Glifo-M
Generic Name
Linagliptin 5 mg & Metformin HCl
Manufacturer
Local Pharmaceutical Company
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| glifo m 5 mg tablet | ৳ 15.00 | ৳ 150.00 |
Description
Overview of the medicine
Glifo-M 5 mg tablet is an oral antidiabetic medication combining Linagliptin, a DPP-4 inhibitor, and Metformin HCl, a biguanide, used to improve glycemic control in adults with type 2 diabetes mellitus.
Uses & Indications
Dosage
Adults
Usually 1 tablet twice daily with meals. Dosage should be individualized based on efficacy and tolerability, up to a maximum of Linagliptin 5 mg and Metformin 2000 mg daily.
Elderly
Initiate with a lower dose; dose adjustment based on renal function.
Renal_impairment
Contraindicated in severe renal impairment (eGFR <30 mL/min/1.73 m2). Dose adjustment required for moderate impairment.
How to Take
Take orally with meals to reduce gastrointestinal side effects associated with Metformin.
Mechanism of Action
Linagliptin inhibits DPP-4, increasing incretin hormones (GLP-1 and GIP) leading to glucose-dependent insulin release and reduced glucagon secretion. Metformin reduces hepatic glucose production, decreases intestinal glucose absorption, and improves insulin sensitivity.
Pharmacokinetics
Onset
Glucose-lowering effects within hours of administration.
Excretion
Linagliptin: primarily via bile/feces. Metformin: primarily via urine (unchanged).
Half life
Linagliptin: terminal half-life >100 hours (but effective half-life for DPP-4 inhibition approx. 12-15 hours). Metformin: 4-9 hours.
Absorption
Linagliptin: rapidly absorbed, Tmax 1.5 hours. Metformin: slowly absorbed, Tmax 2-3 hours.
Metabolism
Linagliptin: minimally metabolized, primarily by CYP3A4. Metformin: not metabolized.
Side Effects
Contraindications
- Hypersensitivity to linagliptin or metformin.
- Severe renal impairment (eGFR <30 mL/min/1.73 m2).
- Metabolic acidosis (including diabetic ketoacidosis).
- Acute or chronic metabolic acidosis, including diabetic ketoacidosis, with or without coma.
- Patients undergoing radiological studies with intravascular iodinated contrast materials.
- Acute or chronic disease that may cause tissue hypoxia (e.g., cardiac or respiratory failure, recent myocardial infarction, shock).
- Hepatic impairment, alcohol abuse.
Drug Interactions
Metformin
Cationic drugs (e.g., cimetidine, amiloride, digoxin, ranitidine, vancomycin, trimethoprim) may increase metformin concentration. Alcohol can potentiate lactic acidosis risk. Iodinated contrast agents temporarily impair renal function, increasing lactic acidosis risk.
Linagliptin
Weak interaction with strong CYP3A4 inducers (e.g., rifampicin) - may reduce linagliptin efficacy.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Metformin overdose can lead to lactic acidosis. Linagliptin overdose has limited data; manage symptomatically. Hemodialysis can be used to remove Metformin.
Pregnancy & Lactation
Not recommended during pregnancy due to insufficient data. Metformin is excreted in breast milk; avoid use during lactation or monitor infant for hypoglycemia.
Side Effects
Contraindications
- Hypersensitivity to linagliptin or metformin.
- Severe renal impairment (eGFR <30 mL/min/1.73 m2).
- Metabolic acidosis (including diabetic ketoacidosis).
- Acute or chronic metabolic acidosis, including diabetic ketoacidosis, with or without coma.
- Patients undergoing radiological studies with intravascular iodinated contrast materials.
- Acute or chronic disease that may cause tissue hypoxia (e.g., cardiac or respiratory failure, recent myocardial infarction, shock).
- Hepatic impairment, alcohol abuse.
Drug Interactions
Metformin
Cationic drugs (e.g., cimetidine, amiloride, digoxin, ranitidine, vancomycin, trimethoprim) may increase metformin concentration. Alcohol can potentiate lactic acidosis risk. Iodinated contrast agents temporarily impair renal function, increasing lactic acidosis risk.
Linagliptin
Weak interaction with strong CYP3A4 inducers (e.g., rifampicin) - may reduce linagliptin efficacy.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Metformin overdose can lead to lactic acidosis. Linagliptin overdose has limited data; manage symptomatically. Hemodialysis can be used to remove Metformin.
Pregnancy & Lactation
Not recommended during pregnancy due to insufficient data. Metformin is excreted in breast milk; avoid use during lactation or monitor infant for hypoglycemia.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Generally 24-36 months from manufacturing date.
Availability
Pharmacies, hospitals
Approval Status
Approved by major regulatory bodies (e.g., FDA, DGDA)
Patent Status
Varies by region, some patents expired or expiring, others may be active for combination formulations
Clinical Trials
Extensive clinical trials support the efficacy and safety of linagliptin and metformin in type 2 diabetes.
Lab Monitoring
- Renal function (eGFR) before initiation and at least annually.
- HbA1c levels regularly.
- Vitamin B12 levels periodically with long-term Metformin use.
- Liver function tests if hepatic dysfunction is suspected.
Doctor Notes
- Assess renal function prior to initiation and periodically thereafter.
- Counsel patients on the symptoms of lactic acidosis and pancreatitis.
Patient Guidelines
- Take as directed by your doctor, preferably with meals.
- Do not stop taking without consulting your doctor.
- Report any unusual muscle pain, breathing difficulty, or extreme tiredness immediately (signs of lactic acidosis).
Missed Dose Advice
If a dose is missed, take it as soon as you remember, unless it is almost time for the next dose. Do not take a double dose to make up for a missed one.
Driving Precautions
Generally does not affect ability to drive or operate machinery. However, if symptoms of hypoglycemia (dizziness, weakness) occur, caution is advised.
Lifestyle Advice
- Maintain a healthy diet and regular exercise routine.
- Monitor blood sugar levels regularly.
- Limit alcohol intake.
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Global Brand Names
International brand names for this medicine. Click a brand to search for detailed information.
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