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linagliptin metformin

Descriptions

Linagliptin and metformin combination is used to treat high blood sugar levels caused by type 2 diabetes. Linagliptin helps to control blood sugar levels by increasing substances in the body that make the pancreas release more insulin. It also signals the liver to stop producing sugar (glucose) when there is too much sugar in the blood. Metformin reduces the absorption of sugar from the stomach, reduces the release of stored sugar from the liver, and helps your body use sugar better. This medicine does not help patients who have insulin-dependent or type 1 diabetes.

Mechanism of Action

Linagliptin and metformin exert their glucose-lowering effects through complementary mechanisms. Linagliptin inhibits the DPP-4 enzyme, thus prolonging the half-life of the intestinal incretins, GLP-1 and gastric inhibitory polypeptide. This results in enhanced glucose-dependent insulin secretion and decreased glucagon production, leading to an overall improvement in glucose homeostasis both in the fasting and post-prandial state.14 In addition, preclinical data have shown that linagliptin, via its incretin-enhancing effects, can slow disease progression by preserving pancreatic β-cell mass and function.

Interactions

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.

Beta-blocker medications (such as metoprolol, propranolol, glaucoma eye drops such as timolol) may prevent the fast/pounding heartbeat you would usually feel when your blood sugar falls too low (hypoglycemia). Other symptoms of low blood sugar, such as dizziness, hunger, or sweating, are unaffected by these drugs.

Warnings

This drug has a black box warning. This is the most serious warning from the Food and Drug Administration (FDA). A black box warning alerts doctors and patients about drug effects that may be dangerous.

Metformin, one of the medications in this combination drug, can cause a rare but serious condition. It’s called lactic acidosis (a buildup of lactic acid in the blood). If not treated, it can lead to death. The risk of lactic acidosis from metformin use is highest in people with severe kidney disease, so don’t take this drug if you have this condition. Your risk is also increased with factors such as dehydration (not drinking enough water), surgery, and having too many drinks that contain alcohol. These factors also include liver problems and certain types of heart disease, such as congestive heart failure that gets abruptly worse.

Precaution

Before using this medication, tell your doctor or pharmacist your medical history, especially of: kidney disease, severe breathing problems (such as obstructive lung disease, severe asthma), liver disease, a disease of the pancreas (pancreatitis), stones in your gallbladder (gallstones).

Before having surgery or any X-ray/scanning procedure using iodinated contrast, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products). You may need to stop this medication for a short time for the surgery/procedure. Ask your doctor or dentist for instructions before your surgery/procedure.

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