Liglimet
Generic Name
Liglipin and Metformin Hydrochloride
Manufacturer
PharmaCorp Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| liglimet 25 mg tablet | ৳ 15.00 | ৳ 90.00 |
Description
Overview of the medicine
Liglimet is a fixed-dose combination of Liglipin (a dipeptidyl peptidase-4 (DPP-4) inhibitor) and Metformin Hydrochloride (a biguanide) indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus.
Uses & Indications
Dosage
Adults
The usual recommended dose is one tablet (Liglipin 25 mg / Metformin 500 mg) once or twice daily, with meals. The dose should be individualized based on the patient’s current regimen, effectiveness, and tolerability.
Elderly
Dose adjustment should be made based on renal function. Regular monitoring of renal function is advised.
Renal_impairment
Contraindicated in severe renal impairment (eGFR <30 mL/min/1.73m²). Dose adjustment may be necessary for moderate renal impairment (eGFR 30-60 mL/min/1.73m²).
How to Take
Take orally with meals to reduce gastrointestinal side effects associated with Metformin. Do not crush, cut, or chew the tablet.
Mechanism of Action
Liglipin works by increasing the levels of active incretin hormones (GLP-1 and GIP), which enhance glucose-dependent insulin secretion and suppress glucagon release. Metformin reduces hepatic glucose production, decreases intestinal absorption of glucose, and improves insulin sensitivity by increasing peripheral glucose uptake and utilization.
Pharmacokinetics
Onset
Glycemic effects begin within hours, full therapeutic effect may take several days for Metformin.
Excretion
Liglipin is primarily excreted via the enterohepatic system (renal excretion is minor). Metformin is eliminated predominantly via renal excretion.
Half life
Liglipin: ~12-24 hours; Metformin: ~4-9 hours.
Absorption
Liglipin is rapidly absorbed with peak plasma concentrations reached within 1.5 hours. Metformin is slowly and incompletely absorbed from the gastrointestinal tract, with peak plasma concentrations occurring within 2.5 hours.
Metabolism
Liglipin undergoes minimal metabolism. Metformin is not metabolized and is excreted unchanged.
Side Effects
Contraindications
- Hypersensitivity to Liglipin, Metformin, or any component of the formulation.
- Severe renal impairment (eGFR <30 mL/min/1.73m²).
- Acute or chronic metabolic acidosis, including diabetic ketoacidosis, with or without coma.
- History of lactic acidosis.
- Hepatic impairment.
- Heart failure requiring pharmacological treatment.
Drug Interactions
Alcohol
Increases the risk of lactic acidosis, especially in fasting, malnourished, or hepatically impaired patients.
Iodinated contrast agents
Discontinue Metformin temporarily prior to or at the time of the procedure and for 48 hours afterward.
Cationic drugs (e.g., Cimetidine, Furosemide, Nifedipine)
May increase Metformin levels by competing for renal tubular transport.
Carbonic anhydrase inhibitors (e.g., Topiramate, Acetazolamide)
May increase the risk of lactic acidosis.
Storage
Store below 30°C in a dry place, away from direct light and moisture. Keep out of reach of children.
Overdose
Overdose of Metformin may lead to lactic acidosis, requiring urgent medical intervention. Overdose of Liglipin is generally well tolerated. Management includes symptomatic and supportive measures. Hemodialysis can be useful for Metformin overdose.
Pregnancy & Lactation
Pregnancy Category B. Studies in animals have not shown harm, but adequate studies in pregnant women are lacking. Should be used during pregnancy only if clearly needed. It is unknown whether Liglipin is excreted in human milk; Metformin is excreted into human milk. Therefore, caution should be exercised when administered to a nursing woman.
Side Effects
Contraindications
- Hypersensitivity to Liglipin, Metformin, or any component of the formulation.
- Severe renal impairment (eGFR <30 mL/min/1.73m²).
- Acute or chronic metabolic acidosis, including diabetic ketoacidosis, with or without coma.
- History of lactic acidosis.
- Hepatic impairment.
- Heart failure requiring pharmacological treatment.
Drug Interactions
Alcohol
Increases the risk of lactic acidosis, especially in fasting, malnourished, or hepatically impaired patients.
Iodinated contrast agents
Discontinue Metformin temporarily prior to or at the time of the procedure and for 48 hours afterward.
Cationic drugs (e.g., Cimetidine, Furosemide, Nifedipine)
May increase Metformin levels by competing for renal tubular transport.
Carbonic anhydrase inhibitors (e.g., Topiramate, Acetazolamide)
May increase the risk of lactic acidosis.
Storage
Store below 30°C in a dry place, away from direct light and moisture. Keep out of reach of children.
Overdose
Overdose of Metformin may lead to lactic acidosis, requiring urgent medical intervention. Overdose of Liglipin is generally well tolerated. Management includes symptomatic and supportive measures. Hemodialysis can be useful for Metformin overdose.
Pregnancy & Lactation
Pregnancy Category B. Studies in animals have not shown harm, but adequate studies in pregnant women are lacking. Should be used during pregnancy only if clearly needed. It is unknown whether Liglipin is excreted in human milk; Metformin is excreted into human milk. Therefore, caution should be exercised when administered to a nursing woman.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
24-36 months from manufacturing date
Availability
Pharmacies, Hospitals
Approval Status
Approved
Patent Status
Off-patent (generic available for components)
Clinical Trials
Extensive clinical trial data are available for both Liglipin and Metformin as individual components and in combination, demonstrating efficacy and safety in type 2 diabetes management. Ongoing post-marketing surveillance continues to monitor long-term outcomes.
Lab Monitoring
- Renal function (eGFR) should be assessed before initiating therapy and at least annually thereafter (more frequently in elderly or renally impaired patients).
- HbA1c levels should be monitored regularly to assess glycemic control.
- Vitamin B12 levels should be measured periodically, especially in patients with risk factors for deficiency.
Doctor Notes
- Emphasize the importance of renal function monitoring, especially before initiating therapy and periodically thereafter.
- Educate patients on the symptoms of lactic acidosis and hypoglycemia.
- Consider temporary discontinuation of Metformin in patients undergoing radiological studies with iodinated contrast media or surgical procedures.
Patient Guidelines
- Take Liglimet exactly as prescribed by your doctor.
- Always take this medicine with meals to help reduce stomach upset.
- Do not stop taking Liglimet without consulting your doctor, even if you feel well.
- Monitor your blood glucose levels regularly as advised by your healthcare provider.
- Report any unusual or severe side effects to your doctor immediately.
Missed Dose Advice
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and resume your regular dosing schedule. Do not double the dose to catch up.
Driving Precautions
Liglimet alone is unlikely to cause hypoglycemia and affect driving. However, if used in combination with other antidiabetic agents (e.g., insulin, sulfonylureas) that can cause hypoglycemia, patients should be warned about the risk of hypoglycemia and advised to take precautions before driving or operating machinery.
Lifestyle Advice
- Maintain a balanced diet that is low in sugar and saturated fats.
- Engage in regular physical activity as recommended by your doctor.
- Manage your weight to improve blood sugar control.
- Limit or avoid alcohol consumption.
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