Linax Plus 2.5/500 Tablet 1 Strip

✔️ Dosage & Administration

The dose should be individualized based on efficacy and tolerability. The maximum recommended daily dose is linagliptin 5 mg and metformin 2000 mg, preferably taken with meals.

Immediate-release tablets:

• Starting dose (new patients): 2.5 mg linagliptin + 500 mg metformin twice daily with meals
• Patients already on metformin: continue metformin dose with 2.5 mg linagliptin twice daily
• Switching from individual components: use equivalent combined doses

Extended-release tablets (once daily):

• Recommended dose: 5 mg linagliptin + 1000 mg metformin once daily with food
• Dose may be adjusted but should not exceed 5 mg/2000 mg per day
• Tablets should be taken whole with a meal

✔️ Linax Plus is contraindicated in:

• Severe renal impairment
• Diabetic ketoacidosis or other metabolic acidosis
• Hypersensitivity to linagliptin or metformin

Metformin accumulation increases risk of lactic acidosis in renal dysfunction.

✔️ Drug Interactions

• Cationic drugs (e.g., digoxin, morphine, quinidine, ranitidine): may compete with metformin for renal elimination; monitoring is advised.
• Carbonic anhydrase inhibitors (e.g., topiramate, acetazolamide): may increase risk of metabolic acidosis.
• P-gp/CYP3A4 inducers (e.g., rifampin): may reduce linagliptin effectiveness.
• Drugs affecting glucose levels (e.g., corticosteroids, diuretics, thyroid hormones): may reduce glycemic control or increase risk of hypoglycemia when withdrawn.

✔️ Side Effects

• Nasopharyngitis
• Diarrhea
• Hypoglycemia (especially when combined with sulfonylureas)

✔️ Pregnancy & Lactation

Safety data in pregnancy is limited; use only if clearly necessary. Caution is advised during breastfeeding.

✔️ Precautions & Warnings

• Risk of lactic acidosis with metformin, especially in renal impairment or severe illness
• Possible acute pancreatitis; discontinue if suspected
• Temporarily stop before contrast imaging or surgery
• Long-term metformin use may reduce vitamin B12 levels (monitor periodically)

Symptoms of lactic acidosis include abdominal discomfort, muscle pain, rapid breathing, weakness, and unusual fatigue. Immediate medical attention is required if these occur.

✔️ Storage:

Store in a cool, dry place below 30°C, protected from light and moisture. Keep out of reach of children.