linagliptin and metformin
Generic Name: linagliptin and metformin (LIN a GLIP tin and met FOR min)
Brand Name: Jentadueto, Jentadueto XR
What is linagliptin and metformin?
Linagliptin and metformin are oral diabetes medicines that help control blood sugar levels. Metformin works by decreasing glucose (sugar) production in the liver and decreasing absorption of glucose by the intestines. Linagliptin works by regulating the levels of insulin your body produces after eating.
Linagliptin and metformin is a combination medicine used to treat type 2 diabetes. This medicine is not for treating type 1 diabetes.
Linagliptin and metformin may also be used for purposes not listed in this medication guide.
What is the most important information I should know about linagliptin and metformin?
You should not use this medicine if you have ever had a severe allergic reaction to linagliptin. Do not use this medicine if you have severe kidney disease, or if you are in a state of diabetic ketoacidosis (call your doctor for treatment with insulin).
This medicine may cause a serious condition called lactic acidosis. Get emergency medical help if you have even mild symptoms such as: muscle pain or weakness, numb or cold feeling in your arms and legs, trouble breathing, stomach pain, nausea with vomiting, fast or uneven heart rate, dizziness, or feeling very weak or tired.
What should I discuss with my healthcare provider before taking linagliptin and metformin?
You should not use this medicine if you are allergic to metformin (Actoplus Met, Avandamet, Fortamet, Glucophage, Riomet); or
if you have ever had a severe allergic reaction (breathing problems, swelling, severe skin rash) to linagliptin (Onglyza);
if you have severe kidney disease; or
if you are in a state of diabetic ketoacidosis (call your doctor for treatment with insulin).
Some people taking metformin develop a serious condition called lactic acidosis. This may be more likely if you have liver or kidney disease, congestive heart failure, a severe infection, if you are dehydrated, or if you drink large amounts of alcohol. Talk with your doctor about your risk.
To make sure this medicine is safe for you, tell your doctor if you have:
a serious infection called sepsis;
a history of pancreatitis;
a history of alcoholism;
high triglycerides (a type of fat in the blood);
if you have recently had a heart attack; or
if you are over 80 years old and have not recently had your kidney function checked.
If you need to have surgery or any type of x-ray or CT scan using a dye that is injected into your veins, you will need to temporarily stop taking linagliptin and metformin. Be sure your caregivers know ahead of time that you are using this medication.
This medicine is not expected to harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.
It is not known whether linagliptin and metformin passes into breast milk or if it could harm a nursing baby. You should not breast-feed while you are using this medicine.
This medicine is not approved for use by anyone younger than 18 years old.
How should I take linagliptin and metformin?
Follow all directions on your prescription label. Do not take this medicine in larger or smaller amounts or for longer than recommended. Your blood sugar will need to be checked often, and you may need other blood tests at your doctor's office.
Take linagliptin and metformin twice daily with meals, unless your doctor tells you otherwise.
Low blood sugar (hypoglycemia) can happen to everyone who has diabetes. Symptoms include headache, hunger, sweating, confusion, irritability, dizziness, or feeling shaky. Always keep a source of sugar with you in case you have low blood sugar. Sugar sources include fruit juice, hard candy, crackers, raisins, and non-diet soda. Be sure your family and close friends know how to help you in an emergency.
If you have severe hypoglycemia and cannot eat or drink, use a glucagon injection. Your doctor can prescribe a glucagon emergency injection kit and tell you how to use it.
Also watch for signs of high blood sugar (hyperglycemia) such as increased thirst, increased urination, hunger, dry mouth, fruity breath odor, drowsiness, dry skin, blurred vision, and weight loss.
Check your blood sugar carefully during times of stress, travel, illness, surgery or medical emergency, vigorous exercise, or if you drink alcohol or skip meals. These things can affect your glucose levels and your dose needs may also change. Do not change your medication dose or schedule without your doctor's advice.
Your doctor may have you take extra vitamin B12 while you are taking metformin. Take only the amount of vitamin B12 that your doctor has prescribed.
Linagliptin and metformin is only part of a treatment program that may also include diet, exercise, weight control, regular blood sugar testing, and special medical care. Follow your doctor's instructions very closely.
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 (be sure to take the medicine with food). 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. You may have signs of low blood sugar, such as extreme weakness, blurred vision, sweating, trouble speaking, tremors, stomach pain, confusion, and seizure (convulsions).
What should I avoid while taking linagliptin and metformin?
Avoid drinking alcohol. It lowers blood sugar and may increase your risk of lactic acidosis.
Linagliptin and metformin side effects
Get emergency medical help if you have signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
Stop taking this medicine and call your doctor right away if you have symptoms of pancreatitis: severe pain in your upper stomach spreading to your back, nausea and vomiting, loss of appetite, or fast heartbeats.
Some people develop lactic acidosis while taking metformin. Early symptoms may get worse over time and this condition can be fatal. Get emergency medical help if you have even mild symptoms such as:
muscle pain or weakness;
numb or cold feeling in your arms and legs;
feeling dizzy, light-headed, tired, or very weak;
stomach pain, nausea with vomiting; or
slow or uneven heart rate.
Call your doctor at once if you have:
severe or ongoing pain in your joints;
swelling, rapid weight gain; or
severe skin reaction--fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain, followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling.
Common side effects may include:
cough, sore throat
sinus pain, stuffy nose;
upset stomach, diarrhea; or
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)
Linagliptin and metformin dosing information
Usual Adult Dose for Diabetes Type 2:
Linagliptin-metformin immediate release tablets:
-Initial dose for patients currently not receiving metformin: linagliptin 2.5 mg/metformin 500 mg orally twice a day
-Initial dose for patients currently receiving metformin: linagliptin 2.5 mg in combination with one-half of current metformin dose orally twice a day
-Initial dose for patients currently receiving linagliptin and metformin as individual components: switch to combination product containing the same doses of each component orally twice a day
Maintenance dose: Individualize dose based on safety and efficacy
Maximum dose: linagliptin 5 mg/day; Metformin 2000 mg/day
Linagliptin-metformin extended-release tablets:
-Initial dose for patients currently not receiving metformin: linagliptin 5 mg/metformin extended-release 1000 mg orally once a day
-Initial dose for patients currently receiving metformin: linagliptin 5 mg in combination with a similar total daily dose of metformin orally once a day
-Initial dose for patients currently receiving linagliptin and metformin as individual components: switch to combination product containing similar doses of each component orally once a day
Maintenance dose: Individualize dose based on safety and efficacy
Maximum dose: linagliptin 5 mg/day; Metformin 2000 mg/day; maximum dose should be taken as two linagliptin 2.5 mg/metformin extended-release 1000 mg tablets orally once a day
Comment: When used in combination with insulin or an insulin secretagogue, a lower dose of insulin or the insulin secretagogue may be necessary to reduce the risk of hypoglycemia.
Use: To improve glycemic control in adults with type 2 diabetes mellitus as an adjunct to diet and exercise when treatment with both linagliptin and metformin are appropriate.
What other drugs will affect linagliptin and metformin?
Other drugs may increase or decrease the effects of linagliptin and metformin on lowering your blood sugar. Tell your doctor about all your current medicines and any you start or stop using, especially:
rifampin (to treat tuberculosis); or
insulin or other oral diabetes medicine.
This list is not complete. Other drugs may interact with linagliptin and metformin, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.
More about linagliptin/metformin
Related treatment guides
Where can I get more information?
- Your pharmacist can provide more information about linagliptin and metformin.
- 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: January 10, 2017
Last reviewed: April 19, 2016