Empalina 25/5

Indications

Empalina is designed to support glycemic control in adults with type 2 diabetes mellitus when combined with diet and exercise. It helps manage blood sugar levels effectively.

Pharmacology

Empalina combines two key components:

• Linagliptin: Inhibits the DPP-4 enzyme, increasing the levels of incretin hormones like GLP-1 and GIP. This stimulates insulin release in response to glucose and reduces glucagon levels, enhancing overall glucose management.
• Empagliflozin: Blocks the SGLT2 transporter, reducing glucose reabsorption in the kidneys and increasing glucose excretion in urine.

Dosage & Administration

• Standard Dose: 10 mg Empagliflozin and 5 mg Linagliptin daily, taken in the morning, with or without food.
• Adjusted Dose: May be increased to 25 mg Empagliflozin and 5 mg Linagliptin daily if needed.
• Renal Impairment: Not recommended if eGFR is below 45 mL/min/1.73 m². Monitor renal function closely.

Interactions

• Diuretics: Can increase urine output and risk of dehydration.
• Insulin/Secretagogues: May heighten the risk of hypoglycemia.
• P-glycoprotein/CYP3A4 Inducers: Rifampin may reduce Linagliptin effectiveness.

Contraindications

• Severe renal or hepatic impairment.
• History of hypersensitivity to Linagliptin or Empagliflozin.
• Pregnancy and breastfeeding.

Side Effects

Common side effects include headache, dizziness, nausea, and gastrointestinal issues. Serious reactions may involve pancreatitis, ketoacidosis, and severe infections.

Pregnancy & Lactation

Empalina is not recommended during pregnancy, particularly in the second and third trimesters. Its safety during breastfeeding is also not established.

Precautions & Warnings

• Pancreatitis & Ketoacidosis: Monitor for signs of acute pancreatitis and ketoacidosis.
• Volume Depletion: Risk of dehydration and low blood pressure.
• Infections: Increased risk of urinary tract and genital infections.

Overdose Effects

In case of overdose, contact Poison Control and provide supportive care. Hemodialysis may not effectively remove Empagliflozin or Linagliptin.

Therapeutic Class

Sodium-glucose Cotransporter-2 (SGLT2) Inhibitors.

Storage Conditions

Store at temperatures below 30°C. Keep away from light and moisture. Keep out of reach of children.