Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use Januvia (Sitagliptin).

Hypersensitivity reaction: A Anaphylaxis (severe allergic reaction) called hypersensitivity reaction has occurred for some people with the use of Januvia (Sitagliptin). Stop taking the medication and get immediate medical attention if you have symptoms of a severe allergic reaction, including Fever, swollen glands, yellowing of the skin or eyes, or flu-like symptoms with skin rash or blistering.

Immune system: Januvia (Sitagliptin) can reduce the number of cells that fight infection in the body (white blood cells). This side effect may be more of a concern for people who already have a weakened immune system. People who have HIV infection, have had an organ transplant and are taking medications to reduce the activity of the immune system, or are taking medication to treat certain types of cancer are more likely to have a weakened immune system. If any of these conditions apply to you, discuss with your doctor how Januvia (Sitagliptin) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Januvia (Sitagliptin), and whether any special monitoring is needed.

Kidney function: Januvia (Sitagliptin) has been reported to cause decreased kidney function and may cause kidney failure. Your doctor may recommend regular testing to check your kidney function while you are taking Januvia (Sitagliptin). If you notice signs of kidney problems, such as decreased urine production; swelling in your hands, wrists, feet, or ankles; difficulty breathing, or weakness, contact your doctor as soon as possible.

People with decreased kidney function may require lower doses of Januvia (Sitagliptin). If you have Kidney Disease or decreased kidney function, discuss with your doctor how Januvia (Sitagliptin) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Januvia (Sitagliptin), and whether any special monitoring is needed.

Januvia (Sitagliptin) is not recommended for people with moderately to severely reduced kidney function.

Liver function: Januvia (Sitagliptin) is not recommended for people with severely reduced liver function. People with moderately reduced liver function should discuss with their doctor how Januvia (Sitagliptin) may affect their medical condition, how their medical condition may affect the dosing and effectiveness of Januvia (Sitagliptin), and whether any special monitoring is needed.

Low blood glucose (sugar): Hypoglycemia (low blood sugar) can occur when Januvia (Sitagliptin) is used in combination with metformin and a sulfonylurea (e.g., glyburide, gliclazide), or insulin. If you experience low blood sugar (e.g., headache, drowsiness, weakness, dizziness, confusion, irritability, hunger, fast heartbeat, sweating, and feeling jittery) while taking Januvia (Sitagliptin), contact your doctor.

Pancreatitis: Januvia (Sitagliptin) may cause pancreatitis (inflammation of the pancreas). People with a history of pancreatitis, gallstones, Alcoholism, or high triglycerides may be more at risk of experiencing this. If you experience prolonged and severe abdominal pain with or without vomiting while taking Januvia (Sitagliptin), contact your doctor immediately.

Type 1 Diabetes and diabetic ketoacidosis: Januvia (Sitagliptin) should not be used by people with type 1 diabetes or to treat diabetic ketoacidosis (increased ketones in the blood or urine).

Pregnancy: Januvia (Sitagliptin) is not recommended for use during pregnancy. If you become pregnant while taking Januvia (Sitagliptin), contact your doctor immediately.

Breast-feeding: It is not known if Januvia (Sitagliptin) passes into breast milk. If you are a breast-feeding mother and are taking Januvia (Sitagliptin), it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of using Januvia (Sitagliptin) have not been established for children.

Seniors: Seniors are more likely to have decreased renal function and may require lower doses of Januvia (Sitagliptin).

Before you begin using a medication, be sure to inform your doctor of any medical conditions or Allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use Invokana (Canagliflozin).

Amputation: There may be an increased risk for lower leg or toe amputations in people taking Invokana (Canagliflozin), especially if you are at high risk for heart disease. Good foot care is very important for people with diabetes. Contact your doctor as soon as possible if you notice symptoms of leg pain; poor circulation; bluish, cold skin; and poor hair or toenail growth.

Cholesterol: Invokana (Canagliflozin) can cause increased blood cholesterol levels, particularly low-density lipoprotein. If you are at risk of developing High Cholesterol or you have high cholesterol levels before starting Invokana (Canagliflozin), discuss with your doctor how Invokana (Canagliflozin) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Invokana (Canagliflozin), and whether any special monitoring is needed.

Diabetic ketoacidosis: If blood sugar levels are too high (hyperglycemia), a condition known as diabetic ketoacidosis may occur. In this condition, your body starts to use body fat as fuel, eventually leading to a large concentration of acid in the blood stream. This can result in unconsciousness, coma or death. Your risk of developing diabetic ketoacidosis may be increased if you are on a low carbohydrate diet, drink a lot of alcohol, have a severe illness or infection, or have problems with your pancreas. There have been reports of diabetic ketoacidosis in people taking Invokana (Canagliflozin).

If you develop symptoms of diabetic ketoacidosis such as difficulty breathing, feeling very thirsty, vomiting, abdominal pain, nausea, loss of appetite, confusion, and unusual tiredness, seek urgent medical attention.

Dizziness: Some people taking Invokana (Canagliflozin) may experience decreases in blood pressure. This occurs because the medication causes an increased amount of fluid, along with the glucose, to be removed from the body through the kidneys. These blood pressure drops could lead to dizziness, lightheadedness, and falls. This may occur when you shift your body position, such as rising from a sitting or lying position. If you experience this problem, try getting up more slowly. If it persists or if you faint, contact your doctor. Seniors and other individuals who are at risk of experiencing Low Blood Pressure (e.g., dehydration, taking medications for high blood pressure) should discuss with their doctor how Invokana (Canagliflozin) may affect their medical condition, how their medical condition may affect the dosing and effectiveness of Invokana (Canagliflozin), and whether any special monitoring is needed.

Fractures: There is a small increase in the risk of bone fractures for people taking Invokana (Canagliflozin). If you are at risk of Osteoporosis or are taking medications that may decrease the strength of your bones, discuss with your doctor how Invokana (Canagliflozin) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Invokana (Canagliflozin), and whether any special monitoring is needed.

Glucose control: When Invokana (Canagliflozin) is taken along with other medications for diabetes, glucose levels may drop too far, causing confusion, cold sweats, cool and pale skin, headache, fast heartbeat, or weakness. Your doctor may suggest decreasing the dose of your other medications when you first start taking Invokana (Canagliflozin). If you take other medications for diabetes, discuss with your doctor how Invokana (Canagliflozin) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Invokana (Canagliflozin), and whether any special monitoring is needed.

Kidney function: Invokana (Canagliflozin) may cause a decrease in kidney function. If you have reduced kidney function or Kidney Disease, discuss with your doctor how Invokana (Canagliflozin) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Invokana (Canagliflozin), and whether any special monitoring is needed.

Potassium levels: Increases in blood levels of potassium may occur when taking Invokana (Canagliflozin). This is more likely to happen to people who are taking other medications that prevent potassium from being removed from the body, or those who have moderately reduced kidney function. This doesn't often cause problems, but potassium levels should be monitored by your doctor. If you experience unexplained nausea, fatigue, muscle weakness or tingling sensations, contact your doctor.

Yeast infections: There is an increased risk of developing genital or vaginal yeast infections when taking Invokana (Canagliflozin) as a result of increased glucose in the urine. This is more likely to occur for uncircumcised males and for people who have a history of yeast infections.

Pregnancy: Invokana (Canagliflozin) should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking Invokana (Canagliflozin), contact your doctor immediately.

Breast-feeding: It is not known if Invokana (Canagliflozin) passes into breast milk. If you are a breast-feeding mother and are taking Invokana (Canagliflozin), it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of Invokana (Canagliflozin) have not been established for children less than 18 years of age.

Seniors: Seniors are more likely to experience side effects with Invokana (Canagliflozin) and may require lower doses.