Trajenta Duo contains linagliptin that belongs to a class of drugs called DPP-4 inhibitors (dipeptidyl peptidase-4 inhibitors). It is prescribed in the treatment of Type 2 Diabetes mellitus. Metformin is an agent belonging to the biguanide class of antidiabetics. It is used in the treatment of non-insulin-dependent diabetes mellitus
Linaglitin has a unique way of controlling blood glucose. GLP-1 and GIP are two most important hormones in body that stimulate insulin secretion in response to food intake. DPP-4 destroys GLP-1 and GIP. This leads to an increase in blood glucose levels as insulin is not secreted as required. Linagliptin inhibits DPP-4 and hence prevents inactivation of GLP-1 and GIP by DPP-4. This allows GLP-1 and GIP to potentiate the secretion of insulin in beta cells of pancreas. It also suppresses glucagon release by the alpha cells in the pancreas that is responsible to increase the glucose content of blood.
Linagliptin has a better safety profile as compared to other drugs in its class and hence can be prescribed in patients with poor kidney function.
Trajenta Duo is a brand from Boehringer Ingelheim pharmaceutical company. Established in 1885, Boehringer Ingelheim is one of the leading companies in India.
Their vision is to develop innovative therapies that can extend patients’ lives. “Making more health” is a company’s initiative with the goal to improve health in communities around the world.
Your doctor may have prescribed Trajenta Duo because you could be suffering from Type II Diabetes.
Trajenta Duo is an orally available antidiabetic agent which contains the active substance Linagliptin. It increases the count of natural substances known as incretins which in turn helps increase insulin release by the pancreas while decreasing the production of sugars by your liver. Trajenta Duo is prescribed for patients suffering from type-2 diabetes which arises when the body is not able to use insulin effectively. Diabetes occurs when your blood glucose (blood sugar) is too high.
Blood glucose is your main source of energy and it comes from the food you consume. Your pancreas produces a hormone called insulin, which helps convert the glucose from your food to energy by carrying it into your cells. In a diabetic patient, their body doesn’t produce enough insulin or doesn’t manage insulin well. Glucose then accumulates in your blood and doesn’t reach your cells causing a host of health problems and diseases that may include:
Trajenta Duo has been known to work well among patients with impaired insulin production, who follow a proper diet and exercise routine.
As directed by your Physician
As directed by your Physician
Adverse Reactions/ Side Effects
Hypoglycaemia, severe and disabling arthralgia, nasopharyngitis, rash, mouth ulcer, stomatitis, diarrhoea, cough. Rarely, hypersensitivity reactions.
Potentially Fatal: Acute pancreatitis.
Warnings and Precautions
Patient w/ history of pancreatitis; angioedema to other DPP-4 inhibitor. Not intended in patients w/ IDDM or for the treatment of diabetic ketoacidosis. Pregnancy and lactation. Monitoring Parameters Monitor HbA1Cand serum glucose levels; signs/symptoms of pancreatitis.
Patients with risk factors for lactic acidosis, stable heart failure, dehydration, prerenal azotemia. Mild to moderate renal impairment. Hepatic impairment. Children and elderly. Pregnancy and lactation. Monitor renal function prior to initiation of therapy and annually thereafter; haematologic parameters at baseline and annually thereafter; vitamin B12 serum concentration every 2-3 years (prolonged use). Monitor for signs and symptoms of lactic acidosis.
Acute or chronic metabolic acidosis with or without coma, acute conditions which may alter renal function (e.g. dehydration, severe infection, shock), acute or chronic disease-causing hypoxia (e.g. unstable cardiac or respiratory failure, recent MI, shock), acute alcohol intoxication or alcoholism. Severe renal (eGFR<30 mL/min) impairment. Intravascular administration of iodinated contrast agents.
Increased risk of hypoglycaemia when used w/ an insulin secretagogue (e.g. sulfonylurea) or insulin. Plasma concentration of linagliptin may be decreased by strong inducers of P-glycoprotein (e.g. rifampicin) and may be increased by strong P-glycoprotein inhibitors (e.g. ritonavir).
Increased risk of lactic acidosis with carbonic anhydrase inhibitors (e.g. acetazolamide, dichlorphenamide), NSAIDs, and antihypertensive agents (e.g. ACE inhibitors). Increased plasma concentration and reduced clearance with OCT2 inhibitors (e.g. cimetidine, dolutegravir, ranolazine, trimethoprim, vandetanib, isavuconazole).
Potentially Fatal: Contrast-induced nephropathy and increased risk of lactic acidosis with iodinated contrast agents.
Hypoglycaemia, lactic acidosis manifested as acidotic dyspnoea, abdominal pain, muscle cramps, hypothermia followed by coma.
Perform haemodialysis to remove lactate and metformin in the blood.
Oral: Store at 25°C.
Mechanism of Action
Linagliptin inhibits dipeptidyl peptidase-4 (DPP-4), an enzyme which is involved in the inactivation of the incretin hormones GLP-1 (glucagon-like peptide-1) and GIP (glucose-dependent insulinotropic polypeptide). Both incretin hormones are involved in the physiological regulation of glucose homeostasis. Inhibition of DPP-4 leads to increased and prolonged active incretin levels. Metformin decreases hepatic gluconeogenesis, decreases intestinal absorption of glucose and improves insulin sensitivity (increases peripheral glucose uptake and utilisation).