Linacord-D is a combination of Linagliptin 5 mg and Dapagliflozin 10 mg medication used to manage type 2 diabetes mellitus. This combination utilizes the complementary actions of two different classes of antidiabetic drugs to improve glycemic control.

Composition:

Linagliptin: 5 mg

Dapagliflozin: 10 mg

Mechanism of Action:

Linagliptin: A Dipeptidyl Peptidase-4 (DPP-4) inhibitor that increases levels of incretin hormones. These hormones enhance insulin release from pancreatic beta cells and decrease glucagon secretion from alpha cells, leading to a reduction in blood glucose levels.

Dapagliflozin: A Sodium-Glucose Co-Transporter-2 (SGLT2) inhibitor that prevents the reabsorption of glucose in the kidneys, causing excess glucose to be excreted in the urine. This results in lower blood glucose levels and can also promote weight loss and blood pressure reduction.

Indications:

Type 2 Diabetes Mellitus: This combination is indicated to improve glycemic control in adults with type 2 diabetes mellitus, particularly when diet and exercise alone do not provide adequate glycemic control, and when treatment with both linagliptin and dapagliflozin is appropriate.

Dosage:

The typical dosage is one tablet taken orally once daily in the morning, with or without food.

The exact dosage and frequency should be determined by a healthcare provider based on the patient's individual needs and response to treatment.

Side Effects:

Common Side Effects:

o Linagliptin: Nasopharyngitis, headache, back pain.

o Dapagliflozin: Urinary tract infections, genital infections, increased urination, nasopharyngitis.

Serious Side Effects:

Linagliptin: Pancreatitis, hypersensitivity reactions.

Dapagliflozin: Ketoacidosis, severe urinary tract infections, acute kidney injury, volume depletion leading to hypotension, and increased risk of bone fractures.

Precautions:

Kidney Function: Regular monitoring of kidney function is important. Dapagliflozin is not recommended for patients with severe renal impairment (eGFR below 45 mL/min/1.73 m²).

Liver Function: Use with caution in patients with liver disease.

Heart Failure: Dapagliflozin has shown benefits in patients with heart failure but should be used with caution in patients with a history of cardiovascular conditions.

Hypersensitivity: Patients with a history of serious hypersensitivity reactions to linagliptin or dapagliflozin should not use this combination.

Contraindications:

Severe renal impairment (eGFR below 30 mL/min/1.73 m²).

Active bladder cancer (due to dapagliflozin).

Hypersensitivity to linagliptin, dapagliflozin, or any other components of the medication.

Type 1 diabetes or diabetic ketoacidosis.

Drug Interactions:

Insulin and Insulin Secretagogues: Increased risk of hypoglycemia when used together. Dose adjustments may be necessary.

Diuretics: Increased risk of volume depletion and hypotension when used with dapagliflozin.

Rifampin and other CYP3A4 inducers: May decrease the effectiveness of linagliptin.

Monitoring:

Regular monitoring of blood glucose levels.

Periodic assessment of kidney function.

Monitoring for signs and symptoms of pancreatitis.

Monitoring for signs of infection, particularly urinary and genital infections.