Adjunct to diet and exercise to improve glycemic control in adults with type /2 diabetes mellitus, when combination treatment with both linagliptin and metformin is appropriate
Can be used in:
Patients inadequately controlled on maximal tolerated dose of metformin monotherapy
Patients on combination therapy with metformin + sulphonylurea
Patients on insulin + metformin but not achieving control
Patients switching from free combination of linagliptin + metformin.
Recommended dosage: 2.5/850 mg twice daily with meals to reduce GI upset; maximum total daily dose is 5 /mg linagliptin + 2000 /mg metformin
Initiating therapy:
If not previously on metformin: start with 2.5/500 /mg twice daily, then may escalate to 850 /mg strength based on tolerance and need
If switching from separate linagliptin + metformin: start at equivalent combination dose
If on metformin + sulphonylurea or insulin with inadequate control: use Trajenta Duo at similar metformin dose plus linagliptin 2.5 /mg twice daily; consider lowering sulfonylurea or insulin to reduce hypoglycemia risk
Moderate to severe renal impairment or elderly: dose adjustment, caution advised; regular renal monitoring (every 3–6 months or more frequently) recommended
Missed dose: take as soon as remembered, unless next dose is due. Do not double up. Skip if too close to next scheduled dose
Malaysia
