linagliptin + metformin at a glance
Medicine class
DPP-4 inhibitor combined with a biguanide
Licensed use
Blood glucose control in adults with type 2 diabetes
Administration
Take with meals to reduce metformin-related stomach effects
Low blood sugar
Unlikely on its own, but risk increases with insulin or a sulphonylurea
What is linagliptin + metformin used for?
Licensed alongside diet and exercise for adults with type 2 diabetes to improve glycaemic control:
When metformin alone has not provided adequate control.
With other diabetes treatments, including insulin, when these and metformin have not provided adequate control.
As a fixed-combination replacement for people already taking linagliptin and metformin as separate tablets.
How does linagliptin + metformin work?
Linagliptin blocks DPP-4, prolonging incretin activity so insulin release rises and glucagon falls when glucose is elevated. Metformin reduces glucose production by the liver and improves the body's response to insulin.
linagliptin + metformin preparations and strengths
Tablet
Route: Oral
Strengths: 2.5 mg + 1000 mg, 2.5 mg + 850 mg
How to take linagliptin + metformin
Follow the pharmacy label and prescriber's instructions. Taking the film-coated tablets with meals helps reduce nausea, diarrhoea and other gastrointestinal effects.
Tell healthcare staff before surgery or a scan involving injected iodinated contrast.
Contact a healthcare professional promptly during severe vomiting, diarrhoea, fever or reduced fluid intake, as dehydration increases the risk of metformin-associated lactic acidosis.
linagliptin + metformin side effects
Common or expected effects
- Abdominal discomfort or pain
- Diarrhoea or nausea
- Taste disturbance
- Reduced vitamin B12 level or vitamin B12 deficiency
- Low blood sugar when combined with insulin or a sulphonylurea
Get urgent medical advice
- Lactic acidosis: deep or rapid breathing, abdominal pain, muscle cramps, severe weakness, feeling unusually cold or reduced consciousness
- Pancreatitis: severe, persistent abdominal pain that may spread to the back
- Serious allergy: facial, mouth or throat swelling, breathing difficulty or widespread hives
- Bullous pemphigoid or another severe skin reaction: new large blisters, peeling or extensive rash
linagliptin + metformin in pregnancy
The fixed combination should not be used during pregnancy because experience with linagliptin is insufficient, although metformin alone can be used in pregnancy. Anyone planning pregnancy or who becomes pregnant should contact their diabetes or pregnancy team promptly for a treatment review and should not stop treatment without advice.
linagliptin + metformin while breastfeeding
Metformin is compatible with breastfeeding in healthy, full-term infants, but there is insufficient information about linagliptin. The fixed combination requires an individual prescriber review.
linagliptin + metformin interactions
Important interactions include:
Insulin or sulphonylureas
Can increase the risk of hypoglycaemia.
Rifampicin, carbamazepine, phenobarbital or phenytoin
May reduce linagliptin's glucose-lowering effect.
Iodinated contrast agents
Can cause kidney injury and metformin accumulation; the radiology team must arrange interruption and renal reassessment.
Common questions about linagliptin + metformin
Answers are fully visible for fast scanning and source review.
Can linagliptin + metformin cause low blood sugar?
It rarely causes hypoglycaemia by itself, but the risk increases with insulin or a sulphonylurea.
Why should it be taken with food?
Food helps reduce gastrointestinal effects caused by metformin, such as nausea, abdominal discomfort and diarrhoea.
Can it lower vitamin B12?
Yes. Metformin can reduce vitamin B12, especially with longer use or existing risk factors. New tiredness, a sore red tongue, pallor or pins and needles should be assessed.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.