Linagliptin, Metformin HCl
Indications
Linagliptin, Metformin HCl is used for:
LINAGLIPTIN
Linagliptin is used for the management of type 2 diabetes mellitus
METFORMIN
For use as an adjunct to diet and exercise in adult patients (18 years and older) with niddm. May also be used for the management of metabolic and reproductive abnormalities associated with polycystic ovary syndrome (pcos). Jentadueto is for the treatment of patients when both linagliptin and metformin is appropriate
Linagliptin is used for the management of type 2 diabetes mellitus
METFORMIN
For use as an adjunct to diet and exercise in adult patients (18 years and older) with niddm. May also be used for the management of metabolic and reproductive abnormalities associated with polycystic ovary syndrome (pcos). Jentadueto is for the treatment of patients when both linagliptin and metformin is appropriate
Adult Dose
Child Dose
Renal Dose
Administration
Contra Indications
Precautions
Pregnancy-Lactation
Interactions
Adverse Effects
Side effects of Linagliptin, Metformin HCl :
Mechanism of Action
LINAGLIPTIN
Linagliptin is a competitive and reversible dipeptidyl peptidase (dpp)-4 enzyme inhibitor that slows the breakdown of insulinotropic hormone glucagon-like peptide (glp)-1 for better glycemic control in diabetes patients. Glp and glucose-dependent insulinotropic polypeptide (gip) are incretin hormones that increase the production and release of insulin from pancreatic beta cells and decrease the release of glucagon from pancreatic alpha cells. This results in a overall decrease in glucose production in the liver and increase an of insulin in a glucose-dependent manner
METFORMIN
Metformin's mechanisms of action differ from other classes of oral antihyperglycemic agents. Metformin decreases blood glucose levels by decreasing hepatic glucose production, decreasing intestinal absorption of glucose, and improving insulin sensitivity by increasing peripheral glucose uptake and utilization. These effects are mediated by the initial activation by metformin of amp-activated protein kinase (ampk), a liver enzyme that plays an important role in insulin signaling, whole body energy balance, and the metabolism of glucose and fats. Activation of ampk is required for metformin's inhibitory effect on the production of glucose by liver cells. Increased peripheral utilization of glucose may be due to improved insulin binding to insulin receptors. Metformin administration also increases ampk activity in skeletal muscle. Ampk is known to cause glut4 deployment to the plasma membrane, resulting in insulin-independent glucose uptake. The rare side effect, lactic acidosis, is thought to be caused by decreased liver uptake of serum lactate, one of the substrates of gluconeogenesis. In those with healthy renal function, the slight excess is simply cleared. However, those with severe renal impairment may accumulate clinically significant serum lactic acid levels. Other conditions that may precipitate lactic acidosis include severe hepatic disease and acute/decompensated heart failure
Linagliptin is a competitive and reversible dipeptidyl peptidase (dpp)-4 enzyme inhibitor that slows the breakdown of insulinotropic hormone glucagon-like peptide (glp)-1 for better glycemic control in diabetes patients. Glp and glucose-dependent insulinotropic polypeptide (gip) are incretin hormones that increase the production and release of insulin from pancreatic beta cells and decrease the release of glucagon from pancreatic alpha cells. This results in a overall decrease in glucose production in the liver and increase an of insulin in a glucose-dependent manner
METFORMIN
Metformin's mechanisms of action differ from other classes of oral antihyperglycemic agents. Metformin decreases blood glucose levels by decreasing hepatic glucose production, decreasing intestinal absorption of glucose, and improving insulin sensitivity by increasing peripheral glucose uptake and utilization. These effects are mediated by the initial activation by metformin of amp-activated protein kinase (ampk), a liver enzyme that plays an important role in insulin signaling, whole body energy balance, and the metabolism of glucose and fats. Activation of ampk is required for metformin's inhibitory effect on the production of glucose by liver cells. Increased peripheral utilization of glucose may be due to improved insulin binding to insulin receptors. Metformin administration also increases ampk activity in skeletal muscle. Ampk is known to cause glut4 deployment to the plasma membrane, resulting in insulin-independent glucose uptake. The rare side effect, lactic acidosis, is thought to be caused by decreased liver uptake of serum lactate, one of the substrates of gluconeogenesis. In those with healthy renal function, the slight excess is simply cleared. However, those with severe renal impairment may accumulate clinically significant serum lactic acid levels. Other conditions that may precipitate lactic acidosis include severe hepatic disease and acute/decompensated heart failure