Linatab E 5/10

Indications

Linatab E is used as an adjunct treatment alongside a healthy diet and regular exercise to help manage blood sugar levels in adults with type 2 diabetes mellitus.
Consult a registered healthcare provider before use.

Pharmacology

Linatab E combines Linagliptin, a DPP-4 inhibitor, and Empagliflozin, an SGLT2 inhibitor, to manage blood sugar levels in type 2 diabetes.

• Linagliptin works by increasing the activity of incretin hormones (GLP-1 and GIP), which promote insulin release and lower glucagon levels, helping regulate glucose balance.
• Empagliflozin reduces glucose reabsorption in the kidneys by inhibiting the SGLT2 transporter, leading to increased glucose excretion in urine.

Together, these components improve glycemic control by enhancing insulin secretion and reducing excessive glucose production.

Dosage & Administration

• Recommended Dosage: 10 mg Empagliflozin + 5 mg Linagliptin, taken once daily, preferably in the morning, with or without food.
• Increased Dose: The dose may be increased to 25 mg Empagliflozin + 5 mg Linagliptin once daily.
• Renal Impairment: Before starting treatment, assess renal function. Do not initiate therapy if the eGFR is below 45 mL/min/1.73 m². Discontinue if eGFR drops below 45 mL/min/1.73 m².
  Follow your healthcare provider’s instructions for optimal results.

Drug Interactions

• Diuretics: Coadministration with diuretics can increase urine volume, leading to a higher risk of dehydration.
• Insulin or Insulin Secretagogues: May increase the risk of hypoglycemia when used together.
• P-glycoprotein or CYP3A4 Inhibitors: Rifampin and other enzyme inducers may reduce Linagliptin’s effectiveness.
• Urine Glucose Test: SGLT2 inhibitors, like Empagliflozin, may cause false positives in urine glucose tests.

Contraindications

Linatab E should not be used in individuals with:

• Severe renal impairment, end-stage renal disease, or on dialysis
• A history of severe allergic reactions to Linagliptin or Empagliflozin
  Consult your healthcare provider to ensure this medication is suitable for you.

Side Effects

Possible side effects include:

• Pancreatitis, Ketoacidosis, Volume Depletion, Urosepsis, Hypoglycemia (with insulin or insulin secretagogues), Necrotizing Fasciitis (Fournier’s Gangrene), Genital Mycotic Infections, and Hypersensitivity Reactions.
  For a full list of adverse effects, consult the product label or your healthcare provider.

Pregnancy & Lactation

Linatab E is not recommended during the second or third trimesters of pregnancy. Limited data are available on its use in pregnant women, so always consult a healthcare provider. Uncontrolled diabetes during pregnancy carries significant risks for both the mother and fetus.

Precautions & Warnings

• Pancreatitis: Caution is advised due to the risk of acute pancreatitis.
• Ketoacidosis: SGLT2 inhibitors like Empagliflozin may increase the risk of ketoacidosis, a potentially life-threatening condition.
• Volume Depletion: May cause hypotension and kidney issues.
• Genital Infections: Increased risk of fungal infections in the genital area, particularly in females.
• Hypoglycemia: When combined with insulin or secretagogues, there is a risk of low blood sugar.
  Consult a doctor for a complete list of potential risks and necessary precautions.

Overdose Effects

In case of an overdose, contact Poison Control or seek emergency medical help immediately. Symptomatic support is recommended, and removing unabsorbed material from the gastrointestinal tract may be necessary.

Therapeutic Class

Sodium-glucose Cotransporter-2 (SGLT2) Inhibitors

Storage Conditions

Store Linatab E below 30°C in a dry place, away from light. Keep out of the reach of children.