Linadus M XR 5/1000mg Tablet 1 Strip

✔️ Composition

Linagliptin + Metformin Hydrochloride

✔️ Mechanism of Action

Metformin: Lowers glucose production in the liver, slows intestinal absorption of glucose, and enhances insulin sensitivity.

Linagliptin: A DPP-4 inhibitor that prolongs incretin activity, enhancing insulin secretion and decreasing glucagon levels in a glucose-dependent manner.

Together, they target both fasting and postprandial glucose levels for better blood sugar control.

✔️ Dosage & Administration

Adults (Extended-Release Tablets):

Individualized dosing based on current therapy and tolerability.

Maximum: Linagliptin 5 mg + Metformin 2000 mg per day.

It should be taken with meals to minimize gastrointestinal side effects.

Missed Dose: Take as soon as remembered. If it’s close to the next dose, skip the missed one. Do not double-dose.

✔️ Renal Dose Adjustment

eGFR <30 mL/min/1.73 m²: Contraindicated

eGFR 30–45: Do not initiate; reassess if already on therapy

Monitor renal function before starting and periodically thereafter.

✔️ Storage ConditionContraindications

• Known hypersensitivity to components
• Type 1 diabetes or diabetic ketoacidosis
• Severe renal or hepatic impairment
• Acute conditions that may affect kidney function (e.g., dehydration, sepsis)
• Excessive alcohol use
• Pregnancy and lactation (use only if clearly needed)

✔️ Side Effects

Very common (>10%): Hypoglycemia (with sulfonylureas)

Common (1–10%): Diarrhea, nasopharyngitis, headache, nausea

Others (Frequency not defined): Pancreatitis, allergic reactions, decreased appetite, vomiting, pruritus, cough

✔️ Drug Interactions

Linagliptin: Affected by CYP3A4 and P-gp modulators (e.g., ritonavir, rifampicin).

Metformin: Increased lactic acidosis risk with alcohol, iodinated contrast agents, and cationic drugs (e.g., cimetidine). Monitor renal function closely.

✔️ Precautions & Warnings

Monitor for signs of lactic acidosis, pancreatitis, or hypoglycemia.

• Temporarily discontinue before contrast imaging or surgery.
• Caution in the elderly, the renally impaired, or those with heart failure.
• In breastfeeding, metformin appears in breast milk; linagliptin data are lacking—assess risk-benefit.

✔️ Storage:

Keep in a cool & dry place (below 30°C), protected from light & moisture. Keep out of the reach of children.