Metglip-DS
Generic Name
Metformin Hydrochloride and Linagliptin Tablet
Manufacturer
Example Pharmaceutical Co. Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| metglip ds 5 mg tablet | ৳ 5.00 | ৳ 50.00 |
Description
Overview of the medicine
Metglip-DS 5 mg Tablet is a combination oral antidiabetic medicine containing Metformin and Linagliptin, used to improve glycemic control in adults with type 2 diabetes mellitus.
Uses & Indications
Dosage
Adults
Recommended starting dose is Metformin 500 mg/Linagliptin 2.5 mg twice daily or Metformin 1000 mg/Linagliptin 5 mg once daily, adjusted based on efficacy and tolerability. Maximum recommended daily dose is Metformin 2000 mg and Linagliptin 5 mg.
Elderly
Dosage should be individualized based on renal function, starting with lower doses. Metformin accumulation risk increases with age due to decreased renal function.
Renal_impairment
Not recommended in patients with eGFR <30 mL/min/1.73m². Dosage adjustment may be needed for eGFR 30-60 mL/min/1.73m², avoiding Metformin if eGFR <45 mL/min/1.73m².
How to Take
Take orally with meals to reduce gastrointestinal side effects of Metformin. Swallow the tablet whole with water. Do not crush, chew, or break the tablet.
Mechanism of Action
Metformin decreases hepatic glucose production, decreases intestinal absorption of glucose, and improves insulin sensitivity by increasing peripheral glucose uptake and utilization. Linagliptin is a dipeptidyl peptidase-4 (DPP-4) inhibitor that increases incretin hormone levels (GLP-1 and GIP), leading to increased insulin synthesis and release from pancreatic beta cells and decreased glucagon secretion from alpha cells, thereby lowering blood glucose.
Pharmacokinetics
Onset
Metformin: Usually within a few days to 2 weeks for significant glucose lowering. Linagliptin: Rapidly absorbed, peak concentrations reached within 1.5 hours.
Excretion
Metformin: Primarily renal excretion (unchanged). Linagliptin: Predominantly excreted via the enterohepatic system (bile and feces); about 5% renally.
Half life
Metformin: Approximately 6.2 hours (plasma), 17.6 hours (blood). Linagliptin: Effective half-life for DPP-4 inhibition is approximately 12 hours, terminal half-life is >100 hours.
Absorption
Metformin: Absolute bioavailability of a 500 mg tablet given under fasting conditions is approximately 50-60%. Food decreases the extent and slightly delays the absorption. Linagliptin: Approximately 30% bioavailability, Tmax of 1.5 hours.
Metabolism
Metformin: Not metabolized in the liver; excreted unchanged. Linagliptin: Minimal metabolism; a small fraction metabolized by CYP3A4.
Side Effects
Contraindications
- Hypersensitivity to Metformin, Linagliptin, or any excipients.
- Severe renal impairment (eGFR <30 mL/min/1.73m²).
- Acute or chronic metabolic acidosis, including diabetic ketoacidosis, with or without coma.
- Known history of pancreatitis (for Linagliptin component).
- Serious hypersensitivity reactions (e.g., anaphylaxis, angioedema) to Linagliptin.
Drug Interactions
Insulin or insulin secretagogues
Increased risk of hypoglycemia; a lower dose of insulin/secretagogue may be required.
P-glycoprotein/CYP3A4 inducers (e.g., rifampin)
May decrease Linagliptin exposure, reducing efficacy.
Carbonic anhydrase inhibitors (e.g., topiramate, acetazolamide)
May increase risk of lactic acidosis with Metformin.
Loop diuretics, corticosteroids, sympathomimetics, niacin, calcium channel blockers
May increase blood glucose, requiring dosage adjustment of Metglip-DS.
Drugs that reduce Metformin clearance (e.g., cimetidine, ranolazine, dolutegravir, trimethoprim)
May increase Metformin levels and risk of lactic acidosis.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Overdose of Metformin may lead to lactic acidosis, which is a medical emergency. Linagliptin overdose rarely leads to severe adverse events. Management of overdose involves supportive measures and consideration of hemodialysis for severe Metformin overdose.
Pregnancy & Lactation
Use in pregnancy only if the potential benefit justifies the potential risk to the fetus. It is not known if Metformin or Linagliptin are excreted in human milk. Consult a doctor before use during pregnancy or lactation.
Side Effects
Contraindications
- Hypersensitivity to Metformin, Linagliptin, or any excipients.
- Severe renal impairment (eGFR <30 mL/min/1.73m²).
- Acute or chronic metabolic acidosis, including diabetic ketoacidosis, with or without coma.
- Known history of pancreatitis (for Linagliptin component).
- Serious hypersensitivity reactions (e.g., anaphylaxis, angioedema) to Linagliptin.
Drug Interactions
Insulin or insulin secretagogues
Increased risk of hypoglycemia; a lower dose of insulin/secretagogue may be required.
P-glycoprotein/CYP3A4 inducers (e.g., rifampin)
May decrease Linagliptin exposure, reducing efficacy.
Carbonic anhydrase inhibitors (e.g., topiramate, acetazolamide)
May increase risk of lactic acidosis with Metformin.
Loop diuretics, corticosteroids, sympathomimetics, niacin, calcium channel blockers
May increase blood glucose, requiring dosage adjustment of Metglip-DS.
Drugs that reduce Metformin clearance (e.g., cimetidine, ranolazine, dolutegravir, trimethoprim)
May increase Metformin levels and risk of lactic acidosis.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Overdose of Metformin may lead to lactic acidosis, which is a medical emergency. Linagliptin overdose rarely leads to severe adverse events. Management of overdose involves supportive measures and consideration of hemodialysis for severe Metformin overdose.
Pregnancy & Lactation
Use in pregnancy only if the potential benefit justifies the potential risk to the fetus. It is not known if Metformin or Linagliptin are excreted in human milk. Consult a doctor before use during pregnancy or lactation.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
24 months
Availability
Pharmacies, hospitals
Approval Status
Approved by regulatory authorities (e.g., FDA, DGDA)
Patent Status
Off-patent for active ingredients
Clinical Trials
Extensive clinical trials have demonstrated the efficacy and safety of Metformin and Linagliptin combination in improving glycemic control in type 2 diabetes.
Lab Monitoring
- Renal function (eGFR) before initiation and at least annually (more frequently in elderly or those at risk of renal impairment).
- HbA1c levels regularly (e.g., every 3-6 months).
- Vitamin B12 levels periodically (especially with long-term Metformin use).
- Liver function tests (if clinically indicated).
Doctor Notes
- Emphasize patient education on lifestyle modification.
- Monitor renal function closely, especially in elderly and those with comorbidities.
- Be vigilant for signs of lactic acidosis and pancreatitis.
- Adjust concomitant diabetes medications to prevent hypoglycemia.
Patient Guidelines
- Take this medicine exactly as prescribed by your doctor.
- Do not stop taking this medicine without consulting your doctor.
- Inform your doctor about all other medications you are taking.
- Report any unusual symptoms or severe side effects to your doctor immediately.
- Carry a form of fast-acting sugar (e.g., glucose tablets, juice) to treat mild hypoglycemia.
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 double the dose to make up for a missed one.
Driving Precautions
This medicine generally does not affect the ability to drive or operate machinery. However, if symptoms of hypoglycemia (dizziness, blurred vision) occur, avoid driving or operating machinery.
Lifestyle Advice
- Maintain a healthy diet and regular exercise routine.
- Limit alcohol intake.
- Monitor blood glucose levels regularly as advised by your doctor.
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Global Brand Names
International brand names for this medicine. Click a brand to search for detailed information.