Formet L 2.5mg+500mg Tablet | 1 Strip

✔️ Dosage & Administration

Dosage should be individualized based on patient response and tolerability.

Immediate-release tablet:

• Usual maximum dose: 2.5 mg Linagliptin + 1000 mg Metformin HCl twice daily with meals.
• Starting dose: 2.5 mg Linagliptin + 500 mg Metformin HCl twice daily, with gradual dose escalation to minimize GI side effects.
• Patients already on either drug can switch to an equivalent combination dose.

Extended-release tablet:

• Usual maximum dose: 5 mg Linagliptin + 2000 mg Metformin HCl once daily with a meal.
• For those previously on Metformin alone, start with 5 mg Linagliptin + 1000 mg Metformin HCl once daily.
• Patients on the immediate-release form may switch to an equivalent extended-release dose.
• Tablets containing 2.5 mg Linagliptin + 1000 mg Metformin HCl XR should be taken two tablets together once daily.

✔️ Overdose Effects

Supportive management is recommended. Linagliptin is unlikely to be removed by dialysis, but Metformin can be dialyzed. Metformin overdose may cause lactic acidosis; immediate medical attention is required.

✔️ Side Effects

Common adverse effects include nasopharyngitis and diarrhea. Hypoglycemia may occur, especially when used with sulfonylureas.

✔️ Interaction

• Cationic drugs (e.g., amiloride, digoxin, morphine, quinidine, ranitidine, vancomycin) may compete for renal tubular secretion with Metformin; monitor closely.
• Carbonic anhydrase inhibitors (e.g., topiramate, acetazolamide) may increase risk of metabolic acidosis; use cautiously.
• Strong P-gp/CYP3A4 inducers (e.g., rifampin) may reduce Linagliptin levels; alternative therapy is recommended.
• Hyperglycemia-inducing drugs (e.g., corticosteroids, diuretics, oral contraceptives, phenytoin, calcium channel blockers) may impair glucose control; close monitoring is advised.

✔️ Contraindications

• Formet L is contraindicated in patients with:
• Renal impairment
• Acute or chronic metabolic acidosis (including diabetic ketoacidosis)
• Known hypersensitivity to Linagliptin or Metformin

✔️ Pregnancy & Lactation

Use only if clearly needed, as adequate human studies are lacking. Caution should be exercised during lactation.

✔️ Precautions & Warnings

• Discontinue immediately if lactic acidosis or pancreatitis is suspected.
• Temporarily stop use before surgery or radiologic procedures involving iodinated contrast agents.
• Monitor vitamin B12 levels during long-term therapy.
• Advise patients about symptoms of hypoglycemia and lactic acidosis (fatigue, muscle pain, rapid breathing, abdominal discomfort).
• Use caution when consuming alcohol or engaging in prolonged exercise without adequate food intake.
• Patients should carry medical identification indicating their diabetic status and therapy.

✔️ Storage:

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