Januvia with antibiotics: interactions and safety

Antibiotic courses are common, short-term and often combined with chronic medications such as Januvia (Sitagliptin). Most antibiotics do not interfere meaningfully with Sitagliptin at 25mg, 50mg, 100mg, but a few classes do, and a small number of combinations are best avoided.

Common antibiotic interactions

Macrolides (clarithromycin, erythromycin) and certain antifungals can inhibit hepatic metabolism (CYP3A4) and raise plasma levels of many medications including some Diabetes Treatment agents. Rifampicin has the opposite effect, accelerating metabolism. Most penicillins, cephalosporins, fluoroquinolones and tetracyclines have no clinically meaningful interaction with Sitagliptin at 25mg, 50mg, 100mg.

Practical guidance

According to the prescribing information for Sitagliptin, an antibiotic course should be reviewed by the prescriber or pharmacist for known interactions before Januvia is co-administered. Adjusted 25mg, 50mg, 100mg dosing or temporary substitution is sometimes preferred for the duration of the antibiotic course.

Frequently asked questions

Can I take Januvia during an antibiotic course? ▾

For most common antibiotics, yes. A few classes — notably macrolides and azole antifungals — alter how Sitagliptin is metabolised and may need a temporary 25mg, 50mg, 100mg adjustment. The prescribing pharmacist should review any new antibiotic against the existing Januvia regimen.

Will antibiotics make Januvia stop working? ▾

Most antibiotics do not affect Januvia efficacy. Rifampicin and a few others can lower Sitagliptin levels and reduce effect; in those cases the prescriber may adjust the dose during and shortly after the antibiotic course.

More on Januvia

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