Limpa 5/25mg Tablet

✔️ Key adverse reactions include:

Serious Conditions:

• Pancreatitis.
• Diabetic ketoacidosis.
• Necrotizing fasciitis of the perineum (Fournier’s gangrene).
• Heart failure.

Infections:

• Urosepsis and pyelonephritis.
• Genital fungal infections.

Other Reactions:

• Hypoglycemia (with insulin or secretagogues).
• Volume depletion (symptomatic hypotension, transient increases in creatinine).
• Hypersensitivity reactions (e.g., rash, itching, urticaria).
• Severe joint pain.
• Bullous pemphigoid.

✔️ Dosage and Administration of Limpa 5/25mg Tablet

Standard Dose:

• 10 mg of Empagliflozin and 5 mg of Linagliptin once daily, taken in the morning, with or without food.

Increased Dose:

• May be increased to 25 mg of Empagliflozin and 5 mg of Linagliptin once daily.

Renal Impairment:

• Assess kidney function before initiation. Do not start therapy if the estimated glomerular filtration rate (eGFR) is below 45 mL/min/1.73 m². Discontinue use if eGFR drops below this threshold.

✔️ In case of overdose: Limpa 5/25mg Tablet

1. Immediate Action: Contact a poison control center and provide supportive care.
2. Removal of Drug: Gastrointestinal decontamination may be considered.
3. Dialysis: Empagliflozin removal via hemodialysis is unstudied, while Linagliptin is unlikely to be removed significantly by hemodialysis or peritoneal dialysis.

✔️ Interactions

• Diuretics: Co-administration may increase urine output and the risk of volume depletion.
• Insulin or Insulin Secretagogues: Combining with these medications may elevate the risk of hypoglycemia.
• P-glycoprotein (P-gp) or CYP3A4 Inducers: Strong inducers, such as Rifampin, can decrease Linagliptin levels, potentially reducing its effectiveness.
• Urine Glucose Test: SGLT2 inhibitors cause increased urinary glucose excretion, potentially resulting in positive glucose test results.
• 1,5-anhydroglucitol (1,5-AG) Assay: Measurements for glycemic control may be unreliable in patients using SGLT2 inhibitors.

✔️ Contraindications

• Severe renal impairment, end-stage kidney disease, or dialysis.
• History of hypersensitivity to Linagliptin or Empagliflozin (e.g., anaphylaxis, angioedema, severe skin reactions, or bronchial hyperreactivity).

✔️ Pregnancy and Lactation

• Pregnancy: Use during the second and third trimesters is not recommended due to insufficient data. Poorly controlled diabetes during pregnancy poses risks to both mother and fetus.
• Lactation: Insufficient information is available, so caution is advised.

✔️ Precautions and Warnings

• Pancreatitis: Acute and sometimes fatal cases have been reported.
• Ketoacidosis: Serious and life-threatening cases requiring hospitalization have occurred, especially in patients with type 1 or type 2 diabetes.
• Volume Depletion: Can cause hypotension or transient changes in renal function.
• Urinary Tract Infections: Increased risk of severe infections, including urosepsis and pyelonephritis.
• Hypoglycemia: Especially when used with insulin or insulin secretagogues.
• Fournier’s Gangrene: Rare but serious necrotizing infection requiring urgent surgical intervention.
• Mycotic Infections: Increased risk of genital fungal infections.

✔️ Storage Conditions

• Store below 30°C, away from light and moisture.
• Keep out of the reach of children.