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Although the mechanisms by which metabolites influence the immune system are complex, they can generally be categorized into two main types

Accessed October 28, 2025

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Common side effects: Headache Upper respiratory infection symptoms (sore throat, runny/stuffy nose) Constipation Vomiting Mouth ulcers Rare but serious side effects: Heart failure (shortness of breath, swelling, sudden weight gain) Pancreatitis (persistent nausea/vomiting, severe abdominal or back pain) Allergic reactions (hives, facial swelling, difficulty breathing) Hypoglycemia when combined with insulin or sulfonylureas (hunger, sweating, confusion) Kidney problems (decreased function or failure requiring dialysis) Severe skin reactions (blisters, skin erosion) Severe joint pain What should you tell your healthcare provider before taking Januvia

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