What is Jentadueto?

Jentadueto is a medication for the treatment of type 2 diabetes that contains two prescription drugs, Linagliptin and Metformin. Linagliptin is a member of a family of drugs called dipeptidyl peptidase-4 (DPP-4) inhibitors, which work to help you lower your blood sugar levels. Metformin is a member of a family of drugs called biguanides, which help to decrease the amount of sugar made by your liver and help your cells to respond to insulin.

What is it used for?

Jentadueto is generally prescribed along with a healthy diet and regular exercise to help improve the regulation of blood sugar in adults with type 2 diabetes.

It is prescribed for patients:

• who are not controlled on Metformin alone
• currently on Linagliptin (Trajenta) and Metformin alone
• who use a combination drug with a sulfonylurea

How does it work?

Jentadueto is a medication that contains two antidiabetic drugs, Linagliptin and Metformin. Linagliptin belongs to a group of medications called dipeptidyl peptidase-4 inhibitors, or DPP-4 inhibitors for short. They help you control blood sugar by blocking the breakdown of hormones that are involved with your appetite, your eating habits, and how your body digests food. More importantly, these hormones affect how your body regulates blood sugar levels. When the medication slows the breakdown of these hormones, your pancreas will start to increase insulin production. Linagliptin also decreases production of glucagon in the pancreas, which can increase your blood sugar levels. When your blood sugar levels start to return to normal, the effects of insulin and glucagon slowly diminishes. This stops your medication from causing low blood sugar, or hypoglycemia, which is a common side effect in many oral antidiabetic drugs.

Metformin belongs to the biguanide class of antidiabetic drugs, and its main effect is a decrease in sugar production that occurs in your liver. It also increases your body’s sensitivity to insulin, which increases the ability for your body to process sugar. Mainly, Metformin decreases high blood sugar by slowing sugar production in your liver, which is medically known as hepatic gluconeogenesis. An average patient with type 2 diabetes has three times the normal rate of heptic gluconeogenesis, and with Metformin treatment it has been shown to reduce this by over one-third. Besides decreasing liver sugar production, Metformin also decreases the absorption of blood sugar from your gastrointestinal (GI) tract.

How to take this medication

Before taking this drug, your doctor should assess your kidney function with what is called an estimated glomerular filtration rate (eGFR). Once you are prescribed Jentadueto, it is taken once daily with a meal. Make sure to swallow the tablet whole. Do not split, crush, dissolve, or chew the tablet.

Dosage

The usual adult dose is 2.5 mg (Linagliptin) and 500 mg (Metformin), or 2.5/850 mg, or 2.5/1000 mg, twice daily, taken with meals. Take the Jentadueto tablet with meals to lower your chance of getting an upset stomach. Make sure to not exceed a total daily dose of Linagliptin 5 mg and Metformin 2000 mg.

Warnings and Precautions

You should not take this medication if you:

• are allergic (hypersensitive) to Linagliptin, Metformin or any of the other non-medicinal ingredients
• have type 1 diabetes (your body does not produce any insulin)
• had, or have liver or kidney problems
• have a history of lactic acidosis
• have metabolic acidosis or diabetic ketoacidosis (increased ketones in the blood or urine)
• have upcoming x-ray tests that require the injection of dyes or contrast agents
• are highly stressed, have severe infections, are experiencing trauma, are prior to a surgery or have recently had surgery
• have cardiovascular collapse (abrupt failure of blood circulation) or cardiorespiratory insufficiency
• are dehydrated (a reduction in the amount of body fluids). This can happen if you are sick with a fever, vomiting, or diarrhea, or sweat a lot with activity or exercise and do not drink enough fluids.
• drink a lot of alcohol, regularly or occasionally (such as in binge drinking)
• are breastfeeding
• are pregnant or are planning on becoming pregnant

Jentadueto side effects

In rare cases, lactic acidosis caused by metformin has resulted in death, hypothermia, hypotension, and resistant bradyarrhythmias (slow heart rhythm). Symptoms of lactic acidosis include feeling sick, myalgias (muscle pain), somnolence (drowsiness), respiratory distress, and abdominal pain.

Risk factors for lactic acidosis include kidney impairment, the use of other drugs at the same time, being older than 65, imagery studies with the use of a contrast dye, surgery and other procedures, hypoxic states, and excessive alcohol intake.

Common side effects may include:

• Stuffy nose or runny nose and sore throat (nasopharyngitis)
• Diarrhea, nausea, and stomach upset, bloating, flatulence>

Less common side effects may include:

• Allergic reactions, such as hives, rash, and swelling of the lips, face, and throat, or coughing, wheezing, or shortness of breath
• Pancreatitis (inflammation or infection of the pancreas)
• Lactic Acidosis, a build-up of lactic acid in the blood that can cause death
• Low blood sugar (hypoglycemia)
• Mouth ulceration

If you take Jentadueto with other medications that can cause low blood sugar, such as sulfonylurea drugs, you have a higher risk of having low blood sugar. Call your doctor if you have any symptoms of low blood sugar. You should first check your blood sugar levels and after treating them, call your doctor. Symptoms of low blood sugar level can include shaking, sweating, rapid heartbeat, change in vision, hunger, headache and change in mood.

Manufacturer: Boehringer Ingelheim