Carlina M 2.5/850 Tablet 1 Strip

✔️ Side Effects:

• Diarrhoea or loose stools
• Nausea, vomiting, or mild stomach discomfort
• Loss of appetite or a metallic taste in the mouth
• Stuffy or runny nose and sore throat

✔️ Interaction

• Insulin or sulfonylureas (like glimepiride): Combining these with Linagliptin+metformin can increase your risk of low blood sugar (hypoglycaemia). Your doctor may need to adjust your doses.
• Corticosteroids (like prednisone): These medications can raise your blood sugar levels, making Linagliptin+metformin less effective.
• Diuretics (water pills): Certain diuretics can affect your kidney function or increase blood sugar levels, requiring closer monitoring.
• Carbonic anhydrase inhibitors (like topiramate): These can increase the risk of lactic acidosis when taken with this medication.

✔️ Warnings:

• Be aware of early symptoms like unusual muscle pain, trouble breathing, deep/rapid breathing, extreme fatigue, or a sudden slow heartbeat, and seek emergency care if they occur.
• Your doctor should perform blood tests to check your kidney function before you start taking Linagliptin+metformin and at least once a year while you are on it.
• If you need an X-ray or CT scan involving contrast dye, inform your doctor; you will likely need to temporarily stop taking this medication to protect your kidneys.
• Although Linagliptin+metformin alone rarely causes low blood sugar, it can happen when combined with other diabetes drugs. Keep a fast-acting source of sugar, like glucose tablets or fruit juice, nearby in case you feel shaky, sweaty, or dizzy.
• Tell your doctor promptly if you develop severe, persistent joint pain or notice any painful blisters on your skin.

✔️ Dosage & Administration

Carlina-M 850 is indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus when treatment with both linagliptin and metformin is appropriate.

Immediate-release tablets:

• Patients not currently taking metformin: Initial dose is 2.5 mg/500 mg twice daily.
• Patients already taking metformin: The initial dose should be based on the patient's current metformin dose. For example, a patient taking metformin 1000 mg twice daily may be started on 2.5 mg/1000 mg twice daily.
• The maximum recommended dose is 2.5 mg/1000 mg twice daily.

Extended-release tablets:

• Dose should be individualized according to effectiveness and tolerability.
• The maximum recommended total daily dose is 5 mg linagliptin/2000 mg metformin.
• Patients not currently taking metformin may be started on 5 mg/1000 mg once daily.
• Patients already taking metformin should receive 5 mg linagliptin daily with a similar total daily metformin dose.
• When switching from immediate-release linagliptin/metformin, use 5 mg linagliptin daily with an equivalent total daily metformin dose.

Hepatic impairment: Use is not recommended because of the increased risk of lactic acidosis.

Child Dose

Safety and effectiveness in patients under 18 years have not been established.

Renal Dose

• Assess eGFR before starting treatment.
• eGFR <30 mL/min/1.73 m²: Contraindicated; discontinue if it falls below this level during treatment.
• eGFR 30–45 mL/min/1.73 m²: Initiation of treatment is not recommended.
• If eGFR falls below 45 mL/min/1.73 m² during treatment, reassess the benefits and risks of continuing therapy.
• Monitor eGFR at least annually, or more frequently in patients at increased risk of renal impairment, such as elderly patients.

✔️ Storage Condition

Store in a cool and dry place away from sunlight