Compare Januvia vs. Actos

Head-to-head comparisons of medication uses, side effects, ratings, and more.

Januvia
(sitagliptin)

Actos
(pioglitazone)

Lowers your blood sugar. Januvia (sitagliptin) is a good add-on treatment if your blood sugars are not controlled and you don't want to use an injectable medicine.Lowers blood sugar. Actos (pioglitazone) can improve blood sugar control but is not a top choice since it has a lot of side effects.
Reviews & ratings
Filter group. All currently selected
Filter group. All currently selected
4.34Januvia
Reviews for Januvia
44%
of people (All ages) say Januvia is worth it
34%
say it works well
17%
say it's a big hassle
143 reviews
Have you used Januvia (sitagliptin)?
Worth itNot sureNot worth it
Reviews for Actos
42%
+2% better vs. Januvia
30%
+4% better vs. Januvia
21%
+4% better vs. Januvia
175 reviews
Have you used Actos (pioglitazone)?
Worth itNot sureNot worth it
Side effects
JanuviaActos
  • Common cold 2%
  • Diarrhea 1%
  • Upper respiratory infection 3%
  • Headache 1%
More Januvia side effects »
  • Swelling 11%
  • Low blood sugar 8%
  • Colds and flu 4%
  • Headache 2%
  • Heart failure 2%
  • Sinus infection 1%
  • Back pain 1%
  • Muscle pain 2%
More Actos side effects »
How it works
JanuviaActos
Januvia (sitagliptin) is an anti-diabetic drug that enhances your body's release of insulin.Actos (pioglitazone) is a thiazolidinedione that improves your body's ability to use insulin to lower your blood sugar.
Type of medication
JanuviaActos
Prescription onlyPrescription only
Available as
JanuviaActos
  • Pill
  • Pill
Used for
JanuviaActos
Risk factors for serious side effects
JanuviaActos
  • History of pancreatitis
  • High blood triglyceride levels
  • Gallstones (stones in gallbladder)
  • History of alchoholism
  • Kidney problems
Detailed Januvia (sitagliptin) risks & warnings »
  • Heart failure
  • Current liver problems
  • History of bladder cancer
  • Women
Detailed Actos (pioglitazone) risks & warnings »
Pregnancy

Research studies with animals haven’t found a risk to unborn babies, but it hasn’t been properly studied in humans.

Food
JanuviaActos
  • Take once a day in the morning with or without food.
  • Take once a day with or without food.
Kidneys and liver
JanuviaActos
  • Januvia (sitagliptin) can worsen kidney problems. Your doctor may check your kidney function before and during treatment. Your doctor may have to adjust the dose or stop this medicine based on changes in kidney function.
  • If you've had liver problems or damage in the past, talk to your doctor before starting Actos (pioglitazone), since there's a small chance that it can hurt your liver. Tell your doctor about any stomach pain that don't go away, dark urine, or yellowing of eyes/skin. Your doctor will check your liver regularly.
Pain
JanuviaActos
  • Tell your doctor right away if you have severe stomach pain, nausea, and/or vomiting. These are symptoms of pancreatitis.
No pain related info.
Weight
JanuviaActos
  • It is less likely to cause weight gain and low blood sugar compared to other diabetes medicines.
  • Can cause weight gain, headache, and swelling from fluid build-up.
  • Can cause weight gain.
Upsides and benefits
JanuviaActos
  • Oral blood sugar-lowering medicine.
  • Januvia (sitagliptin) is not linked to worsening heart failure like other medicines in its class.
  • Uses the hormones naturally produced by your body to affect how sugar is processed.
  • It is less likely to cause weight gain and low blood sugar compared to other diabetes medicines.
  • Improves sugar control and lowers A1c levels by around 1%.
  • Easily taken by mouth as a once a day pill.
  • Prevents the harmful effects of high sugar levels on your organs.
  • Rarely causes low blood sugar.
  • Lower the risk of heart attack or stroke.
Downsides and risks
JanuviaActos
  • Lowers A1c (average blood sugar over time) by less than 1%.
  • Available as brand version only.
  • Some people might get frequent cold-like symptoms.
  • Rare but serious side effects include pancreatitis and severe joint pain.
  • May take several weeks to lower blood sugar.
  • Can cause weight gain.
  • People with heart failure or history of bladder cancer shouldn't use this medicine.
  • Some people might get fluid accumulation (edema), from minor ankle swelling to fluid in lungs that makes it hard to breathe.
  • Raises the risk of bone fractures, especially for people who already have a risk for fractures.
Tips from our pharmacists for people taking the medication
JanuviaActos
  • Take once a day in the morning with or without food.
  • Can cause headache and cold-like symptoms.
  • Tell your doctor right away if you have severe stomach pain, nausea, and/or vomiting. These are symptoms of pancreatitis.
  • Tell your doctor right away if you are experiencing severe joint pain.
  • Check your blood sugar regularly to check for low blood sugar.
  • Take once a day with or without food.
  • May need several weeks to see full effect on blood sugar control.
  • Can cause weight gain, headache, and swelling from fluid build-up.
  • Tell your doctor about any shortness of breath, heart troubles, or unusual swelling.
  • Not recommended for patients with a history of heart failure or bladder cancer.
  • Check your blood sugar regularly.
Learn more
More about JanuviaSide effectsReviews & ratingsAlternativesFDA package insert
Have you used Januvia (sitagliptin)?
Worth itNot sureNot worth it
More about ActosSide effectsReviews & ratingsAlternativesFDA package insert
Have you used Actos (pioglitazone)?
Worth itNot sureNot worth it