linagliptin (Tradjenta)
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Indications
- adjunct to diet & exercise to improve glycemic control in adults with diabetes mellitus type 2
- may be use in combination with other oral hypoglycemic agents including metformin, glimepiride, &/or pioglitazone
- safe for patients > 70 years of age not taking a sulfonylurea[6]
- add-on therapy to insulin in patients with type 2 diabetes[5]
* neither cardiovascular benefits or cardiovascular harms[8]
Contraindications
- avoid in combination with sulfonylurea[6]
- has not been studied in combination with insulin
Dosage
- 5 mg PO QD
- may be taken with or without food
- no dosage adjustment with renal insufficiency[3][7]
Tabs: 5 mg
Dosage adjustment in renal failure
Adverse effects
Drug interactions
- increased risk of hypoglycemia when used in combination with sulfonylurea
- drug interaction(s) of gliptins with sulfonylureas
- drug interaction(s) of fluoroquinolones with hypoglycemic agents
Mechanism of action
- dipeptidyl peptidase-4 inhibitor
- inhibits incretin catabolism
- enhances incretin system Cllinical trials:
- non-inferior to glimepiride as add-on to metformin [ 4]
- non-inferior to sulfonylurea for cardiovascular risk, hypoglycemia is less, but cost is much higher[9]
More general terms
Component of
References
- ↑ FDA NEWS RELEASE: May 2, 2011 http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm253501.htm
- ↑ Highlight linigliptin of prescribing information http://bidocs.boehringer-ingelheim.com/BIWebAccess/ViewServlet.ser?docBase=renetnt&folderPath=/Prescribing+Information/PIs/Tradjenta/Tradjenta.pdf
- ↑ 3.0 3.1 Prescriber's Letter 18(6): 2011 New Drug: Tradjenta (Linagliptin) Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=270604&pb=PRL (subscription needed) http://www.prescribersletter.com
- ↑ Gallwitz B et al 2-year efficacy and safety of linagliptin compared with glimepiride in patients with type 2 diabetes inadequately controlled on metformin: a randomised, double-blind, non-inferiority trial The Lancet, Early Online Publication, 28 June 2012 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/22748821 <Internet> http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2812%2960691-6/fulltext
Scheen AJ and Paquot N Gliptin versus a sulphonylurea as add-on to metformin The Lancet, Early Online Publication, 28 June 2012 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/22748818 <Internet> http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(12)60859-9/fulltext - ↑ 5.0 5.1 Physician's First Watch, Aug 27 2012 Massachusetts Medical Society http://www.jwatch.org
FDA approves updated prescribing information for Tradjenta <TM> (linagliptin) tablets for add-on therapy to insulin in adults with type 2 diabetes http://newsroom.lilly.com/releasedetail.cfm?ReleaseID=701013 - ↑ 6.0 6.1 6.2 Barnett AH et al. Linagliptin for patients aged 70 years or older with type 2 diabetes inadequately controlled with common antidiabetes treatments: A randomised, double-blind, placebo-controlled trial. Lancet 2013 Aug 13 PMID: https://www.ncbi.nlm.nih.gov/pubmed/23948125
- ↑ 7.0 7.1 7.2 Neumiller JJ1, Setter SM. Review of linagliptin for the treatment of type 2 diabetes mellitus. Clin Ther. 2012 May;34(5):993-1005. PMID: https://www.ncbi.nlm.nih.gov/pubmed/22440191
- ↑ 8.0 8.1 Rosenstock J, Perkovic V, Johansen OE et al. Effect of linagliptin vs placebo on major cardiovascular events in adults with type 2 diabetes and high cardiovascular and renal risk: The CARMELINA randomized clinical trial. JAMA 2018 Nov 9; PMID: https://www.ncbi.nlm.nih.gov/pubmed/30418475 https://jamanetwork.com/journals/jama/fullarticle/2714646
McGuire DK, Alexander JH, Johansen OE et al. Linagliptin effects on heart failure and related outcomes in individuals with type 2 diabetes mellitus at high cardiovascular and renal risk in CARMELINA. Circulation 2018 Nov 11 Not indexed in PubMed https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.118.038352 - ↑ 9.0 9.1 Rosenstock J et al. Effect of linagliptin vs glimepiride on major adverse cardiovascular outcomes in patients with type 2 diabetes: The CAROLINA randomized clinical trial. JAMA 2019 Sep 19; 322:1155 PMID: https://www.ncbi.nlm.nih.gov/pubmed/31536101 https://jamanetwork.com/journals/jama/article-abstract/2751398
- ↑ 10.0 10.1 NEJM Knowledge+ Endocrinology