The U.S. Food and Drug Administration (FDA) warned that Type 2 diabetes drugs in the Dipeptidyl peptidase-4 (DPP-4) inhibitors class may cause severe joint pain. Januvia/Janumet (Sitagliptin) was developed and marketed by Merck & Co. as an oral anti-hyperglycemic beginning in 2006. It was the first approved medication in the DPP-4 class to hit the market. Januvia is widely prescribed and is expected to exceed sales of over $7 billion per year by 2018.

The FDA safety report warns that ingestion of DPP-4 inhibitors may cause severe and disabling joint pain. The FDA said it identified cases of severe joint pain associated with the use of DPP-4 inhibitors in a review of medical literature and adverse events reported to the FDA. Patients started having symptoms from one day to years after they started taking DPP-4 inhibitors like Januvia/Janumet. Incretin mimetic medications, including Januvia/Janumet have already been connected to serious injuries including pancreatitis and pancreatic cancer.