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off-label use should generally be limited to clinical trials or specialist-directed care

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[DOI] [PMC free article] [PubMed] [Google Scholar] 87.Hauge M, Ekberg JP, Engelstoft MS, Timshel P, Madsen AN, Schwartz TW

Clinical Pharmacology.] Use with Medications Known to Cause Hypoglycemia As is typical with other antihyperglycemic agents used in combination with a sulfonylurea, when Januvia was used in combination with a sulfonylurea, a class of medications known to cause hypoglycemia, the incidence of hypoglycemia was increased over that of placebo

If you experience nausea or other gastrointestinal effects, discuss with your healthcare professional whether adjusting the timing might help manage these symptoms

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