When januvia is used in combination with a sulphonylurea or with insulin, a lower dose of the sulphonylurea or insulin may be considered to reduce the risk of hypoglycaemia see section 4.

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Some people who take medicines called DPP-4 inhibitors like JANUVIA may develop a skin reaction called bullous pemphigoid that can require treatment in a hospitalTell your doctor right away if you develop blisters or the breakdown of the outer layer of your skinerosionYour doctor may tell you to stop taking JANUVIA.

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Your name may need to be listed on a Januvia pregnancy registry when you start using this medicine.

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