Linaglip-M 5/1000 ER Tablet (4pcs)

✔️ Uses of Linaglip-M 5/1000 ER Tablet

• Treatment of Type 2 Diabetes Mellitus

✔️ How does Linaglip-M 5/1000 ER Tablet work?

Linaglip-M 5/1000 ER Tablet contains two diabetes medications: metformin and linagliptin. Metformin is a kind of diabetes drug known as a biguanide. It acts by decreasing glucose synthesis in the liver, slowing glucose absorption from the intestines, and boosting insulin sensitivity. Linagliptin is a DPP-4 inhibitor that acts by enhancing pancreatic insulin release while reducing blood sugar-raising chemicals. This lowers fasting and postmeal sugar levels. They work together to improve blood sugar management.

✔️ Side effects of Linaglip-M 5/1000 ER Tablet

• Diarrhea
• Nausea
• Vomiting
• Upset stomach
• Headache
• Nasal congestion (stuffy nose)
• Sore throat
• Respiratory tract infection
• Hypoglycaemia (low blood sugar level) in combination with insulin or sulphonylurea

✔️ Quick Suggestions:

• You have been prescribed this combination medicine as it can control blood sugar better than metformin alone.
• Linaglip-M 5/1000 ER Tablet should be taken with food to lower the chances of having an upset stomach.
• Take it in addition to regular exercise and a healthy diet to lower the levels of blood sugar.
• Chances of weight gain and low blood sugar are lesser as compared to other diabetes medicines.
• Hypoglycemia (low blood sugar level) may occur when taken along with other antidiabetic medicines, alcohol, or by delaying/skipping a meal. Carry a sugar source with you for immediate relief.
• Monitor your blood sugar level regularly while you are taking this medicine.
• Inform your doctor about your diabetes treatment if you are due to have any surgery under a general anesthetic.
• Tell your doctor immediately if you experience any deep or rapid breathing, persistent nausea, vomiting, or stomach pain as  Linaglip-M 5/1000 ER Tablet may cause a rare but serious condition called lactic acidosis, which is an excess of lactic acid in the blood.

✔️ Indication of Linaglip-M 5/1000 ER Tablet

Linaglip-M is a medication used to help manage blood sugar levels in adults with type 2 diabetes when both linagliptin and metformin are deemed necessary. It should be taken alongside a healthy diet and exercise routine. However, this medication should not be used to treat type 1 diabetes or diabetic ketoacidosis. Additionally, it has not been studied in patients with a history of pancreatitis, and caution should be taken if prescribed to patients with this medical history. It is important to follow your healthcare provider's instructions and guidelines when taking this medication.

✔️ Pharmacology

Linaglip-M is a combination of two drugs used to treat type 2 diabetes mellitus. The two drugs, Linagliptin and Metformin, work together to improve glycemic control in patients.

Linagliptin is a DPP-4 inhibitor that blocks the degradation of incretin hormones, GLP-1 and GIP. By doing so, it increases insulin release in a glucose-dependent manner and reduces glucagon levels, leading to better glucose homeostasis.

Metformin, on the other hand, reduces both basal and postprandial glucose levels. It achieves this by several mechanisms such as decreasing hepatic glucose production, improving peripheral glucose uptake, delaying intestinal glucose absorption, and increasing intracellular glycogen synthesis.

This combination of medications offers complementary mechanisms of action to effectively lower blood glucose levels without causing hypoglycemia or weight gain. However, it is important to follow a healthy diet and exercise routine alongside taking the medication to achieve optimal glycemic control. As with any medication, it may not be suitable for everyone, and your doctor will monitor your blood glucose levels and adjust the dose accordingly.

✔️ Dosage & Administration of Linaglip-M 5/1000 ER TabletLinaglip-M 5/1000 ER Tablet

• The recommended starting dose for the Linaglip-M tablets depends on whether the patient is currently being treated with Metformin or Linagliptin. For the 2.5/500 and 2.5/850 mg tablets, patients not currently treated with Metformin should start with Linaglip-M 2.5/500 tablet twice daily, while patients already on Metformin should be given Linaglip-M 2.5/500 or 2.5/850 tablet twice daily depending on their current Metformin dose.
• For the 5/1000 mg ER tablet, patients not currently treated with Metformin should start with Linaglip-M 5/1000 ER tablet once daily with a meal, while patients already on Metformin or Linagliptin and Metformin may be switched to Linaglip-M 5/1000 ER tablet once daily with a meal containing the same doses of each component.
• The maximum recommended dose for the 2.5/500 and 2.5/850 mg tablets is Linagliptin 2.5 mg/Metformin 1000 mg twice daily.

It is important to take Linaglip-M 5/1000 ER Tablet as directed by your physician. It is recommended to take the medicine after meals and to swallow it whole with a glass of water. Do not crush or chew the tablet. The appropriate dose and duration of therapy will be determined by your doctor based on factors such as your age, body weight, and disease condition. Do not discontinue the medication without consulting with your doctor.

✔️ Interaction

Linagliptin & Metformin can potentially interact with other drugs, and careful monitoring and dose adjustment may be necessary. Cationic drugs that are eliminated by renal tubular secretion may compete with Metformin for the same transport systems, and caution should be exercised when prescribing these drugs with Linagliptin & Metformin. Carbonic anhydrase inhibitors and alcohol can also increase the risk of metabolic acidosis when taken with Linagliptin & Metformin.

Rifampin, a strong P-GP or CYP 3A4 enzyme inducer, can reduce Linagliptin exposure and lower its efficacy, so it is not recommended to take these drugs together. Patients taking insulin secretagogues or insulin with Linagliptin & Metformin may need lower doses of these medications to prevent hypoglycemia.

Certain medications can cause hyperglycemia and affect glycemic control, so patients taking Linagliptin & Metformin should be closely monitored if they are also taking these medications. Similarly, if these medications are discontinued, patients should be monitored for hypoglycemia.

✔️ Contraindications

This combination of Linagliptin and Metformin is not recommended for patients who have a renal impairment (e.g., serum creatinine >1.5 mg/dL for men, >1.4 mg/dL for women, or abnormal creatinine clearance), which can be caused by conditions such as cardiovascular collapse (shock), acute myocardial infarction, and septicemia. This combination is also not recommended if you have acute or chronic metabolic acidosis, such as diabetic ketoacidosis. Insulin should be used to treat diabetic ketoacidosis in the event of a previous history of hypersensitivities to Linagliptin, such as anaphylaxis, angioedema, exfoliative skin conditions, urticaria, or bronchial hyperreactivity. It is also not recommended if you are allergic to Metformin.

✔️ Pregnancy & Lactation

Pregnancy: Linagliptin & Metformin combination is pregnancy Category B. Linagliptin & Metformin combination tablets should be used during pregnancy only if clearly needed. But the limited data on the combination of Linagliptin & Metformin combination extended-release tablet use in pregnant women are not sufficient to inform a Linagliptin & Metformin extended-release combination - associated or Linagliptin-associated risk for major birth defects and miscarriage.

Nursing mothers: There is no information regarding the presence of both Linagliptin & Metformin combination and Linagliptin & Metformin combination extended-release tablet or Linagliptin in human milk, the effects on the breastfed infant, or the effects on milk production.

✔️ Precautions & Warnings

• To prevent lactic acidosis, it is recommended to avoid excessive alcohol consumption and not to use the combination of linagliptin and metformin in patients with hepatic or hypoxic conditions or renal impairment. Renal function should be checked before starting treatment and at least once a year thereafter.
• When using the combination with an insulin secretagogue or insulin, consider reducing the dose to lower the risk of hypoglycemia. Severe hypersensitivity reactions, including anaphylaxis, angioedema, and skin conditions, have been reported in patients treated with linagliptin. In such cases, discontinue the combination, investigate other potential causes, and initiate appropriate monitoring and treatment.
• Metformin has been associated with vitamin B12 deficiency, and hematologic parameters should be monitored annually. DPP-4 inhibitors may cause severe and disabling arthralgia, which should be considered a possible cause of joint pain, and the medication should be discontinued if necessary.
• There is no conclusive evidence that any antidiabetic medication, including the linagliptin and metformin combination, reduces macrovascular risk. If pancreatitis is suspected, the combination should be discontinued immediately.

✔️ Storage Conditions

Store at 25°C and dry place, protect from light. Keep out of the reach of children.