Medicine Information

Linadus-M XR

Name: Linadus-M XR
Brand: Linadus-M XR
Rating: 4.5 (117 reviews)

Extended-Release TabletLinagliptin 5 mg / Metformin Hydrochloride Extended-Release 1000 mgAntidiabeticATC: A10BD21

Generic Name

Linagliptin 5 mg and Metformin Hydrochloride Extended-Release Tablet

Manufacturer

Square Pharmaceuticals Ltd.

Country

Bangladesh

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Price Details

Current market pricing information

Variant	Unit Price	Strip Price
linadus m xr 5 mg tablet	৳ 24.00	৳ 144.00

Description

Overview of the medicine

Linadus-M XR is an oral antidiabetic medication combining Linagliptin, a dipeptidyl peptidase-4 (DPP-4) inhibitor, and Metformin Hydrochloride, a biguanide. It is used to improve glycemic control in adults with type 2 diabetes mellitus.

Uses & Indications

To improve glycemic control in adults with type 2 diabetes mellitus as an adjunct to diet and exercise.

When Metformin alone does not provide adequate glycemic control.

As initial therapy in type 2 diabetes when diet and exercise alone are insufficient.

Dosage

Adults

Recommended starting dose is 5 mg Linagliptin/500 mg Metformin XR once daily. Titrate gradually to a maximum of 5 mg Linagliptin/2000 mg Metformin XR once daily with the evening meal. Do not exceed 5 mg Linagliptin and 2000 mg Metformin XR daily.

Elderly

Dosage should be individualized based on renal function. Initiate with a lower dose if renal function is compromised.

Renal_impairment

Metformin is contraindicated in severe renal impairment (eGFR <30 mL/min/1.73 m²). Dosing adjustments may be needed for moderate impairment (eGFR 30-45 mL/min/1.73 m²).

How to Take

Take orally once daily with the evening meal. Swallow the tablet whole; do not crush, cut, or chew.

Mechanism of Action

Linagliptin inhibits DPP-4, an enzyme that degrades incretin hormones (GLP-1 and GIP). By inhibiting DPP-4, Linagliptin increases and prolongs active incretin levels, which enhances glucose-dependent insulin secretion and suppresses glucagon secretion. 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 typically observed within a few days to weeks.

Excretion

Linagliptin: Primarily excreted unchanged in feces (80%), minor renal excretion. Metformin: Primarily excreted unchanged in urine.

Half life

Linagliptin: Effective half-life ~12 hours. Metformin: Plasma elimination half-life ~7 hours.

Absorption

Linagliptin: Rapidly absorbed, peak plasma concentration (Cmax) reached in 1.5 hours. Metformin: Slowly and incompletely absorbed, Tmax 4-8 hours for XR formulation.

Metabolism

Linagliptin: Limited metabolism, primarily by cleavage of piperidine ring. Metformin: Not metabolized in humans.

Side Effects

Contraindications

Severe renal impairment (eGFR <30 mL/min/1.73 m²)
Metabolic acidosis, including diabetic ketoacidosis
Known hypersensitivity to Linagliptin or Metformin
Acute or chronic metabolic acidosis, including diabetic ketoacidosis, with or without coma

Drug Interactions

Alcohol

Increases the risk of lactic acidosis with Metformin.

Rifampin

Reduced efficacy of Linagliptin.

Carbonic Anhydrase Inhibitors (e.g., topiramate, acetazolamide)

May increase risk of lactic acidosis with Metformin.

Cationic drugs (e.g., amiloride, digoxin, morphine, procainamide, quinidine, ranitidine, triamterene, trimethoprim, vancomycin)

May increase Metformin accumulation by competing for renal tubular transport systems.

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, which requires emergency medical attention. Linagliptin overdose may lead to mild gastrointestinal symptoms. Treatment is symptomatic and supportive; hemodialysis can be effective for Metformin removal.

Pregnancy & Lactation

Use during pregnancy is not recommended unless clearly necessary. Limited data on human lactation; consider alternatives or discontinue breastfeeding if required.

Frequently Asked Questions

Common questions about this medicine

Pack Sizes

10 Tablets (1x10)30 Tablets (3x10)

Shelf Life

Typically 24-36 months from manufacturing date.

Availability

Pharmacies, hospitals, clinics

Approval Status

Approved (DGDA)

Patent Status

Patent protected (Linagliptin component)

Clinical Trials

Clinical trials demonstrated superior glycemic control compared to monotherapy or placebo. Studies like CAROLINA and CARMELINA have evaluated cardiovascular safety outcomes for Linagliptin.

Lab Monitoring

Renal function (eGFR) should be assessed before initiation and at least annually thereafter.
HbA1c levels to monitor glycemic control.
Vitamin B12 levels periodically, especially in patients with risk factors for deficiency.

Doctor Notes

Ensure renal function is assessed before initiating and periodically during therapy.
Counsel patients on the symptoms of lactic acidosis and hypoglycemia.
Monitor for signs of pancreatitis and vitamin B12 deficiency.

Patient Guidelines

Take the tablet whole; do not crush, cut, or chew.
Inform your doctor about all other medications you are taking.
Report any unusual muscle pain, breathing difficulties, or severe stomach pain immediately.
Adhere to diet and exercise recommendations.

Missed Dose Advice

If a dose is missed, take it as soon as you remember. If it is almost time for the next dose, skip the missed dose and resume your regular dosing schedule. Do not take two doses at once to make up for a missed dose.

Driving Precautions

This medicine is unlikely to affect your ability to drive or operate machinery. However, if you experience symptoms of hypoglycemia (e.g., dizziness, blurred vision), do not drive or operate machinery.