linagliptin / metformin
Jentadueto (linagliptin / metformin) is a combination medication used along with a healthy diet and exercise to treat Type 2 diabetes. It's taken by mouth, either once or twice daily, depending on the formulation your provider prescribes (immediate-release or extended-release). Both formulations of Jentadueto (linagliptin / metformin) need to be taken with food to prevent stomach upset. Some of the more common side effects of this medication include diarrhea, cough, and runny or stuffy nose.
What is Jentadueto (linagliptin / metformin)?
What is Jentadueto (linagliptin / metformin) used for?
- Type 2 diabetes in adults
How Jentadueto (linagliptin / metformin) works
Jentadueto (linagliptin / metformin) is a combination of two medications.
- Linagliptin is a dipeptidyl peptidase-4 (DPP-4) inhibitor. It works by blocking DPP-4, a protein that breaks down certain hormones in your body. These hormones normally tell your body to make more insulin and produce less sugar. When DPP-4 causes these hormone levels to drop, you end up having high blood sugar levels. By blocking the action of DPP-4, linagliptin helps your body produce more insulin and make less sugar. In doing so, linagliptin helps lower your blood sugar levels.
- Metformin is a biguanide that lowers blood sugar in several ways. It lowers the amount of sugar that your liver makes. It also makes your body more sensitive to the effects of insulin. When your body is able to use insulin better, it can move more blood sugar into your cells to use as energy. In addition, metformin lowers the amount of sugar that gets absorbed through your intestines. As a result of these three pathways, metformin helps lower the amount of sugar in your bloodstream.
Drug facts
Side effects of Jentadueto (linagliptin / metformin)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Cough, runny or stuffy nose, and other symptoms of an upper respiratory tract infection 6%)
- Diarrhea (6%)
Less Common Side Effects
- Nausea and vomiting
- Passing gas
- Weakness
- Stomach discomfort
- Headache
Jentadueto (linagliptin / metformin) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Buildup of lactic acid: confusion, feeling weak, fast or slow heartbeat, rapid breathing, no appetite, nausea, vomiting
- Inflamed pancreas: upper stomach pain, fever, nausea, vomiting
- Severe skin or allergic reactions: rash, blisters, sores, trouble breathing, swelling
The following Jentadueto (linagliptin / metformin) side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
- Heart failure—shortness of breath, swelling of the ankles, feet, or hands, sudden weight gain, unusual weakness or fatigue
- High lactic acid level—muscle pain or cramps, stomach pain, trouble breathing, general discomfort and fatigue
- Low vitamin B12 level—pain, tingling, or numbness in the hands or feet, muscle weakness, dizziness, confusion, trouble concentrating
- Pancreatitis—severe stomach pain that spreads to your back or gets worse after eating or when touched, fever, nausea, vomiting
- Redness, blistering, peeling, or loosening of the skin, including inside the mouth
- Severe joint pain
Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):
- Cough
- Diarrhea
- Runny or stuffy nose
- Sore throat
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Pros and cons of Jentadueto (linagliptin / metformin)
Pros
- Combines two medications into one pill for convenience
- Taken once or twice daily, depending on which formulation you take
- Taken by mouth
Cons
- Need to take with meals
- Not safe for use in people with moderate-to-severe kidney disease
- More likely to cause high levels of acid compared to some other medications for diabetes
Pharmacist tips for Jentadueto (linagliptin / metformin)
- Take Jentadueto (linagliptin / metformin) with food. The metformin in this medication can cause stomach problems, including diarrhea, nausea, vomiting, and belly pain. So food can help lower the risk of these side effects.
- While you're taking Jentadueto (linagliptin / metformin), make sure to drink enough fluids to keep hydrated, especially if you're experiencing vomiting or diarrhea or feeling ill. These conditions can lead to dehydration and raise your risk of having a buildup of lactic acid in your blood.
- If you're scheduled for a surgery, let your primary care provider know ahead of time. They can discuss with you when to stop Jentadueto (linagliptin / metformin) before surgery and when to restart this medication afterwards. This is because you might not be able to eat or drink during the time around your surgery, which can raise your risk of lactic acidosis.
- Talk with a provider or radiologist about your medication history before getting any procedures done. The contrast dyes that are used for certain imaging procedures can temporarily affect your kidneys. If you're taking Jentadueto (linagliptin / metformin), this effect on the kidneys can raise your risk of metformin buildup in your body and lactic acidosis, which can be dangerous. Don't restart this medication until your provider checks your kidney health to make sure it's safe for you to do so.
- If you feel cold in your hands or feet, dizzy, weak, confused, or nauseous or have trouble breathing, belly pain, or a racing heart, stop taking Jentadueto (linagliptin / metformin) and get medical attention right away. These can be signs of a serious condition called lactic acidosis (high acid levels in the blood), which sometimes can require treatment in the hospital.
- Jentadueto (linagliptin / metformin) can interact with certain medications. For example, ranolazine (Ranexa), a medication used to treat chest pain, can expose your body to more metformin, which raise your risk of lactic acidosis. Let your provider or pharmacist know what medications you're taking, including over-the-counter products and supplements, before you start Jentadueto (linagliptin / metformin).
- Make sure to get your routine blood tests done on time while you’re taking Jentadueto (linagliptin / metformin). By doing so, your provider can check for side effects, like liver injury or changes to your vitamin B12 levels, or your risk for lactic acidosis (too much acid in your blood). This makes sure Jentadueto (linagliptin / metformin) is safe for you to take.
- It's important to eat healthy and exercise regularly to keep your blood sugar under control. Make sure to work with your provider on a diet and exercise plan while taking Jentadueto (linagliptin / metformin).
Common questions about Jentadueto (linagliptin / metformin)
A 6-month clinical study showed that people who took Jentadueto (linagliptin / metformin) saw their A1C drop by 1.2% to 1.6% (depending on the dose of Jentadueto), compared to a drop of 0.1% experienced by people who took placebo. A1C is a measure of the average amount of sugar in your blood over about 3 months. In addition, people who took Jentadueto (linagliptin / metformin) saw their fasting blood sugar levels (before your first meal of the day) drop by an average of 33 mg/dL to 49 mg/dL, whereas people who took placebo saw their fasting blood sugar levels rise by about 10 mg/dL. Overall, people experienced greater improvements in A1C and fasting blood sugar levels with Jentadueto (linagliptin / metformin) than with either Tradjenta (linagliptin) or metformin alone. Follow up with your provider to discuss how well this medication is working to lower your blood sugar levels.
It's best to avoid or limit drinking alcohol if you're taking Jentadueto (linagliptin / metformin). In general, alcohol raises your risk of low blood sugar. In addition, drinking too much alcohol while you're taking Jentadueto (linagliptin / metformin) can raise the risk of having an inflamed pancreas (pancreatitis) or raise the risk of having a high level of acid in your blood (lactic acidosis), which can be dangerous. If you drink alcohol regularly and it's difficult for you to cut it out completely, ask your provider what's a safer amount to drink.
It's possible that your provider might prescribe Jentadueto (linagliptin / metformin) and insulin for you at the same time. Be mindful that taking Jentadueto (linagliptin / metformin) with insulin or other medications that lower your blood sugar level (such as glipizide) puts you at risk for having dangerously low blood sugar levels. Symptoms of low blood sugar include feeling shaky, confused, or very hungry. If you're taking insulin along with Jentadueto (linagliptin / metformin), your provider might ask you to check your blood sugar more often to make sure your levels don't drop too much. Make sure you know how to treat low blood sugar (less than 70 mg/dL) and when you need to call 911.
Jentadueto and Jentadueto XR are 2 different formulations of the same medications - linagliptin and metformin. The main difference between the two formulations is how often you take the medication. Jentadueto, the immediate-release formulation, is taken twice a day with food, while Jentadueto XR, the extended-release formulation, is taken once a day with food. In addition, Jentadueto (linagliptin / metformin) XR tablets shouldn't be cut, crushed, or chewed since this can change how the medication gets absorbed in your body. Talk with your provider to see which formulation is a better option for you.
Jentadueto (linagliptin / metformin) and Glyxambi (empaglifozin / linagliptin) both come in tablets and are used for people with Type 2 diabetes. One main difference between the two medications is the active ingredients in each medication. Both medications contain linagliptin. But Jentadueto also contains metformin, while Glyxambi contains empaglifozin. Another main difference is how you take the medication. You typically take Jentadueto once or twice daily with food, while you take Glyxambi once daily in the morning, with or without food. A third difference is the side effects you get from each medication. For example, Jentadueto can cause low vitamin B12 levels or high levels of lactic acid, while Glyxambi can raise your risk of genital and urinary tract infections. Ask your provider about the pros and cons of each product to decide which one is a good choice for you.
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Risks and warnings for Jentadueto (linagliptin / metformin)
Jentadueto (linagliptin / metformin) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Lactic acidosis (too much acid in your body)
- Risk factors: Kidney or liver problems | Heart failure or heart attack | Age 65 or older | Not eating food or fasting before surgery | Excessive alcohol use | Imaging procedure using contrast dye | Taking certain medications that affect the kidneys
Metformin in Jentadueto (linagliptin / metformin) can cause a rare, but serious medical condition called lactic acidosis (too much lactic acid in your blood). If left untreated, this condition can lead to other health problems, including organ failure, which can be deadly. Discuss with your primary care provider about your medical history before starting Jentadueto (linagliptin / metformin) and any planned procedures during treatment. They can check for your risk for lactic acidosis. Get medical attention immediately if you experience trouble breathing, irregular heartbeat, muscle pain, belly pain, or feeling very tired or dizzy. These can be signs that you have too much lactic acid in your blood.
Pancreas problems
Though rare, people who took linagliptin in clinical studies have reported having inflammation of the pancreas (pancreatitis). It's not known if Jentadueto (linagliptin / metformin) can raise your risk of pancreatitis if you've had this problem before. Some common symptoms of an inflamed pancreas are upper stomach pain, fever, nausea, and vomiting. If you start to feel any of these symptoms, contact your provider right away. You might need to stop taking Jentadueto (linagliptin / metformin).
Heart failure
- Risk factors: Heart failure | Heart problems | Kidney problems
If you've recently had a heart or kidney problem, let your provider know before starting Jentadueto (linagliptin / metformin). Though rare, people who took medications similar to linagliptin have developed heart failure. But it's unclear whether Jentadueto (linagliptin / metformin) carries this same risk and more research is needed in this area. Let your provider know right away if you experience any symptoms of heart failure, such as trouble breathing, tiredness, swelling in your body, or sudden weight gain. Your provider might recommend that you go to the hospital and that you stop taking Jentadueto (linagliptin / metformin).
Serious allergic reactions
- Risk factor: History of allergy to DPP-4 inhibitors (also called "gliptins")
Jentadueto (linagliptin / metformin) might cause serious allergic reactions, such as rash, peeling or blistering skin, swelling, trouble breathing, and dizziness. Let your provider know if you've had an allergic reaction to other DPP-4 inhibitors or "gliptins", such as Januvia (sitagliptin) or Tradjenta (linagliptin). Though unclear, it's possible that taking Jentadueto (linagliptin / metformin) might cause you to have another allergic reaction. If you experience an allergic reaction to Jentadueto (linagliptin / metformin), stop the medication and get medical care right away.
Low vitamin B12 levels
- Risk factors: Long-term use of metformin | Lower than average calcium or vitamin B12 intake
Taking diabetes medications that contain metformin, including Jentadueto (linagliptin / metformin), for a long period of time can cause your vitamin B12 levels to drop. Having low vitamin B12 levels can lead to a higher risk of anemia. Your provider will check your vitamin B12 levels through blood work every 2 to 3 years. If needed, your provider might recommend that you take vitamin B12 supplementation. Let your provider know if you frequently have low energy, dizziness, muscle problems, or tingling or numbness in your hands and feet.
Joint pain
People who take diabetic medications similar to linagliptin in Jentadueto (linagliptin / metformin) have experienced severe joint pain. This can happen anytime from a day to many years after starting the medication. For most people, the pain goes away after they stop the medication. If you experience any discomfort in your joints, speak to your provider right away.
Severe skin reactions
Some people taking Jentadueto (linagliptin / metformin) have experienced an itchy, blistering rash (bullous pemphigoid). Typically, the blisters or sores go away once you stop taking the medication. If you have itchy skin, rash with blisters, or sores, talk to a provider right away and stop taking Jentadueto (linagliptin / metformin).
Jentadueto (linagliptin / metformin) dosage
Tablet| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 2.5mg/500mg | 60 tablets | $310.43 | $5.17 |
| 2.5mg/850mg | 10 tablets | $88.26 | $8.83 |
| 2.5mg/1000mg | 60 tablets | $482.08 | $8.03 |
Typical dosage for Jentadueto (linagliptin / metformin)
- Jentadueto (linagliptin / metformin): The typical starting dose is 2.5 mg/500 mg (linagliptin / metformin) by mouth twice daily with food. The maximum dose is 2.5 mg/1000 mg (linagliptin / metformin) twice daily.
- Jentadueto (linagliptin / metformin) XR: The typical starting dose is 5 mg/1000 mg (linagliptin / metformin) by mouth once daily with food. The maximum dose is 5 mg/2000 mg (linagliptin / metformin) once daily.
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Jentadueto (linagliptin / metformin) contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Jentadueto (linagliptin / metformin) will not be safe for you to take.
- Severe kidney problems
- Sudden or long-term acidosis (dangerously high levels of acid), including diabetic ketoacidosis
- History of allergic reaction to Tradjenta (linagliptin) or metformin
What are alternatives to Jentadueto (linagliptin / metformin)?
