Tab. Lijenta M 850 mg

Indication:
Indicated for the management of type 2 diabetes mellitus in adults, as an adjunct to diet and exercise to improve glycemic control when monotherapy with linagliptin or metformin is insufficient.

Pharmacology, Dosage & Administration:
Linagliptin is a dipeptidyl peptidase-4 (DPP-4) inhibitor that increases incretin levels, enhancing insulin secretion and reducing glucagon levels.
Metformin decreases hepatic glucose production, improves insulin sensitivity, and reduces intestinal glucose absorption.
Usual dosage: 1 tablet twice daily with meals to minimize gastrointestinal side effects. Dosage should be individualized based on patient needs and tolerance.

Interaction:
Metformin: Caution with drugs that impair renal function (e.g., contrast agents, NSAIDs).
Linagliptin: May interact with rifampin (reduces efficacy) and other strong CYP3A4 inducers.

Contraindications:
Severe renal impairment (eGFR <30 mL/min/1.73 m²)
Metabolic acidosis (including diabetic ketoacidosis)
Known hypersensitivity to linagliptin, metformin, or any excipients.

Side Effects:
Common: Nausea, diarrhea, abdominal discomfort, headache
Rare: Risk of lactic acidosis (metformin) and hypoglycemia when combined with insulin or sulfonylureas.
Pregnancy & Lactation:

Should be used during pregnancy only if clearly needed.
Caution is advised during lactation, as both linagliptin and metformin may be excreted in breast milk.

Precautions & Warnings:
Monitor renal function regularly.
Discontinue temporarily in patients undergoing radiologic studies with contrast materials.
Caution in patients with heart failure, hepatic impairment, or a history of pancreatitis.

Overdose Effects:
Metformin overdose may lead to lactic acidosis (life-threatening).
Linagliptin overdose is generally well-tolerated but may require supportive care.
Therapeutic Class:

Dipeptidyl Peptidase-4 (DPP-4) Inhibitor and Biguanide Antidiabetic Combination
Storage Conditions:

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