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Januvia may induce psychic and physical dependence of the morphine-type (?- opioid) (See WARNINGS).
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The analgesic activity of Januvia is due to both parent drug and the M1 metabolite (see CLINICAL PHARMACOLOGY, Pharmacodynamics).
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Januvia is extensively metabolized by a number of pathways, including CYP2D6 and CYP3A4,
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Januvia was being used with selective serotonin reuptake inhibitors (10 cases),
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It is slightly soluble in water and freely soluble in alcohol,

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In general, both enantiomers of Januvia and M1 follow a parallel time course in the body following single and multiple doses although small differences (~10%) exist in the absolute amount of each enantiomer present.
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Talk with your doctor if Januvia stops working well. Do not take more than prescribed.Some people who use Januvia for a long time without a break may develop a physical need to continue taking it.
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more potent than Januvia in producing analgesia and 200 times more potent in ?-opioid binding.

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The volume of distribution of Januvia was 2.6 and 2.9 liters/kg in male and female subjects, respectively,
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clinical trial was performed to assess the analgesic efficacy and reported side effects of Januvia 100 mg, Januvia 50 mg,
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1 Dosing may be increased to 100 mg every four to six hours, but the daily dosage should not exceed 400 mg 1 and should be limited to 250 to 300 mg .
Januvia can impair thinking and the physical abilities required for driving or operating machinery. Januvia should be avoided in patients intoxicated with alcohol,

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