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empagliflozin and linagliptin

Generic Name: empagliflozin and linagliptin (EM pa gli FLOE zin and LIN a GLIP tin)
Brand Name: Glyxambi

What is empagliflozin and linagliptin?

Empagliflozin and linagliptin are oral diabetes medicines that help control blood sugar levels. Empagliflozin works by helping the kidneys get rid of glucose from your bloodstream. Linagliptin works by regulating the levels of insulin your body produces after eating.

Empagliflozin and linagliptin is a combination medicine used together with diet and exercise to treat type 2 diabetes. This medicine is not for treating type 1 diabetes.

Empagliflozin and linagliptin may also be used for purposes not listed in this medication guide.

What is the most important information I should know about empagliflozin and linagliptin?

You should not use this medicine if you have severe kidney disease (or if you are on dialysis), if you have ever had a severe allergic reaction to empagliflozin or linagliptin, or if you are in a state of diabetic ketoacidosis.

Call your doctor at once if you have signs of a serious side effect, such as severe pain in your upper stomach spreading to your back, vomiting, fast heart rate, dizziness, feeling very thirsty or hot, decreased urination, heavy sweating, or hot and dry skin.

What should I discuss with my healthcare provider before taking empagliflozin and linagliptin?

You should not use empagliflozin and linagliptin if you are allergic to it, or if you have:

  • severe kidney disease (or if you are on dialysis);

  • a history of severe allergic or skin reaction after taking linagliptin; or

  • if you are in a state of diabetic ketoacidosis (call your doctor for treatment with insulin).

To make sure empagliflozin and linagliptin is safe for you, tell your doctor if you have:

  • kidney disease;

  • liver disease;

  • a pancreas disorder;

  • low blood pressure;

  • gallstones;

  • high cholesterol or triglycerides (a type of fat in the blood);

  • a history of alcoholism;

  • a history of genital infection (penis or vagina);

  • if you are on a low salt diet; or

  • if you are 65 or older.

It is not known whether this medicine will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.

It is not known whether empagliflozin and linagliptin passes into breast milk or if it could harm a nursing baby. Tell your doctor if you are breast-feeding a baby.

How should I take empagliflozin and linagliptin?

Follow all directions on your prescription label. Your doctor may occasionally change your dose to make sure you get the best results. Do not use this medicine in larger or smaller amounts or for longer than recommended.

Empagliflozin and linagliptin is usually taken in the morning. You may take this medicine with or without food.

Your blood sugar will need to be checked often, and you may also need to test the level of ketones your urine. Empagliflozin can cause life-threatening ketoacidosis (too much acid in the blood). Even if your blood sugar is normal, contact your doctor if a urine test shows that you have ketones in the urine.

Low blood sugar (hypoglycemia) can happen to everyone who has diabetes. Symptoms include headache, hunger, sweating, irritability, dizziness, nausea, fast heart rate, and feeling anxious or shaky. To quickly treat low blood sugar, always keep a fast-acting source of sugar with you such as fruit juice, hard candy, crackers, raisins, or non-diet soda.

Your doctor can prescribe a glucagon emergency injection kit to use in case you have severe hypoglycemia and cannot eat or drink. Be sure your family and close friends know how to give you this injection in an emergency.

Also watch for signs of high blood sugar (hyperglycemia) such as increased thirst or urination, blurred vision, headache, and tiredness.

Blood sugar levels can be affected by stress, illness, surgery, exercise, alcohol use, or skipping meals. Ask your doctor before changing your dose or medication schedule.

This medicine can cause unusual results with certain lab tests for glucose (sugar) in the urine. Tell any doctor who treats you that you are using empagliflozin and linagliptin.

Store at room temperature away from moisture and heat.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An empagliflozin and linagliptin overdose can cause life threatening hypoglycemia.

Symptoms of severe hypoglycemia include extreme weakness, confusion, tremors, sweating, fast heart rate, trouble speaking, nausea, vomiting, rapid breathing, fainting, and seizure (convulsions).

What should I avoid while taking empagliflozin and linagliptin?

Avoid getting up too fast from a sitting or lying position, or you may feel dizzy. Get up slowly and steady yourself to prevent a fall.

Empagliflozin and linagliptin side effects

Get emergency medical help if you have signs of an allergic reaction: hives, itching, flaking or peeling skin; trouble swallowing, difficult breathing; swelling of your face, lips, tongue, or throat.

Stop taking this medicine and call your doctor at once if you have:

  • severe or ongoing pain in your joints;

  • a light-headed feeling, like you might pass out;

  • ketoacidosis (too much acid in the blood)--nausea, vomiting, stomach pain, confusion, unusual drowsiness, or trouble breathing;

  • pancreatitis--severe pain in your upper stomach spreading to your back, nausea and vomiting, fast heart rate;

  • dehydration symptoms--feeling very thirsty or hot, being unable to urinate, heavy sweating, or hot and dry skin;

  • signs of a bladder infection--pain or burning when you urinate, urine that looks cloudy, pain in pelvis or back; or

  • signs of a genital infection (penis or vagina)--pain, burning, itching, rash, redness, odor, or discharge.

Common side effects may include:

  • urination problems;

  • sinus pain; or

  • cold symptoms such as stuffy nose, sneezing, sore throat.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Empagliflozin and linagliptin dosing information

Usual Adult Dose for Diabetes Type 2:

Initial dose: Empagliflozin 10 mg-linagliptin 5 mg orally once daily in the morning
-May increase to empagliflozin 25 mg-linagliptin 5 mg orally once daily if the lower dose is tolerated
Maximum dose: Empagliflozin 25 mg-linagliptin 5 mg once daily

Comments: When used in combination with insulin or insulin secretagogues, a lower dose of the insulin secretagogues or insulin may be necessary to reduce the risk of hypoglycemia.

Use: As an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus when treatment with both empagliflozin and linagliptin is appropriate.

What other drugs will affect empagliflozin and linagliptin?

Other drugs may increase or decrease the effects of empagliflozin and linagliptin on lowering your blood sugar. Tell your doctor about all your current medicines and any you start or stop using, especially:

  • other oral diabetes medicine;

  • insulin;

  • rifampin (to treat tuberculosis); or

  • heart or blood pressure medication, including a diuretic or "water pill."

This list is not complete. Other drugs may interact with empagliflozin and linagliptin, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

Where can I get more information?

  • Your pharmacist can provide more information about empagliflozin and linagliptin.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 1.05.

Date modified: October 14, 2016
Last reviewed: September 06, 2016