Adlinameg 2.5 mg+500 mg

Description

Adlinameg Product Description

Indications
Adlinameg is prescribed as an adjunct to diet and exercise to help improve glycemic control in adults with type 2 diabetes mellitus. It is indicated when treatment with both Linagliptin and Metformin Hydrochloride is appropriate.

Take this medication as directed by a registered healthcare professional.

Pharmacology
Linagliptin is an anti-diabetic agent used to improve glycemic control in patients with type 2 diabetes mellitus. As a DPP-4 (dipeptidyl peptidase-4) inhibitor, Linagliptin works by preventing the breakdown of incretin hormones, such as GLP-1 (glucagon-like peptide-1) and GIP (glucose-dependent insulinotropic peptide). These hormones help increase insulin secretion from the pancreas in a glucose-dependent manner and reduce glucagon secretion from pancreatic alpha cells, contributing to better blood sugar control.

Metformin Hydrochloride is an oral antihyperglycemic drug of the biguanide class, used in managing type 2 diabetes. It lowers blood glucose levels by reducing both basal and postprandial plasma glucose. Unlike sulfonylureas, Metformin does not cause hypoglycemia. It works by decreasing glucose production in the liver, reducing intestinal absorption of glucose, and enhancing insulin sensitivity, thus improving peripheral glucose uptake and utilization.

Dosage & Administration
Linagliptin & Metformin Immediate Release Tablet:
The dosage of Linagliptin & Metformin should be adjusted based on individual effectiveness and tolerability. The maximum recommended dose is 2.5 mg of Linagliptin and 1000 mg of Metformin Hydrochloride taken twice daily with meals. Dose escalation should be gradual to minimize gastrointestinal side effects typically associated with Metformin Hydrochloride.

• Recommended Starting Dose:
  • For patients not currently taking Metformin Hydrochloride, begin treatment with 2.5 mg Linagliptin and 500 mg Metformin Hydrochloride twice daily.
  • For patients already on Metformin Hydrochloride, start with 2.5 mg Linagliptin and the current dose of Metformin Hydrochloride twice daily.
  • Patients previously treated with both Linagliptin and Metformin Hydrochloride may switch to this combination, ensuring the same doses of each ingredient.

Linagliptin & Metformin Extended-Release Tablet:
The dosage of the extended-release combination should also be individualized based on effectiveness and tolerability, with a maximum total daily dose of 5 mg Linagliptin and 2000 mg Metformin Hydrochloride. This combination should be taken once daily with a meal.

• Recommended Starting Dose:
  • For patients not currently taking Metformin, initiate treatment with 5 mg Linagliptin and 1000 mg Metformin Hydrochloride extended-release tablet once daily with a meal.
  • For patients already on Metformin, start with a 5 mg Linagliptin total daily dose and an equivalent total daily dose of Metformin, administered once daily with a meal.
  • Patients who are already taking the immediate release version of Linagliptin & Metformin may switch to the extended-release tablet, which contains 5 mg of Linagliptin and the same total dose of Metformin, taken once daily with a meal.

Note: 5 mg Linagliptin & 1000 mg Metformin Hydrochloride extended-release tablets should be taken as a single tablet daily. For those using 2.5 mg Linagliptin & 1000 mg Metformin extended-release tablets, take two tablets together once daily.

Follow the guidance of a registered healthcare professional for proper medication use.

Drug Interactions

• Cationic Drugs: Cationic drugs (e.g., amiloride, digoxin, morphine, procainamide, quinidine, quinine, ranitidine, triamterene, trimethoprim, or vancomycin) eliminated through renal tubular secretion may potentially interact with Metformin. This interaction is theoretical (except for cimetidine). If necessary, adjust doses of Adlinameg or the interacting drug and monitor the patient closely.

• Carbonic Anhydrase Inhibitors: Medications like topiramate may decrease serum bicarbonate levels and lead to hyperchloremic metabolic acidosis. Using such drugs alongside Adlinameg could increase the risk of lactic acidosis.

• Inducers of P-Glycoprotein and CYP3A4 Enzymes: Rifampin may reduce Linagliptin’s effectiveness by decreasing its exposure. In such cases, alternative treatments (without Linagliptin) are recommended.

• Drugs Affecting Glycemic Control: Certain medications, such as diuretics, corticosteroids, and oral contraceptives, can increase blood sugar levels and affect glycemic control. Patients should be monitored closely for adjustments in their diabetes management.

Contraindications

• Adlinameg should not be used in patients with renal impairment, as Metformin is primarily excreted through the kidneys, and impaired renal function can lead to Metformin accumulation and lactic acidosis.
• It is contraindicated in patients with acute or chronic metabolic acidosis, including diabetic ketoacidosis.
• The combination is also contraindicated in patients allergic to Linagliptin or Metformin Hydrochloride.

Side Effects
The most commonly reported side effects include nasopharyngitis and diarrhea. Hypoglycemia is more common when Adlinameg is used in combination with sulfonylureas.

Pregnancy & Lactation
Due to the lack of adequate and well-controlled studies in pregnant women, this medication should only be used during pregnancy when absolutely necessary. Caution is also advised when administering the drug to lactating mothers.

Precautions & Warnings

• Lactic Acidosis: If symptoms of lactic acidosis (such as abdominal discomfort, muscle pain, or unusual fatigue) occur, discontinue the medication immediately and seek urgent medical attention.
• Pancreatitis: There have been reports of acute pancreatitis associated with Linagliptin and Metformin. If pancreatitis is suspected, discontinue the drug and initiate appropriate treatment.
• Radiologic Studies & Surgery: Temporarily discontinue Linagliptin & Metformin before undergoing radiologic procedures with iodinated contrast or surgery that requires restricted food and fluid intake.
• Vitamin B12 Deficiency: Metformin may lower Vitamin B12 levels, so annual monitoring of hematologic parameters is recommended.

Overdose Effects
In case of overdose, supportive measures, such as gastrointestinal decontamination and clinical monitoring, should be employed. While Linagliptin is not significantly removed by hemodialysis, Metformin Hydrochloride can be dialyzed.

Therapeutic Class
This medication falls under the category of combination oral hypoglycemic preparations.

Storage Conditions
Store at a cool and dry place (below 30°C), away from light and moisture. Keep out of the reach of children.