Januvia Dosage/Direction for Use

Recommended Dosing: The recommended dose of JANUVIA is 100 mg once daily. JANUVIA can be taken with or without food.
Patients with Renal Impairment: Because there is a dosage adjustment based upon renal function, assessment of renal function is recommended prior to initiation of JANUVIA and periodically thereafter.
For patients with mild renal impairment (estimated glomerular filtration rate [eGFR] ≥60 mL/min/1.73 m² to <90 mL/min/1.73 m²), no dosage adjustment for JANUVIA is required.
For patients with moderate renal impairment (eGFR ≥45 mL/min/1.73 m² to < 60 mL/min/1.73 m²), no dosage adjustment for JANUVIA is required.
For patients with moderate renal impairment (eGFR ≥30 mL/min/1.73 m² to <45 mL/min/1.73 m²), the dose of JANUVIA is 50 mg once daily.
For patients with severe renal impairment (eGFR ≥15 mL/min/1.73 m² to <30 mL/min/1.73 m²) or with end-stage renal disease (ESRD) (eGFR <15 mL/min/1.73 m²), including those requiring hemodialysis or peritoneal dialysis, the dose of JANUVIA is 25 mg once daily. JANUVIA may be administered without regard to the timing of dialysis.
Concomitant Use with an Insulin Secretagogue (e.g., Sulfonylurea) or with Insulin: When JANUVIA is used in combination with an insulin secretagogue (e.g., sulfonylurea) or with insulin, a lower dose of the insulin secretagogue or insulin may be required to reduce the risk of hypoglycemia. (See Use with Medications Known to Cause Hypoglycemia under Precautions.)