DAPAGLIFLOZIN,LINAGLIPTIN

Background and Date of Approval

Dapagliflozin and linagliptin combination is an antidiabetic medication approved by the US FDA to improve glycaemic control in adults with type 2 diabetes. Dapagliflozin received approval on 13 January 2014, and linagliptin on 2 May 2011. The combination works by enhancing insulin secretion and reducing glucose reabsorption.

Uses

Dapagliflozin and Linagliptin are used together to manage blood sugar levels in adults with type 2 diabetes. Dapagliflozin helps the kidneys remove excess glucose, while Linagliptin increases insulin production and reduces glucose production.

How is it administered?

Dapagliflozin and Linagliptin combination is typically administered orally once daily, with or without food. It is important to follow the prescribed dosage and timing recommended by a healthcare provider. The tablet should be swallowed whole and not crushed or chewed.

Side Effects

Side effects are unwanted symptoms caused by medicines. Although all drugs can cause side effects, not everyone experiences them. Common side effects of Dapagliflozin and Linagliptin: Urinary tract infections Increased urination Nasopharyngitis (cold symptoms) Headache Back pain Serious side effects of Dapagliflozin and Linagliptin: Diabetic ketoacidosis Severe allergic reactions (rash, swelling, difficulty breathing) Kidney problems (decreased kidney function) Low blood pressure (dizziness, fainting)

Warnings

Risk of Diabetic Ketoacidosis (DKA): Use with caution in patients with type 1 diabetes or those with significantly high blood sugar, as they may be at higher risk of DKA. Kidney Impairment: Dapagliflozin may impair kidney function, and the combination should be used with caution in patients with reduced kidney function. Volume Depletion: Dapagliflozin can cause dehydration and low blood pressure, potentially leading to dizziness, fainting, or kidney issues. Use cautiously in patients with dehydration or heart conditions. Urinary Tract Infections (UTIs): Patients may be at increased risk of UTIs due to increased glucose in the urine. Monitor for symptoms such as burning or pain during urination. Pancreatitis: Linagliptin may increase the risk of pancreatitis (inflammation of the pancreas). Monitor for symptoms such as severe abdominal pain, nausea, or vomiting. Allergic Reactions: Serious allergic reactions, such as rash, swelling, and difficulty breathing, may occur and require immediate medical attention. Bladder Cancer Risk: Long-term use of dapagliflozin may increase the risk of bladder cancer. Exercise caution in patients with a history of bladder cancer or those at higher risk. Pregnancy and Breastfeeding: The safety of the combination during pregnancy and breastfeeding has not been established. Avoid unless clearly necessary, and consult a healthcare provider.

Precautions

Take precautions when using Dapagliflozin and Linagliptin by regularly monitoring kidney function, as the medication can impact renal health. Stay cautious if you have a history of urinary tract infections, dehydration, or heart conditions. Ensure proper hydration and report any unusual symptoms, such as abdominal pain or breathing difficulties, to your healthcare provider.

Word of Advice

Follow your healthcare provider's instructions carefully regarding dosage and timing of Dapagliflozin and Linagliptin. Maintain adequate hydration and monitor for side effects including urinary tract infections or dizziness. Kidney function and overall health require regular assessment through scheduled check-ups. Inform your doctor of all other medications and existing medical conditions to identify potential drug interactions.

References

1. Jain A, Vispute A, Dange A, Naskar A, Mondal A, Vivekanand B, Sharma B, Varade D, Shukla D, Bhatia G, Chaudhari H, Ram Babu K, Gavali O, Sorate S, Bhanushali S, Kothari V, Khandelwal V, Sharma A, Pawar R, Mayabhate M, Shahavi V, Rajput A, Jaiswal M. A Randomized, Double-Blind, Parallel-Group Phase III Trial Investigating the Glycemic Efficacy and Safety Profile of Fixed-Dose Combination Dapagliflozin and Linagliptin Over Linagliptin Monotherapy in Patients with Inadequately Controlled Type 2 Diabetes with Metformin. https://pubmed.ncbi.nlm.nih.gov/37957465/ 2. Hong JH, Kim MJ, Min KW, Won JC, Kim TN, Lee BW, Kang JG, Kim JH, Park JH, Ku BJ, Lee CB, Kim SY, Shon HS, Lee WJ, Park JY. Efficacy and safety of a fixed-dose combination of dapagliflozin and linagliptin (AJU-A51) in patients with type 2 diabetes mellitus: A multicentre, randomized, double-blind, parallel-group, placebo-controlled phase III study. https://pubmed.ncbi.nlm.nih.gov/39375869/ 3. Dharmalingam M, Kumar Sharma S, Prakash V, Maiti A, Kumar R, Murthy LSS, Ramanathan B, Maheshwari S, Naik Kethavath S, Ogale D, Bachubhai PVK, Sonawane AB, Shah V, Suresh M, Chakraborty S, Kumar Manjunath K. Evaluating the Efficacy, Safety, and Tolerability of Combination Therapy of Dapagliflozin and Linagliptin Over Dapagliflozin and Vildagliptin in Patients With Type 2 Diabetes Mellitus Inadequately Controlled With Metformin. https://pubmed.ncbi.nlm.nih.gov/38738005/

Frequently Asked Questions

What is Dapagliflozin and Linagliptin combination tablets used for?

Linagliptin and Dapagliflozin tablets are used to manage blood sugar levels in adults with type 2 diabetes. Linagliptin helps increase insulin production, while Dapagliflozin reduces glucose reabsorption in the kidneys.

Is the Dapagliflozin and Linagliptin combination safe for kidneys?

The Dapagliflozin and Linagliptin combination can be safe for kidneys when used in patients with normal or mildly impaired kidney function. However, it should be used with caution in those with moderate to severe kidney impairment. Regular monitoring of kidney function is recommended during treatment.

Does the Dapagliflozin and Linagliptin combination reduce HbA1c?

Yes, the Dapagliflozin and Linagliptin combination effectively reduces HbA1c levels. Dapagliflozin helps lower blood sugar by increasing glucose excretion, while Linagliptin enhances insulin secretion, together improving long-term blood sugar control in people with type 2 diabetes.

What to avoid when taking Dapagliflozin and Linagliptin combination?

Avoid dehydration by staying well-hydrated, as Dapagliflozin can cause increased urination. Also, avoid using the combination if you have severe kidney problems or a history of pancreatitis.

Does the Dapagliflozin and Linagliptin combination increase creatinine?

Dapagliflozin and Linagliptin combination may slightly increase creatinine levels due to its effect on kidney function. Regular monitoring of kidney function is recommended during treatment.

Written By: Muskan Patel, M.Pharm

Reviewed By: Dr. Vishwa Patel, MBBS