Description
Generic
Indications
When treatment with both Linagliptin and Metformin Hydrochloride is appropriate, this is indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus..
Pharmacology
Linagliptin is shown to make strides glycemic control in patients with sort 2 diabetes mellitus. Linagliptin is an inhibitor of DPP-4 (dipeptidyl peptidase-4), an chemical that debases the incretin hormones GLP-1 (glucagon like peptide-1) and GIP (glucose subordinate insulinotropic polypeptide). Hence, Linagliptin increments the concentrations of dynamic incretin hormones, fortifying the discharge of affront from pancreatic beta (β) cells in a glucose-dependent way and diminishing the discharge of glucagon from pancreatic alpha (α) cells within the circulation. Metformin Hydrochloride may be a biguanide sort verbal antihyperglycemic sedate utilized within the administration of sort 2 diabetes. It brings down both basal and postprandial plasma glucose. Its component of activity is distinctive from those of sulfonylureas and it does not deliver hypoglycemia. Metformin Hydrochloride diminishes hepatic glucose generation, diminishes intestinal assimilation of glucose and progresses affront affectability by an increment in fringe.
Administration & Dosage
Linagliptin & Metformin immediate release tablet: The dosage of Linagliptin & Metformin should be individualized on the basis of both effectiveness and tolerability. Maximum recommended dose of 2.5 mg Linagliptin and 1000 mg Metformin Hydrochloride twice daily with meals. Dose escalation should be gradual to reduce the gastrointestinal (GI) side effects associated with Metformin Hydrochloride use.
Recommended starting dose: In patients currently not treated with Metformin Hydrochloride, initiate treatment with 2.5 mg Linagliptin and 500 mg Metformin Hydrochloride twice daily.
In patients already treated with Metformin Hydrochloride, start with 2.5 mg Linagliptin and the current dose of Metformin Hydrochloride twice daily.
Patients already treated with Linagliptin and Metformin Hydrochloride, individual components may be switched to this combination containing the same doses of each component.Linagliptin & Metformin extend release tablet: The dosage of this combination should be individualized on the basis of both effectiveness and tolerability, while not exceeding the maximum recommended total daily dose of Linagliptin 5 mg and Metformin Hydrochloride 2000 mg. this combination should be given once daily with a meal.
Recommended starting dose: In patients currently not treated with metformin, initiate this combination treatment with 5 mg Linagliptin/1000 mg Metformin Hydrochloride extended-release once daily with a meal.
In patients already treated with Metformin, start this combination with 5 mg of Linagliptin total daily dose and a similar total daily dose of Metformin once daily with a meal.
In patients already treated with Linagliptin & Metformin immediate release tablet, switch to extend release tablet containing 5 mg of Linagliptin total daily dose and a similar total daily dose of Metformin once daily with a meal.
5 mg Linagliptin & 1000 mg Metformin Hydrochloride extended-release tablet should be taken as a single tablet once daily. Patients using 2.5 mg Linagliptin & 1000 mg Metformin extended release tablets should take two tablets together once daily.
Interaction
Amiloride, digoxin, morphine, ranitidine, trimethoprim, and other cationic drugs may reduce metformin elimination.
P-glycoprotein/CYP3A4 inducer (i.e. rifampin): When used together, the efficacy of this medicine may be reduced.
Contraindications
In spite of the fact that Linagliptin experiences negligible renal excretion, Metformin Hydrochloride is known to be considerably excreted by the kidney. The chance of Metformin Hydrochloride collection and lactic acidosis increments with the degree of renal disability. Subsequently, this combination is contraindicated in patients with renal disability. It is additionally contraindicated in intense or inveterate metabolic acidosis (diabetic ketoacidosis) and in extreme touchiness to Linagliptin or Metformin Hydrochloride.
Side Effect
Nasopharyngitis and diarrhea are the most common side effects. Patients taking this combination and sulfonylureas are more likely to experience hypoglycemia.
Pregnancy & Lactation
Because there are no adequate and well-controlled studies in pregnant women with this combination or its individual components, it should only be used if clearly needed during pregnancy. When given to a lactating mother, extreme caution should be exercised.
Precautions & Warnings
In a understanding with lactic acidosis who is taking Metformin, the medicate ought to be suspended quickly and strong treatment instantly organizations. There have been postmarketing reports of intense pancreatitis. In case pancreatitis is suspected, expeditiously suspend Linagliptin & Metformin. Incidentally suspend Linagliptin & Metformin in patients experiencing radiologic ponders with intravascular organization of iodinated differentiate materials or any surgical strategies requiring limited admissions of nourishment and liquids. Metformin may lower Vitamin B12 levels; so hematologic parameters shoud be checked yearly.
Therapeutic Class
Oral hypoglycemic preparations in combination
Storage Conditions
Protect from light and moisture by storing below 30°C. Keep the medicine out of children’s reach.
