Short answer: The Januvia label dose is 100 mg by mouth once daily, with or without food. There is no step-up. The dose is lowered for kidney function: 50 mg once daily with an eGFR of 30 to under 45, and 25 mg once daily under 30 or on dialysis. The Medication Guide says a missed dose is taken when remembered unless the next dose is due.
This is what the FDA label says. Follow your prescriber. Your prescriber may use a different dose or pace than the label's standard schedule.
What Januvia is approved for: Januvia is a DPP-4 inhibitor approved, along with diet and exercise, to improve blood sugar control in adults with type 2 diabetes (section 1). It is not for type 1 diabetes, and it has not been studied in people who have had pancreatitis.
Source
JANUVIA (sitagliptin) tablets, for oral use, prescribing information and Medication Guide. Merck Sharp & Dohme. DailyMed, version published November 17, 2025. DailyMed setid f85a48d0-0407-4c50-b0fa-7673a160bf01
Januvia is a tablet taken by mouth once a day, with or without food. It comes in 25 mg, 50 mg and 100 mg tablets (sections 2.1 and 3).
Kidney function is checked before starting and from time to time after, and the dose is set by eGFR (section 2.2).
On dialysis, Januvia may be taken without regard to the timing of dialysis (section 2.2).
The table below is the label's schedule, from the Dosage and Administration section. Numbers are copied exactly; the section is in brackets.
| Kidney function (eGFR, mL/min/1.73 m2) | Januvia dose |
|---|---|
| 45 or higher (no dosage adjustment required) | 100 mg once daily |
| eGFR greater than or equal to 30 to less than 45 | 50 mg once daily |
| eGFR less than 30 (including patients with end stage renal disease [ESRD] on dialysis) | 25 mg once daily |
Kidney function is assessed before starting Januvia and periodically after. People 65 and older have kidney function checked more often, since Januvia is cleared mostly by the kidneys (section 8.5).
When Januvia is used with insulin or a sulfonylurea, a lower dose of the insulin or sulfonylurea may be needed to reduce the risk of low blood sugar (also section 7.1).
After acute kidney worsening, the label says cautious restarting can be considered if another cause is thought likely.
Tablets are stored at 20 to 25 C (68 to 77 F), with excursions from 15 to 30 C allowed.
The prescribing information has no missed-dose section. The Medication Guide says: if you miss a dose, take it as soon as you remember. If you do not remember until it is time for your next dose, skip the missed dose and go back to your regular schedule. Do not take two doses of Januvia at the same time.
More on this: missed a dose of Januvia.
In Dose Track you set up Januvia as a protocol with the dose and schedule your prescriber gave you. A protocol can hold dose steps, each with its own dose and length in days or weeks, so a step-up plan like the one on the label can be entered once and the app moves to the next step on its own. Reminders follow the schedule, and every dose is logged with the date and time, so you can see which step you are on and when your last dose was. The app follows what you enter; it does not choose or change a dose.
This page is what the FDA label says, in plain words. It is not medical advice. Follow your prescriber, and ask them or your pharmacist about anything here.