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Januvia approval occurred in october 2006, and the fda said the approval of januvia meant also that this drug could be used either by itself or in combination with other drugs for blood sugar control.

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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.

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.

Your doctor can prescribe a glucagon emergency injection kit to use in case you have severe hypoglycemia and cannot eat or drinkBe sure your family and close friends know how to give you this injection in an emergency.

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