Januvia's Interaction with Drugs and Supplements

Thursday 12 March 2020
6 minute(s) read

Medically reviewed by

Stefan Reiner, PharmD, RPh
on 2 September 2020

Table of Contents

I. Januvia overview

II. Herbs and Supplements

a. Aloe Vera

b. Garlic

c. Ginseng

d. St. John’s Wort

III. Drugs

IV. Alcohol

V. Birth Control

Januvia overview

Januvia is a once-daily prescription used to improve blood sugar levels in those with type 2 diabetes. Type 2 diabetes occurs when the body becomes resistant to insulin, and the pancreas cannot create enough insulin. In conjunction with proper diet and exercise, Januvia can lead to improvements in the quality of life in type 2 diabetes patients. [1]

Sitagliptin is the generic name for Januvia, and this compound works by increasing insulin release and decreasing glucagon; glucagon raises the concentration of fatty acids in the bloodstream. [2]

Januvia is becoming more common in diabetes treatment because of its efficiency in lowering blood sugar, especially when it is paired with other medications like metformin. It can be a successful treatment, but the user should be cautious in mixing other medications with Januvia. Because type 2 diabetes can become more complicated and severe as time goes on, many patients take several drugs to treat their various accompanying conditions.  Listed below are some everyday interactions with Januvia and their respective effects on the body.


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Herbs and supplements

Natural remedies are prevalent today, but consumers should be wary of the benefits and drawbacks of herbal solutions to chronic conditions. Herbs and supplements can have antagonistic or additive effects on diabetes medications. Taking these herbs with Januvia may cause hypoglycemia (low blood sugar), which is a dangerous condition. Ask your doctor if you are taking any specific herbs or supplements.

a. Aloe vera

Aloe vera is a common plant used to treat sunburns, but some researchers suggest that aloe vera can help manage blood sugar levels in diabetes patients. This plant is known for its positive immune-boosting effects, but there are potential interactions between aloe and anti-diabetic drugs, like Januvia. All this research is preliminary, and the sole use of aloe vera will not suffice for prolonged treatment of diabetes. [3]

If you’re taking a medication to help with your blood sugar levels, then gulping down a big glass of aloe vera juice could send your blood sugar crashing. Aloe vera also has a laxative effect, so if your prescription is flushed out of your system prematurely, then medications like Januvia may not be adequately absorbed. [4]

b. Garlic

Garlic is currently one of the most studied drugs because of its purported positive effects on reducing blood pressure levels and cardiovascular events in severely hypertensive (high blood pressure) patients. Garlic compounds contain several antimicrobial, anticarcinogenic, and prebiotic effects. [4] Moderate amounts of garlic supplements can help to fight infections, reduce bad cholesterol, and aid blood flow.

One 2019 study suggests a reduction in systolic blood pressure when garlic is combined with medications like Januvia and metformin. Like all things, garlic supplements should be taken in moderation and could cause adverse effects if you take extreme amounts. [6]

c. Ginseng

Ginseng usage is one of the more popular herbal remedies currently being used in the United States. Humans have been using ginseng root for millennia to cure their various ailments.  In one study, ginseng improved fasting blood glucose (overnight fast) in those with/without diabetes but did not have an impact on a patient’s A1C (blood glucose level) or insulin resistance. Ginseng should only be used after consultation with your doctor and cannot substitute prescribed diabetes medication. [5]

d. St. John’s Wort

Those with diabetes are at an elevated risk for developing depression, and St. John’s Wort is sometimes used as a natural aid to combat depression. It should be noted that natural health products like St. John’s Wort are not standardized in their manufacturing, so side effects and dosage may differ among brands.

Some studies suggest that this herb improves glucose tolerance by enhancing insulin secretion. [6] Other research suggests St. John’s Wort may interact with some medications, like Gliclazide. Gliclazide helps control blood glucose in people with type 2 diabetes, so you should monitor your consumption closely. [7]


Your blood sugar is a sensitive system of the body; so many medications can affect your blood sugar and make it harder to control. Beta-blocker drugs (used to manage abnormal heart rhythms) can prevent the pounding heartbeat feeling when your blood sugar drops. Beta-blockers could leave a patient unaware that something important is going on inside their body. [8]

If you are also on heart medications like Lanoxin (generic name: digoxin), the concentration of the drug may increase when taken with Januvia. Sulfonylureas are medicines that help manage type 2 diabetes and may interact with Januvia. They work by lowering blood glucose through stimulating insulin release from the Beta cells in the pancreas. [9] When Januvia combines with some sulfonylureas, like glyburide medications, low blood glucose may occur. Your dose of insulin or sulfonylurea may need to be reduced if you are also taking Januvia. [10]


Combining alcohol with any prescription drug can be a risky endeavor. Due to high sugar levels in alcoholic beverages, drinking can cause your blood sugar to spike or bottom out depending on how much you drink and how often. A few drinks usually does not create a big problem if your diabetes is under control, but you should always consult a doctor before consuming alcohol on diabetes medications. Drinking on an empty stomach or after exercising may also increase the risk of hypoglycemia (low blood sugar). [11]

Drinking involves a lot of empty calories, which can lead to a diabetes patient’s worst nightmare: excess weight. Drinking too much can also lead to dehydration, which is very dangerous in someone with high blood sugar. A diabetic’s liver is already under stress, so damaging the liver with alcohol will lead to increased adverse effects in someone with diabetes. Drinking on Januvia has the risk of increasing a person’s likelihood of pancreatitis and kidney failure. [12]

Birth Control

Back in the day, women with diabetes were met with few options when it came to birth control. Hormones like estrogen can have a dramatic effect on blood sugar levels, which makes it hard for women to keep diabetes well-controlled. If there is a higher level of sugar in your blood, then Januvia may not work as effectively. Today there are many different types of birth control pills of varying hormonal strengths, so doctors usually recommend pills with a lighter combination of hormones. [13]

Today many alternatives to the pill exist. Women can take depot shots, which prevent pregnancy for three months, a weekly patch that releases estrogen and progestin, or intrauterine devices (IUD). Some IUDs contain hormones that release into the bloodstream over five years. The copper IUD has no hormones and prevents pregnancy for 10 years.

These types of birth control options can be useful for women with diabetes because you seldom have to expose your body to a surge of new birth control hormones, unlike the daily pill. If you are on Januvia, consult your doctor to discuss the best birth control option for you. [14]

If your doctor recommends Januvia for your condition, you can count on Canada Pharmacy Depot for cheap and reliable prescriptions. If Januvia is not available through Canada, we can order it from affiliate countries and get your prescriptions straight to your door. 

The content in this article is intended for informational purposes only. This website does not provide medical advice. In all circumstances, you should always seek the advice of your physician and/or other qualified health professionals(s) for drug, medical condition, or treatment advice. The content provided on this website is not a substitute for professional medical advice, diagnosis or treatment.


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