Linacord-M is a combination of Linagliptin and Metformin medication used primarily for the management of type 2 diabetes mellitus. This combination leverages the complementary mechanisms of two different classes of antidiabetic drugs to improve glycaemic control.

Composition:

Linagliptin: A Dipeptidyl Peptidase-4 (DPP-4) inhibitor.(2.5mg)

Metformin: A Biguanide.(500mg)

Mechanism of Action:

Linagliptin: Inhibits the enzyme DPP-4, which results in increased levels of incretin hormones. These hormones enhance the release of insulin from pancreatic beta cells in response to meals and decrease the secretion of glucagon, thus lowering blood glucose levels.

Metformin: Reduces hepatic glucose production, decreases intestinal absorption of glucose, and improves insulin sensitivity by increasing peripheral glucose uptake and utilization.

Indications:

Type 2 Diabetes Mellitus: This combination is indicated to improve glycemic control in adults with type 2 diabetes when diet and exercise alone are not sufficient, and when treatment with both linagliptin and metformin is appropriate.

Dosage:

 The dosage is individualized based on the patient's current treatment regimen, effectiveness, and tolerability.

 Typically taken orally twice daily with meals to reduce gastrointestinal side effects associated with metformin.

 It is important to follow the prescribing healthcare provider’s instructions regarding the dosage.

Side Effects:

Common Side Effects: Nasopharyngitis, diarrhea, nausea, vomiting, headache, and upper respiratory tract infection.

 Serious Side Effects: Lactic acidosis (a rare but serious side effect of metformin), pancreatitis (associated with linagliptin), hypoglycemia (especially when used with

other antidiabetic medications), and hypersensitivity reactions.

Precautions:

Kidney Function: Regular monitoring of kidney function is important, as metformin is contraindicated in patients with severe renal impairment.

Liver Function: Caution in patients with liver disease.

Heart Failure: Use with caution in patients with congestive heart failure.

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

Contraindications:

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

Acute or chronic metabolic acidosis, including diabetic ketoacidosis.

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

Drug Interactions:

Cationic Drugs: Such as amiloride, digoxin, morphine, which are eliminated by renal tubular secretion, may interact with metformin.

 Other Antidiabetic Drugs: Careful monitoring is required when used with insulin or insulin secretagogues to avoid hypoglycemia.

 Alcohol: Increases the risk of lactic acidosis with metformin.

Monitoring:

Regular monitoring of blood glucose levels.

 Periodic assessment of kidney function.

 Monitoring for signs and symptoms of pancreatitis.

 Routine blood tests to monitor for any potential side effects..

Patient Advice:

Take the medication with meals to minimize gastrointestinal side effects.

 Maintain a proper diet and exercise regimen as prescribed by your healthcare provider.

 Stay hydrated and avoid excessive alcohol intake.

 Be aware of the symptoms of lactic acidosis (e.g., muscle pain, breathing difficulties, stomach pain) and seek immediate medical attention if they occur.

 Adjust Insulin as per physician’s instructions.