Dosage and administration:
LINAMET should be given twice daily with meals. Dose escalation should be gradual to reduce thegastrointestinal (GI) side effects associated with metformin use. For available dosage forms and strengths.
 Recommended starting dose:
- In patients currently not treated with metformin, initiate treatment with 2.5 mg linagliptin/500 mg metformin hydrochloride twice daily.
- In patients already treated with metformin, start with 2.5 mg linagliptin and the current dose of metformin taken at each of the two daily meals (e.g., a patient on metformin 1000 mg twice daily would be started on 2.5 mg linagliptin/1000 mg metformin hydrochloride twice daily with meals).
- Patients already treated with linagliptin and metformin individual components may be switched to LINAMET containing the same doses of each component.
- No studies have been performed specifically examining the safety and efficacy of LINAMET in patients previously treated with other oral antihyperglycemic agents and switched to LINAMET. Any change in therapy of type 2 diabetes mellitus should be undertaken with care and appropriate monitoring as changes in glycemic control can occur.
Concomitant Use with an Insulin Secretagogue (e.g., Sulfonylurea) or with Insulin
When LINAMET is used in combination with an insulin secretagogue (e.g., sulfonylurea) or with insulin, a lower dose of the insulin secretagogue or insulin may be required to reduce the risk of hypoglycemia.
Side effect:
Adverse reaction reported in >5% of patients treated with Linamet and more commonly than in patients treated with placebo are nasopharyngitis and diarrhea. Hypoglycemia was more commonly reported in patients treated with the combination of Linamet and SU compared with those treated with the combination of SU and Metformin.
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