Linagliptin/ Metformin

Tablet:

• 5mg/500mg
• 5mg/850mg
• 5mg/1000mg

• To be taken with a meal
• Treatment should be held for surgery if restricting food/fluid
• Discontinue for iodinated contrast study if eGFR 30-60, in hepatic disease history,in alcoholism history, in heart failure history or if receiving contrast intra-arterially
• Restart after 48 hours if stable renal function

Linagliptin: Dipeptidyl peptidase 4 (DPP-4) inhibitor; It inhibits dipeptidyl peptidase-4, slowing incretin metabolism, increasing insulin synthesis/release thereby decreasing glucagon levels

Metformin: Biguanide; It delays the absorption of glucose from the GI tract and increase insulin sensitivity in the muscle thereby improving peripheral glucose uptake and utilization in cells

• Nasopharyngitis
• Diarrhea
• Nausea
• Vomiting
• Flatulence
• Asthenia
• Hypoglycemia
• Indigestion
• Vitamin B12 deficiency
• Abdominal discomfort
• Headache
• Myalgia
• Hyperuricemia
• Hyperlipasemia
• Anorexia
• Metallic taste
• Rash
• Ovulation induction

• Hypersensitivity to class/components
• eGFR <30
• eGFR 30-45 at treatment initiation
• Type 1 DM
• Metabolic acidosis
• Diabetic ketoacidosis
• Lactic acidosis
• Hypoxemia
• Dehydration
• Sepsis
• Surgery
• Hepatic disease

WARNING:

Lactic acidosis: post-marketing cases of hypothermia, hypotension, resistant bradyarrhythmias and death reported. If suspected, discontinue and hospitalize the patient immediately

None restricted