Januvia interactions: Alcohol, medications, and other factors

Januvia (sitagliptin) is a brand-name prescription drug. It’s used to help manage blood sugar levels in adults with type 2 diabetes. As with other medications, Januvia can interact with certain other drugs and some supplements. An interaction occurs when one substance causes another substance to have a different effect than expected.

For details about Januvia’s interactions, keep reading. For additional information about Januvia, see this article.

In some cases, factors or conditions could prevent your doctor from prescribing Januvia due to the risk of harm. These are known as contraindications. The contraindications of Januvia include:

Having had an allergic reaction to Januvia or any of its ingredients

If you’ve had an allergic reaction to Januvia or any of its ingredients, your doctor will likely not prescribe Januvia. Taking the drug could cause another allergic reaction. You can ask them about other treatments that may be better choices for you.

Note: Before you start treatment with Januvia, it’s important to tell your doctor if this contraindication applies to you. They can determine whether to prescribe Januvia.

Januvia isn’t known to interact with alcohol.

However, it may be best to limit the amount of alcohol you consume while taking the drug. This is because alcohol may affect blood sugar levels. Januvia is used to help manage blood sugar levels in adults with type 2 diabetes. So, drinking alcohol while taking Januvia could make it hard to tell if the drug is working to treat your condition.

If you consume alcohol, talk with your doctor. They can tell you whether there’s a safe amount to drink while taking Januvia.

Before you start treatment with Januvia, tell your doctor and pharmacist which prescription, over-the-counter, and other medications you take. By sharing this information with them, you may help prevent possible interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Here’s a chart of drugs that can interact with Januvia. Keep in mind that this chart does not include all drugs that may interact with Januvia. Some of these interactions are described in detail just below in ‘Drug interactions in depth.’

Here’s a closer look at certain drug interactions of Januvia.

Sulfonylureas

Sulfonylureas area a type of diabetes drug. Like Januvia, they’re used to help manage blood sugar levels in people with type 2 diabetes.

Interaction result. Taking Januvia in combination with a sulfonylurea can increase the risk of low blood sugar with either drug.

Interaction explained. Both Januvia and sulfonylureas can lower blood sugar when taken individually. Taking Januvia and a sulfonylurea together may lower your blood sugar further.

Examples of sulfonylurea drugs. Below are some examples of sulfonylureas that may interact with Januvia:

• glipizide (Glucotrol XL)
• glyburide (Diabeta, Glynase)
• glimepiride (Amaryl)

Steps you or your doctor may take. If you take Januvia with a sulfonylurea, your doctor may recommend a lower dosage of a sulfonylurea than is usually prescribed. Doing so should help reduce your risk of decreased blood sugar when these medications are taken together.

While taking Januvia with a sulfonylurea, watch for symptoms of low blood sugar. Examples include dizziness, headache, shaking, and sweating.

If you have these symptoms, you should eat at least 15 grams (g) of carbohydrates or sugar. Examples of sources of sugar include hard candies, glucose tablets, and fruit juice. Keep in mind that diet or sugar-free candy or soda will not treat low blood sugar.

In severe cases, low blood sugar may cause seizures or loss of consciousness. If you have symptoms of low blood sugar that seem severe or life threatening, 911 or the local emergency number should be called right away. Or someone should get you emergency medical treatment immediately.

Insulin

Insulin is used to help manage blood sugar levels in people with diabetes.

Interaction result. Taking Januvia in combination with insulin can increase the risk of low blood sugar with either medication.

Interaction explained. Both Januvia and insulin can lower blood sugar when used individually. Taking Januvia and insulin together may cause greater decreases in your blood sugar level.

Examples of insulins. Here are some insulins that may interact with Januvia:

• insulin degludec (Tresiba)
• insulin glargine (Lantus, Toujeo)
• insulin detemir (Levemir)
• insulin lispro (Humalog)
• insulin aspart (NovoLog)

Steps you or your doctor may take. If your doctor prescribes Januvia with insulin, they may recommend a lower dosage of insulin than usual. This should help decrease the risk of low blood sugar when these medications are used together.

While taking Januvia with insulin, watch for symptoms of low blood sugar. Examples include: shaking, dizziness, sweating, and headache.

If you have symptoms of low blood sugar, it’s important to eat at least 15 g of sugar or carbohydrates. Sources of sugar include fruit juice, hard candies, and glucose tablets. Keep in mind that diet or sugar-free candy or soda will not treat low blood sugar.

If your blood sugar becomes severely low, you may have seizures or lose consciousness. If you have symptoms of low blood sugar that seem severe or life threatening, 911 or the local emergency number should be called right away. Or someone should get you emergency medical treatment immediately.

Oral birth control

Oral birth control refers to medications that are taken by mouth to help prevent pregnancy.

Interaction result. Oral birth control can make Januvia less effective than usual.

Interaction explained. The hormones in birth control pills can increase your blood sugar level. This can make it more difficult for Januvia to help manage your blood sugar level.

Examples of oral birth control. Below are examples of oral birth control drugs that may interact with Januvia:

• ethinyl estradiol/norgestimate (Estarylla, Sprintec, others)
• drospirenone/estetrol (Nextstellis)
• ethinyl estradiol/norethindrone (Aranelle, Gildagia, others)

Steps you or your doctor may take. Before starting Januvia treatment, tell your doctor if you take any oral birth control pills. They can recommend whether it’s safe for you to take these medications together.

Januvia may have other interactions, such as with supplements, foods, vaccines, or even lab tests. You’ll find details below. Keep in mind that the following information does not include all other possible interactions with Januvia.

Januvia interactions with supplements

Garlic supplements may interact with Januvia. These supplements have been reported to lower blood sugar in some people with type 2 diabetes. (Januvia is also used to treat this condition.)

Taking garlic supplements with Januvia could increase your risk of low blood sugar. Your doctor can advise you on whether it’s safe to take Januvia with garlic supplements.

If your doctor approves you taking Januvia with a garlic supplement, they may have you check your blood sugar levels often. This way, you can monitor whether your they might be dropping too much. You should also watch for symptoms of low blood sugar. To learn about possible symptoms, see ‘Sulfonylureas’ in ‘Drug interactions in depth’ above.

Before you start treatment with Januvia, tell your doctor and pharmacist which supplements, herbs, and vitamins you take. By sharing this information with them, you may help prevent possible interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Januvia and herbs

There are no specific reports of herbs interacting with Januvia. However, it’s possible that some herbs might affect blood sugar levels. Because of this, it’s important to check with your doctor or pharmacist before taking any of these products during Januvia treatment.

Januvia and vitamins

Vitamins have not been reported to interact with Januvia. However, it’s possible that interactions with vitamins could be recognized in the future. Because of this, you should talk with your doctor or pharmacist before taking any vitamin product with Januvia.

Januvia and food

Although garlic supplements* may interact with Januvia, there were no reports of food interactions with the drug.

The amount of garlic in foods or seasonings is typically much less than what’s in a garlic supplement. This small amount of garlic is not likely to affect blood sugar. So, it should be safe to eat foods or seasonings containing garlic during Januvia treatment.

If you have additional questions or want more information about eating certain foods while taking Januvia, talk with your doctor.

* To learn more, see ‘Januvia interactions with supplements’ above.

Januvia and vaccines

Januvia and vaccines have not been reported to interact with each other. For more information about getting certain vaccines while taking Januvia, talk with your doctor or pharmacist.

Januvia and lab tests

No lab tests have been reported to interact with Januvia. Your doctor or pharmacist can tell you more about having certain lab tests during Januvia treatment.

Januvia and cannabis or CBD

Cannabis (often called marijuana) and cannabis products, such as cannabidiol (CBD), have not been specifically reported to interact with Januvia. However, as with any drug or supplement, talk with your doctor before using cannabis in combination with Januvia. The impact of cannabis may affect how well you stick to your Januvia treatment plan.

Note: Cannabis is illegal at a federal level but is legal in many states to varying degrees.

Certain medical conditions and other factors may increase the risk of interactions with Januvia. Before you take Januvia, be sure to talk with your doctor about your health history. Januvia may not be the right treatment option for you if you have certain medical conditions or other factors affecting your health.

Health conditions or factors that might interact with Januvia include the following.

Allergic reaction. If you’ve had an allergic reaction to Januvia or any of its ingredients, your doctor will likely not prescribe Januvia. To learn more, see ‘When to avoid Januvia’ above.

Kidney problems. If you have kidney problems, such as kidney failure, be sure to tell your doctor before taking Januvia. Having kidney problems may increase your risk of side effects with Januvia, including heart failure. Your doctor can recommend whether it’s safe to take Januvia. If they prescribe Januvia, they may give you a lower dosage of the drug than usual.

Pancreatitis. Januvia may cause pancreatitis. The drug hasn’t been studied in people who have had pancreatitis in the past. So, it isn’t known whether having had this condition could increase the risk of pancreatitis with Januvia. If you’ve had pancreatitis, your doctor can recommend whether it’s safe for you to take Januvia.

Heart failure. Januvia may cause heart failure. If you already have heart failure, the drug may worsen your condition. In this case, your doctor can advise you on whether it’s safe to take Januvia.

If your doctor prescribes Januvia, they’ll recommend watching for symptoms of worsened heart failure while you’re taking the drug. Examples of these symptoms include rapid weight gain, trouble breathing, and swelling in your legs, ankles, or feet. Your doctor will also monitor you for these side effects. If you develop worsening heart failure with Januvia, your doctor can instruct you on how to manage it.

Pregnancy. It’s not known whether Januvia is safe to use while pregnant. If you’re pregnant or planning a pregnancy, talk with your doctor before you take the medication. For details about Januvia’s use during pregnancy, see this article.

Breastfeeding. Januvia passes into breast milk during breastfeeding, which could cause side effects in a breastfed child. If you’re breastfeeding, talk with your doctor before using Januvia. To learn more about Januvia’s use while breastfeeding, see this article.

Here are some frequently asked questions about Januvia and possible interactions.

Has Januvia been recalled due to any interactions?

No, Januvia has not been recalled due to any interactions.

A drug recall occurs when a medication is no longer available because it has been removed from the market. This typically happens because of a safety issue. For example, the drug may accidentally contain an unwanted ingredient.

Januvia has not been recalled because of any safety issues, including any of its possible drug interactions.

If you have additional questions about Januvia, talk with your doctor or pharmacist.

Does Januvia interact with other diabetes drugs, such as Ozempic, Trulicity, Farxiga, or Jardiance?

Januvia is known to interact with certain diabetes drugs. However, Januvia is not known to interact with any of the following diabetes medications:

• semaglutide (Ozempic)
• dulaglutide (Trulicity)
• dapagliflozin (Farxiga)
• empagliflozin (Jardiance)

Diabetes drugs that Januvia does interact with include sulfonylureas, meglitinides, and insulin. To learn more, see the ‘Drug interactions in depth’ section above.

Januvia is used to help manage blood sugar levels in adults with type 2 diabetes. Your doctor may prescribe Januvia alone or in combination with other diabetes medications. They can tell you more about taking Januvia with the diabetes drugs mentioned above.

Can I take Januvia with metformin?

Yes, you can take Januvia with metformin (Riomet, Fortamet, Glumetza). Januvia and metformin are not known to interact with each other.

In fact, Januvia is often prescribed in combination with metformin. Both drugs are used to help manage blood sugar levels in people with type 2 diabetes. Sitagliptin (the active drug in Januvia) is available in combination with metformin under the brand names Janumet and Janumet XR.

To learn more about taking Januvia with metformin, talk with your doctor.

You can take certain steps to help prevent interactions with Januvia. Your doctor and pharmacist are key resources, so reach out to them before starting treatment. For example, you should plan to do the following:

• Let them know if you drink alcohol.
• Tell them about any other medications you take, as well as any supplements, herbs, and vitamins.
• Create a medication list, which your doctor and pharmacist can help you fill out.

It’s also important to read the Januvia label and other paperwork that may come with the drug. The label may have colored stickers that mention an interaction. And the paperwork, sometimes called the medication guide or patient package insert, may contain details about interactions. (If Januvia doesn’t come with paperwork, ask your pharmacist to print a copy.) Your doctor and pharmacist can help answer any questions you have.

You can also help prevent interactions with Januvia by taking it exactly as your doctor prescribes.

Besides learning about interactions, you may want to find out more about Januvia. These resources might help:

• Overview of Januvia. For a general overview of Januvia, you can see this article.
• Side effects. If you’re interested in the side effects of Januvia, see this article. Another option is to refer to the Januvia prescribing information.
• Dosage specifics. To learn about the dosage of Januvia, see this article.
• Drug comparison. Learn how Januvia compares with Tradjenta and with metformin.
• Facts about diabetes. To learn more about your condition, see our diabetes hub.

Disclaimer: Medical News Today 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.