’t store this medication in moist or damp areas, such as bathrooms.

Refills

A prescription for this medication is refillable. You should not need a new prescription for this medication to be refilled. Your doctor will write the number of refills authorized on your prescription.

Travel

When traveling with your medication:

• Always carry your medication with you. When flying, never put it into a checked bag. Keep it in your carry-on bag.
• Don’t worry about airport X-ray machines. They can’t harm your medication.
• You may need to show airport staff the pharmacy label for your medication. Always carry the original prescription-labeled container with you.
• Don’t put this medication in your car’s glove compartment or leave it in the car. Be sure to avoid doing this when the weather is very hot or very cold.

Self-management

Your doctor may have you regularly test your blood sugar levels at home. To do this, you’ll need:

• a blood glucose monitor
• blood sugar test strips
• sterile alcohol wipes
• a lancing device and lancets (needles used to obtain drops of blood from your finger to test your blood sugar)
• a needle container for safe disposal of lancets

Ask your doctor or pharmacist how to use your blood glucose monitor to test your blood sugar.

Clinical monitoring

Before starting and during treatment with sitagliptin, your doctor may check your:

• blood sugar levels
• glycosylated hemoglobin (A1C) levels (measures your blood sugar control over the last 2–3 months)
• cholesterol
• kidney function

Your diet

Sitagliptin can help lower your blood sugar levels when combined with lifestyle changes such as improved diet and exercise, and avoiding smoking. Follow the nutrition plan that your doctor, registered dietitian, or diabetes educator recommends.

Hidden costs

If your doctor decides that you need to test your blood sugar at home, you’ll need to purchase the following:

• a blood glucose monitor
• blood sugar test strips
• sterile alcohol wipes
• a lancing device and lancets (needles used to obtain drops of blood from your finger to test your blood sugar)
• a needle container for safe disposal of lancets

Prior authorization

Many insurance companies require a prior authorization for this drug. This means your doctor will need to get approval from your insurance company before your insurance company will pay for the prescription.

There are other drugs available to treat your condition. Some may be better suited for you than others. Talk to your doctor about other drug options that may work for you.

Disclaimer: Healthline 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 other 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.