Linagliptin

What linagliptin does

Linagliptin is a DPP-4 inhibitor, or gliptin, taken once a day by adults with type 2 diabetes alongside diet and exercise. Its practical selling point is how it is cleared. It leaves the body mostly through the gut, not the kidneys, so someone with weak kidneys or a liver condition takes the same 5mg as everyone else. It works by holding back the enzyme that breaks down the gut hormones that trigger insulin, and only while blood sugar is high, so on its own it rarely pushes sugar too low. It does not suit type 1 diabetes or diabetic ketoacidosis.

The two listings

Tradjenta is generic linagliptin on its own: 5mg tablets, one a day.

Glyxambi is a combination in 25/5mg tablets. It adds empagliflozin, an SGLT2 inhibitor that makes the kidneys pass glucose into the urine, to the linagliptin. Two drugs with different actions in one tablet suit someone whose blood sugar needs more than a single medicine. Its page covers the empagliflozin side effects in detail, and the empagliflozin page covers that ingredient on its own.

How it is taken

One tablet a day, at whatever hour suits you, as long as it is the same hour. Food makes no difference. A missed tablet can be taken as soon as you notice, never doubled. Home glucose readings and the HbA1c blood test every few months show how well it is holding blood sugar down.

What to expect

Runny nose, sore throat and cough are the commonest complaints, with some joint pain. Rarely linagliptin inflames the pancreas: severe stomach pain spreading to the back, often with vomiting, means stopping the tablet and getting urgent help. Blistering skin and swelling of the face or lips are also reported. People with a past of pancreatitis or gallstones, or who drink heavily, carry more risk.

Low blood sugar becomes likely when linagliptin joins insulin or a sulfonylurea such as gliclazide, and the dose of those may need lowering. Rifampicin, carbamazepine, phenytoin and St John's wort weaken linagliptin. It is not advised in pregnancy.