Linagliptin

Linagliptin: May be taken with or without food.
Linagliptin + metformin hydrochloride: Should be taken with food.

Hypersensitivity.

Patient with a history of pancreatitis and angioedema with another DDP-4 inhibitor. Patients who are at risk of having heart failure (e.g. history of renal impairment or heart failure). Not indicated for use in patients with type 1 diabetes mellitus or diabetic ketoacidosis. Pregnancy and lactation. Patient Counselling This drug may cause an impaired ability to react due to hypoglycaemia, if affected, do not drive, or operate machinery. Monitoring Parameters Monitor HbA_1c (at least twice yearly in patients with stable glycaemic control and are meeting treatment goals or quarterly for patients not meeting their treatment goals or with changes in therapy). Consider a combined evaluation of HbA_1c with a blood glucose test and/or a glucose management indicator for patients who are prone to glycaemic variability (e.g. insulin deficiency), or those with HbA_1c that is contradictory with the serum glucose levels or symptoms. Monitor blood pressure. Assess for signs and symptoms of hypoglycaemia, pancreatitis (e.g. persistent, severe abdominal pain), heart failure (shortness of breath, swelling of feet), serious hypersensitivity reactions (e.g. angioedema, anaphylaxis), or bullous pemphigoid (e.g. erosions, blisters).

Significant: Heart failure (increased risk of hospitalisation); severe and disabling arthralgia; bullous pemphigoid. Gastrointestinal disorders: Constipation, mouth ulceration, stomatitis. Hepatobiliary disorders: Cholecystitis. Infections and infestations: Nasopharyngitis. Investigations: Increased serum lipase, amylase. Musculoskeletal and connective tissue disorders: Rhabdomyolysis, myalgia. Respiratory, thoracic, and mediastinal disorders: Cough. Skin and subcutaneous tissue disorders: Rash, urticaria, alopecia.
Potentially Fatal: Hypersensitivity reactions (e.g. anaphylaxis, angioedema, exfoliative skin conditions, bronchial hyperreactivity); acute pancreatitis (e.g. haemorrhagic and necrotising cases).

Increased risk of hypoglycaemia when combined with insulin and/or insulin secretagogues (e.g. sulfonylureas). Decreased plasma concentration and reduced efficacy with rifampicin. Increased exposure with ritonavir.

Antidiabetic Agents

A10BH05 - linagliptin ; Belongs to the class of dipeptidyl peptidase 4 (DPP-4) inhibitors. Used in the treatment of diabetes.