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Do not take januvia tablets more than once a day unless specifically instructed to do so by your doctor.

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Januvia may not work as well when you use other medicines at the same timeMany other drugs can also affect blood sugar controlThis includes prescription and over-the-counter medicinesvitaminsand herbal productsNot all possible interactions are listed hereTell your doctor about all medicines you start or stop using.

Also watch for signs of high blood sugarhyperglycemiasuch as increased thirst or urinationblurred visionheadacheand tiredness.

Before you start taking JANUVIAtell your doctor if you have ever had heart failureyour heart does not pump blood well enoughor have problems with your kidneysContact your doctor right away if you have increasing shortness of breath or trouble breathingespecially when you lie downswelling or fluid retentionespecially in the feetanklesor legsan unusually fast increase in weightor unusual tirednessThese may be symptoms of heart failure.

If you take JANUVIA with another medicine that can cause low blood sugarhypoglycemiasuch as a sulfonylurea or insulinyour risk of getting low blood sugar is higherThe dose of your sulfonylurea medicine or insulin may need to be lowered while you use JANUVIASigns and symptoms of low blood sugar may include headachedrowsinessweaknessdizzinessconfusionirritabilityhungerfast heart beatsweatingand feeling jittery.

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i also developed severe joint pain on januvia very soon after beginning the medication.