Empagliflozin and Linagliptin

Hypoglycaemic excluding Insulin · Dipeptidyl peptidase-4 inhibitor/Reversible inhibitor of sodium-glucose co-transporter 2 (SGLT2)

Indications

As an adjunct to diet and exercise to improve glycaemic control in adults with type 2 DM when treatment with both empagliflozin and linagliptin is appropriate.

Dosage

Adults: 10 mg/5 mg once daily. May be increased to 25 mg/5 mg once daily. Children: Not recommended.

Adverse Effects

UTIs, nasopharyngitis, upper respiratory tract infections.

Risk Factor (Pregnancy/Lactation)

Pregnancy: Contraindicated in pregnancy. Lactation: Contraindicated or not recommended. Contraindications: Type 1 DM. Diabetic ketoacidosis. Severe renal impairment, end-stage renal disease, dialysis, eGFR <45 ml/min/1.73 m2. Precautions: Assess renal function before starting treatment. Discontinue if eGFR goes below 45 mL/min /1.73 m2 during treatment. Hypotension. In patients with volume depletion, correct the condition before starting treatment.

Interactions

Diuretics, insulin or insulin secretagogues. Rifampin.

Advice to Patient

Take with or without meals in the morning. Strictly adhere to dietary instructions, regular physical activity, periodic blood glucose monitoring and HbA1c testing, recognition and management of hypoglycaemia and hyperglycaemia, and assessment of diabetes complications. Inform prescriber if there is any expected surgery. Discontinue medication and inform prescriber if you experience severe abdominal pain, vomiting and nausea, fever, trauma, infections, severe joint pain, blisters/erosions, urinary tract infections, symptoms of heart failure such as increased shortness of breath, rapid increase in weight, or swelling of the feet. Inform prescriber of the allergic reactions such as rash, skin flaking or peeling, urticaria, swelling of the skin/face/lips/tongue/throat.

Pharmacokinetics

EMPAGLIFLOZIN: Metabolism: Hepatic. Half-life elimination: 12.4 hrs. Time to peak: 1.5 hrs. Excretion: Urine (54.4%). Faeces (41.2%). LINAGLIPTIN: Metabolism: A small fraction is absorbed and metabolized to a pharmacologically inactive metabolite. Bioavailability: Absolute: Approx. 30%. Excretion: Urine (5%) or Enterohepatic system (80%).

Compiled by Healify Pharmacy from published drug references. How we compile it →

Always consult a pharmacist or doctor.