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Januvia is a once-daily prescription used to improve blood sugar levels in patients with type 2 diabetes. Type 2 diabetes occurs when the body becomes resistant to insulin, and the pancreas cannot create enough insulin to effectively lower blood sugar levels. In conjunction with proper diet and exercise, Januvia can lead to improvements in the quality of life in type 2 diabetes patients.
Sitagliptin is the name for generic Januvia, and this compound works by increasing insulin release and decreasing glucagon; glucagon raises the concentration of fatty acids in the bloodstream. This can lower blood sugar levels.
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 patient must be cautious in taking other medications with Januvia. Since type 2 diabetes can become more progressive as time goes on, many patients take several medications to treat their various accompanying conditions. Listed below are some everyday interactions with Januvia and their respective effects on the body. 
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. It is important to mention to 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. While this research is preliminary, patients must recognize that the sole use of aloe vera will not be appropriate for prolonged treatment of diabetes.
If you’re taking 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.
Garlic is currently one of the most studied vitamins 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. Moderate amounts of garlic supplements can help to fight infections, reduce bad cholesterol, and have been found to increase blood flow.
A 2019 study suggests that a reduction in systolic blood pressure may occur when garlic is combined with medications like Januvia. Like all things, garlic supplements should be taken in moderation and could cause adverse effects if you take extreme amounts. 
Ginseng usage is one of the more popular herbal remedies currently being used in the United States. Humans have been using ginseng root for many years to cure their various ailments. In one study, ginseng improved fasting blood glucose levels (overnight when patients do not eat) 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 be used as a substitute for prescribed diabetes medications.
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. 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.
Your blood sugar regulation is very difficult for your 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. However, beta-blockers could leave a patient unaware that something important is going on inside their body.
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 by stimulating insulin release from the Beta cells in the pancreas. 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.
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 do not create a big problem if your diabetes is under control, but you should always consult a doctor before consuming alcohol while you are taking diabetes medications. Drinking alcohol on an empty stomach or after exercising may also increase the risk of hypoglycemia (low blood sugar).
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 alcohol while on Januvia has the risk of developing pancreatitis and kidney failure. 
Back in the day, women with diabetes had 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 their 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 lower combination of hormones.
Today many alternatives to the pill exist. Women can take Depo-Provera 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.
The content provided in this article is based on thorough research and in some cases, reviewed by a medical professional. Our goal for the information is to provide helpful, general health informational. It is not intended as a substitute for professional medical advice.