Generic
Linagliptin + Metformin Hydrochloride
86 brands available in the market
At a glance
Linagliptin + Metformin Hydrochloride is a combination of two medicines that control high blood sugar levels in people with type 2 diabetes mellitus. It reduces glucose production, increases insulin sensitivity, and enhances incretin hormone activity.
Description
Linagliptin + Metformin Hydrochloride is a combination of two antidiabetic medicines: Metformin and Linagliptin. Metformin is a biguanide that lowers glucose production in the liver, delays glucose absorption from the intestines, and increases insulin sensitivity. Linagliptin is a DPP-4 inhibitor that increases insulin release from the pancreas and decreases hormones that raise blood sugar levels.
Indications
- Type 2 diabetes mellitus - as an adjunct to diet and exercise to improve glycemic control
Therapeutic class
Combination Oral Hypoglycemic Preparations
Pharmacological class
DPP-4 Inhibitor + Biguanide
Pharmacology
Linagliptin inhibits the DPP-4 enzyme, increasing incretin hormone (GLP-1 and GIP) levels, which stimulates glucose-dependent insulin release and reduces glucagon secretion. Metformin decreases hepatic glucose production, reduces intestinal glucose absorption, and increases insulin sensitivity.
Mechanism of action
Controls blood sugar by reducing glucose production, increasing insulin sensitivity, and enhancing incretin activity.
Dosage
Immediate Release Tablets:
- Not currently taking metformin: 2.5 mg/500 mg twice daily
- Already taking metformin: 2.5 mg linagliptin with current metformin dose twice daily
- Maximum dose: 2.5 mg/1,000 mg twice daily
Extended Release Tablets:
- Not currently taking metformin: 5 mg/1,000 mg once daily
- Already taking metformin: 5 mg linagliptin + equivalent metformin dose once daily
- Maximum daily dose: Linagliptin 5 mg + Metformin 2,000 mg
Administration
- Swallow tablet whole; do not chew, crush or break
- Take with food (to reduce stomach upset)
- Take at the same time each day
Missed dose
If you miss a dose, take it as soon as you remember. If it's almost time for your next dose, skip the missed dose and go back to your regular schedule. Do not double the dose.
Side effects
Common Side Effects:
- Diarrhea
- Nausea
- Vomiting
- Upset stomach
- Headache
- Nasal congestion
- Sore throat
- Respiratory tract infection
- Hypoglycemia (with insulin or sulfonylurea)
Precautions & warnings
- Inform doctor immediately if symptoms of lactic acidosis occur (deep/rapid breathing, persistent nausea, vomiting, stomach pain)
- Monitor blood sugar regularly to avoid hypoglycemia
- Avoid alcohol (risk of hypoglycemia and lactic acidosis)
- Temporarily stop before major surgery or contrast dye procedures
- Monitor liver and kidney function regularly
Contraindications
- Renal impairment (eGFR <30 mL/min/1.73 m²)
- Acute or chronic metabolic acidosis (including diabetic ketoacidosis)
- Hypersensitivity to Linagliptin or Metformin
Drug interactions
- Cationic drugs (amiloride, digoxin, morphine, quinidine) may compete for renal tubular transport
- Carbonic anhydrase inhibitors (topiramate) increase risk of metabolic acidosis
- Rifampin decreases linagliptin exposure
Food interactions
Alcohol consumption with Linagliptin + Metformin is unsafe.
Use in pregnancy
Use in Pregnancy: Linagliptin + Metformin is generally considered safe during pregnancy (Category B). Animal studies have shown low or no adverse effects to the developing baby.
Pregnancy Category: B — always consult a doctor before taking during pregnancy.
Use in lactation
Use in Lactation: Linagliptin + Metformin is probably safe during breastfeeding. Limited human data suggests no significant risk to the baby.
Pediatric use
Safety and efficacy not established in children under 18 years.
Geriatric use
Elderly patients may require dose adjustment based on renal function (monitor eGFR).
Renal / hepatic impairment
Renal Impairment: eGFR <30: contraindicated; eGFR 30-45: not recommended to initiate; discontinue if eGFR falls below 30 during treatment.
Hepatic Impairment: Caution in liver disease; not recommended in severe liver disease.
Overdose effects
Overdose: supportive measures; Metformin is dialyzable, Linagliptin is not. Lactic acidosis has been reported in metformin overdose.
Storage conditions
Store below 30°C in a cool and dry place, protected from light and moisture; keep out of reach of children.
Chemical structure
Linagliptin + Metformin Hydrochloride