Lijenta-M 500mg 10pcs

Indications

Lijenta-M 500 is a combination of two medications that helps people with type 2 diabetes mellitus manage their high blood sugar levels. This lessens your risk of developing serious diabetes complications like kidney damage and blindness and lowers your risk of a heart attack or stroke. It is possible to prescribe Lijenta-M 500 alone or in combination with other diabetes drugs.

Pharmacology

The incretin hormones GLP-1 (glucagon-like peptide-1) and GIP are degraded by the enzyme DPP-4, which is inhibited by linagliptin (glucose-dependent insulinotropic polypeptide). By stimulating the release of insulin from pancreatic beta () cells in a glucose-dependent manner and inhibiting the release of glucagon from pancreatic alpha () cells into circulation, linagliptin raises the concentrations of active incretin hormones.

A biguanide-type oral antihyperglycemic medication called metformin hydrochloride is used to treat type 2 diabetes. It lowers plasma glucose at rest and after eating. It does not cause hypoglycemia and has a different mechanism of action from sulfonylureas. By increasing peripheral glucose uptake and utilization, metformin hydrochloride reduces hepatic glucose production, intestinal glucose absorption, and insulin sensitivity.

Dosage & Administration

Depending on the effectiveness and tolerability of the medication, the dosage of Linagliptin & Metformin immediate-release tablets should be customized. Linagliptin 2.5 mg at a maximum recommended dose of 1000 mg of metformin hydrochloride taken twice daily with meals. To minimize the gastrointestinal (GI) side effects related to the use of metformin hydrochloride, dose escalation should be gradual.

Starting with 500 mg of Metformin Hydrochloride and 2.5 mg of Linagliptin twice daily is advised for patients who are not currently receiving Metformin Hydrochloride treatment.

Start with 2.5 mg of Linagliptin and the usual dosage of Metformin Hydrochloride twice daily in patients who are already receiving this medication.

Individual components may be switched to this combination, which contains the same doses of each component, for patients already receiving treatment with Linagliptin and Metformin Hydrochloride.

Interactions

Cationic drugs (amiloride, digoxin, morphine, ranitidine, trimethoprim, etc.): May reduce metformin elimination.

P-glycoprotein/CYP3A4 inducer (i.e. rifampin): The efficacy of this medicine may be reduced when administered in combination.

Contraindications

Linagliptin has a very low renal excretion rate, whereas metformin hydrochloride is known to have a high renal excretion rate. With the severity of renal impairment, the risk of Metformin Hydrochloride accumulation and lactic acidosis rises. Therefore, patients with renal impairment should not take this combination. Acute or chronic metabolic acidosis (diabetic ketoacidosis) and hypersensitivity to linagliptin or metformin hydrochloride are also contraindications.

Side-Effects

The most common side effects are nasopharyngitis and diarrhea. Hypoglycemia is more common in patients treated with this combination and sulfonylureas.

Pregnancy & Lactation

There are no adequate and well-controlled studies in pregnant women with this combination or its individual component; so, it should be used during pregnancy only if clearly needed. Caution should also be exercised when it is administered to a lactating mother.

Precautions

• When a patient with lactic acidosis is taking metformin, the medication should be stopped right away, and supportive therapy should be started right away. 
• Acute pancreatitis has been reported post-marketing. Linagliptin and Metformin should be immediately discontinued if pancreatitis is suspected.
•  Linagliptin and Metformin should be temporarily stopped in patients undergoing radiologic procedures requiring intravascular administration of iodinated contrast materials or any surgical procedures requiring restricted dietary intake. 
• Hematologic parameters should be checked yearly because metformin has been shown to lower Vitamin B12 levels.

Storage Conditions

Keep in a cool & dry place (below 30?C), protected from light & moisture. Keep out of the reach of children.