Linagliptin

Tell your doctor about all the medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements. Especially tell your doctor if you take

• other medicines that can lower your blood sugar
• rifampin (Rifadin, Rimactane, Rifater, Rifamate), an antibiotic that is used to treat tuberculosis 

This is not a complete list of linagliptin drug interactions. Ask your doctor or pharmacist for more information.

Serious side effects have been reported with linagliptin including the following:

• low blood sugar (hypoglycemia). If you take linagliptin with another medicine that can cause low blood sugar, such as a sulfonylurea, your risk of getting low blood sugar is higher. The dose of your sulfonylurea medicine may need to be lowered while you take linagliptin. Signs and symptoms of low blood sugar may include:
  • headache
  • drowsiness
  • weakness
  • dizziness
  • confusion
  • irritability
  • hunger
  • fast heart beat
  • sweating
  • feeling jittery
• severe and persistent joint pain. If you experience severe and persistent joint pain, contact your doctor right away. Do not stop taking your medication. Your doctor will decide if your medication is the possible cause of severe  joint pain and will discontinue the drug if appropriate.

Do not take linagliptin if you are allergic to any of its ingredients.

Symptoms of a serious allergic reaction to linagliptin are:

• rash
• raised red patches on your skin (hives)
• swelling of your face, lips, and throat that may cause difficulty breathing or swallowing

Follow dietary (food) recommendations made by your doctor and dietitian which should include a healthy diet. Skipping meals should be avoided as this can cause problems maintaining blood sugar control. There are no specific foods to avoid while using linagliptin.

• Take linagliptin 1 time each day exactly as your doctor tells you to take it.
• Talk with your doctor if you do not understand how to take linagliptin.
• Your doctor will tell you when to take linagliptin.
• Take linagliptin with or without food.
• If you miss a dose, take it as soon as you remember. If you do not remember until it is time for your next dose, skip the missed dose and go back to your regular schedule. Do not take two doses of linagliptin at the same time.
• Your doctor may tell you to take linagliptin along with other diabetes medicines. Low blood sugar can happen more often when linagliptin is taken with certain other diabetes medicines. 
• When your body is under some types of stress, such as fever, trauma (such as a car accident), infection, or surgery, the amount of diabetes medicine that you need may change. Tell your doctor right away if you have any of these conditions and follow your doctor's instructions.
• Check your blood sugar as your doctor tells you to.
• Stay on your prescribed diet and exercise program while taking linagliptin.
• Talk to your doctor about how to prevent, recognize and manage low blood sugar (hypoglycemia), high blood sugar (hyperglycemia), and complications of diabetes.
• Your doctor will check your diabetes with regular blood tests, including your blood sugar levels and your hemoglobin A1C.

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.

• Complete Blood Count (CBC)
• Diabetes (Type 1 and Type 2)
• Glucose Tolerance Test
• Type 2 Diabetes

Other drugs may increase or decrease the effects of linagliptin 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 medications.

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

Administration

Oral Administration

Administer once daily without regard to meals.1

If a dose is missed, do not double next dose to replace missed dose.1

Dosage

Adults

Monotherapy: 5 mg once daily.1

Combination therapy with a sulfonylurea: 5 mg once daily; dosage of the concomitant sulfonylurea may need to be reduced to decrease risk of hypoglycemia.1

Special Populations

Hepatic Impairment

Dosage adjustment not routinely required.1 (See Pharmacokinetics.)

Renal Impairment

Dosage adjustment not routinely required.1 16 (See Pharmacokinetics.)

Geriatric Patients

Dosage adjustment not routinely required.1

Storage

Oral

25°C (may be exposed to 15–30°C).1

• It is used to lower blood sugar in patients with high blood sugar (diabetes).

Use this medicine as ordered by your doctor. Read all information given to you. Follow all instructions closely.

• Take with or without food.
• To gain the most benefit, do not miss doses.
• Keep taking linagliptin as you have been told by your doctor or other health care provider, even if you feel well.

What do I do if I miss a dose?

• Take a missed dose as soon as you think about it.
• If it is close to the time for your next dose, skip the missed dose and go back to your normal time.
• Do not take 2 doses at the same time or extra doses.

Diabetes mellitus, type 2: As an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes (noninsulin dependent, NIDDM) as monotherapy or in combination with other antidiabetic agents

Substance Name

Linagliptin

CAS Registry Number

668270-12-0

Drug Class

Dipeptidyl-Peptidase IV Inhibitors