Ritagen Duo Tablet 2.5/500 mg

Adult dose

The dosage of this medication is determined based on the maximum recommended doses of the individual components, Linagliptin 2.5 mg and Metformin 1000 mg, not exceeding twice a day, considering the current treatment regimen, efficacy, and tolerability of each patient. This medication is administered twice daily with meals. To reduce gastrointestinal side effects associated with Metformin, dosage increases should be gradual. 1. If currently not treated with Metformin: In cases where there has been no prior experience with diabetes drug therapy and blood sugar control is difficult with monotherapy, the initial dosage is 2.5/500 mg of this medication taken twice daily, with the option to increase to 2.5/1000 mg, one tablet twice a day. 2. In cases transferring from combination therapy with Linagliptin and Metformin: Patients transitioning from a combination therapy of Linagliptin and Metformin should continue taking the same dosage as previously prescribed. 3. If adequate blood sugar control cannot be achieved through a combination of insulin and Metformin: The initial dosage of this medication should consider Linagliptin 2.5 mg taken twice daily (total daily dosage of 5 mg) along with a similar dose to the existing Metformin dosage. When used in combination with insulin, a reduction in insulin dosage may be necessary to reduce the risk of hypoglycemia (refer to precautions for caution in certain patients). There have been no studies conducted on the safety and efficacy of transitioning patients previously treated with other oral hypoglycemic medications to this medication. Any changes in the treatment regimen for type 2 diabetes can lead to changes in blood sugar control, hence careful monitoring is required. For patients with renal impairment: This medication may be used with dose adjustments in patients with moderate renal impairment stage 3a (creatinine clearance [CrCl] 45≤~<60 ml/min or estimated glomerular filtration rate [eGFR] 45≤~<60 mL/min/1.73 m2) without accompanying symptoms that would increase the risk of lactic acidosis. The starting dose of Metformin should not commence at 500 mg or 850 mg once daily. The maximum recommended dose of Metformin is 500 mg twice daily. Kidney function should be closely monitored every 3-6 months. If CrCl < 45 ml/min or eGFR < 45 ml/min/1.73m2 indicating reduced kidney function occurs, this medication should be discontinued immediately. For patients with liver impairment: This medication should not be administered to patients with liver dysfunction due to the Metformin component. (Refer to precautions for contraindications).

This medication may cause serious side effects such as lactic acidosis due to its Metformin Hydrochloride component, and there have been reported fatalities. It should not be administered to certain patients, such as those allergic to the active ingredients, or those with type 1 diabetes, lactic acidosis, or diabetic ketoacidosis. Additionally, it should not be given to patients with severe renal impairment, severe liver dysfunction, acute infections or dehydration, or acute diseases such as acute myocardial infarction. Pregnant or breastfeeding women are also advised against using this medication. There is a possibility of hypoglycemia; therefore, special caution should be taken when used with insulin or sulfonylureas, and dosages of other medications may need to be adjusted as necessary. Patients with reduced renal function should assess their kidney function prior to using this medication and undergo regular kidney function tests. Serious pancreatic diseases, such as acute pancreatitis, may occur; therefore, if severe abdominal pain develops during use, immediate consultation with a physician is necessary. This medication may reduce vitamin B12 levels, so it is essential to regularly check for vitamin B12 deficiency during long-term use. Furthermore, this drug may interact with other medications; thus, it is crucial to inform the doctor or pharmacist of any current medications being taken. If planning to become pregnant or if already pregnant, it is advised to avoid using this medication and to consider alternative methods such as insulin treatment for blood glucose management. Elderly patients may have a higher risk of reduced kidney function; therefore, starting at the lowest possible dose and monitoring kidney function regularly is necessary for effective blood glucose management. It is important to consult healthcare professionals immediately if any unusual symptoms or side effects occur during use.

Serious side effects

Hives, angioedema, lactic acidosis, pancreatitis, similar pemphigus, severe rash with fever, blistering, peeling skin, pain in mouth/eyes mucosa, difficulty breathing, asthma attacks, respiratory abnormalities accompanied by cough and fever, yellowing of skin or eyes (jaundice), systemic lethargy, sudden and very severe headache, lightning headache, seizures, clouding of consciousness, visual disturbances, paralysis, significant decrease in urine output, systemic severe edema, increased blood pressure

Mild side effects

Nasopharyngitis, hypersensitivity, hypoglycemia, taste disturbances, cough, decreased appetite, diarrhea, constipation, nausea, vomiting, abdominal pain, oral ulcer formation, abnormal liver function tests, hepatitis, pruritus, erythema, rashes, arthralgia associated with severe and disabling conditions, increase in lipase, increase in amylase, decrease in vitamin B12, angioedema, dyspepsia, upper abdominal pain, gastrointestinal disturbances, stomatitis, dehydration, hyperglycemia, dizziness, drowsiness, fatigue, itching,

This medication should be stored in a tightly sealed container to protect it from air and moisture. It is important to maintain a storage temperature between 1 and 30 degrees Celsius at room temperature. This helps to preserve the effectiveness of the medication for a longer period.

Appearance

Bright yellow, oval-shaped, biconvex film-coated tablet

Package unit

30 tablets/bottle, 30 tablets/PPT [10 tablets/PTPx3]