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Less commonly, patients have reported pancreatitis and gallstones due to sluggish flow of intestinal fluids as well as bowel obstruction due to slowed intestinal motility

This initial dose is intended to help the body adjust to the medication before increasing the dosage to 0.5 mg, 1 mg, and eventually up to 2.4 mg per week for optimal effects

Future research that elucidates the physiological effects of GLP-1 on glycogen metabolism and energy expenditure in humans would explain currently underinvestigated mechanisms that are likely to contribute to the clinical effects of these medications

Ref: Klausen et al

Pregnant or Breastfeeding Women: The safety of Januvia use during pregnancy and breastfeeding has not been established, and its use in these populations is generally not recommended unless the potential benefits outweigh the risks

Most patients find a specific day of the week works best, with many choosing weekends to allow rest if mild side effects occur