Diplin M 2.5mg/850mg Tablet

✔️ Side Effects:

• Diarrhea
• Nausea
• Vomiting
• Stomach discomfort or indigestion
• Headache
• Nasal congestion
• Sore throat
• Nasopharyngitis or upper respiratory tract infection
• Low blood sugar, particularly when used with insulin or sulfonylureas

✔️ If You Miss a Dose

Take the missed dose when you remember, unless it is nearly time for your next scheduled dose. In that case, skip the missed dose and continue with your normal schedule. Do not take two doses at once to make up for a missed tablet.

✔️ Diplin M 850 should not be used in patients with:

• Allergy or hypersensitivity to linagliptin, metformin, or any component of the formulation
• Type 1 diabetes
• Diabetic ketoacidosis or diabetic pre-coma
• Severe renal impairment or renal failure
• Significant hepatic impairment
• Acute alcohol intoxication or severe alcohol misuse
• Certain acute conditions that can significantly affect kidney function, such as severe dehydration, serious infection, or shock
• Conditions associated with reduced tissue oxygenation, such as severe cardiac or respiratory failure or a recent myocardial infarction

Metformin should also generally be withheld around certain procedures involving iodinated intravenous contrast, depending on kidney function and clinical circumstances.

✔️ Use in Children

The safety and effectiveness of linagliptin/metformin combination therapy have not been established in children and adolescents below 18 years of age.

✔️ Adult Dosage

Diplin M 850 is indicated as an adjunct to diet and exercise for adults with type 2 diabetes when treatment with both linagliptin and metformin is appropriate.

For immediate-release linagliptin/metformin formulations, the usual starting regimen may depend on whether the patient is already receiving metformin. The dose should be individualized according to blood glucose control and tolerability and should not exceed the recommended maximum daily dose.

For extended-release formulations, dosing is also individualized based on treatment response and tolerance, with the maximum recommended total daily dose generally limited to 5 mg linagliptin and 2,000 mg metformin.

Because Diplin M 850 is a specific strength and formulation, the exact dose and frequency should be determined according to the product prescribed by the doctor.

✔️ Kidney Impairment

Kidney function should be assessed before starting metformin-containing treatment and monitored periodically during therapy.

• eGFR below 30 mL/min/1.73 m²: Metformin-containing therapy is contraindicated.
• eGFR 30–45 mL/min/1.73 m²: Starting treatment is generally not recommended; continuation should be evaluated individually.
• If kidney function falls substantially during treatment, the doctor should reassess whether therapy should be continued.
• Older adults and people at increased risk of kidney impairment may require more frequent monitoring.

✔️ Liver Impairment

Use in patients with significant hepatic impairment is generally not recommended because impaired liver function may increase the risk of metformin-associated lactic acidosis.

✔️ How Diplin M 850 Works

Diplin M 850 contains linagliptin and metformin, which lower blood glucose through complementary mechanisms.

Metformin reduces glucose production by the liver, decreases glucose absorption from the intestine, and improves the body's response to insulin. It mainly lowers both fasting and after-meal blood glucose levels.

Linagliptin belongs to the DPP-4 inhibitor group. It increases the activity of incretin hormones, which stimulate insulin release when blood glucose is elevated and reduce glucagon secretion. This helps lower blood glucose levels after meals and during fasting.

Together, these medicines provide better glycemic control than either medicine alone when combination therapy is appropriate.

✔️ How to Take Diplin M 850

Take Diplin M 850 exactly as prescribed by your doctor. It should preferably be taken with food to minimize gastrointestinal discomfort. Swallow the tablet whole with water and do not crush, chew, or break it unless specifically instructed by your doctor.

Try to take each dose at approximately the same time every day. Do not stop treatment simply because your blood sugar has improved.

✔️ Diplin M 850 may interact with certain medicines and substances.

Linagliptin:

• Rifampicin may reduce linagliptin exposure and effectiveness.
• Ritonavir may increase linagliptin exposure.
• Linagliptin has a low-potency effect on P-glycoprotein and may affect medicines such as digoxin.
• It may weakly affect CYP3A4-mediated metabolism of certain medicines.

Metformin:

• Alcohol can increase the risk of lactic acidosis, particularly with excessive or acute alcohol consumption.
• Cationic medicines eliminated through the kidneys, such as cimetidine, may increase metformin exposure.
• Iodinated contrast agents administered intravenously may increase the risk of acute kidney problems and lactic acidosis in susceptible patients.

✔️ Pregnancy and Breastfeeding

Pregnant women should consult their doctor before using Diplin M 850. The potential benefits and risks should be evaluated individually.

Metformin can pass into breast milk in small amounts, while the extent to which linagliptin passes into human milk is not fully established. Because of the potential for effects on a breastfed infant, breastfeeding decisions should be discussed with a healthcare professional.

✔️ Use Diplin M 850 cautiously and under medical supervision in patients with:

• Kidney impairment
• Liver disease
• A history or symptoms suggestive of pancreatitis
• Conditions that may increase the risk of lactic acidosis
• Heart or respiratory conditions associated with tissue hypoxia
• Dehydration or severe infection
• A planned surgical procedure
• Concurrent treatment with insulin or sulfonylureas

✔️ Storage:

• Keep Diplin M 850 out of reach of children
• Store Diplin M 850 at room temperature