Narigenta Duo Extended Release Tablet 2.5/1000 mg (Linagliptin, Metformin Hydrochloride)

Adult dose

This medication should be taken once a day with the evening meal. To maintain its extended-release characteristics, this medication should not be split, crushed, ground, or chewed, but swallowed whole. One 5/1000 mg extended-release tablet should be taken once daily; patients taking the 2.5/1000 mg extended-release tablet should take 2 tablets at the same time once daily. 1. If currently being treated with metformin

This medication's active ingredient, metformin hydrochloride, can rarely cause serious lactic acidosis or hypoglycemia, so caution is needed. This medication should not be administered to certain patients. For example, it should not be used in individuals allergic to this medication or its ingredients, in cases of type 1 diabetes, severe renal impairment, severe liver dysfunction, acute alcohol intoxication, heart failure, or during pregnancy. Due to the risk of hypoglycemia, blood sugar levels should be monitored carefully, especially when taken in combination with sulfonylureas or insulin. Lactic acidosis is a very rare side effect but poses significant risks; hence, the medication should be discontinued immediately and a doctor consulted in cases of dehydration, severe infection, or a rapid decline in heart or kidney function. Kidney function has a significant impact, so regular kidney function tests should be conducted before and during treatment. Patients with weak heart function or cardiovascular diseases such as acute myocardial infarction should use this medication cautiously. If iodine contrast is administered during radiological examinations, the medication should be stopped and kidney function reassessed before resuming. The medication should be discontinued for a certain period before and after surgery; it can be resumed once kidney function returns to normal post-surgery. If acute pancreatitis or blistering skin conditions are suspected while taking this medication, the patient should inform a doctor immediately and stop taking the medication. Metformin can lower Vitamin B12 levels; therefore, it is advisable to regularly check for Vitamin B12 deficiency during long-term use. This medication should be swallowed whole and not crushed or chewed, and the tablet shell may appear in stool, which is normal. Due to potential interactions with other medications, especially those that can affect kidney function, caution is advised when used in combination with other drugs. It is recommended to avoid using this medication during pregnancy or breastfeeding, and consult a doctor if planning a pregnancy. Safety and efficacy in pediatric patients have not been established, so it is preferable not to use it in this population. Elderly individuals are at higher risk for decreased kidney function, so treatment should start at the minimum dosage and kidney function should be monitored regularly. In cases of overdose, there is a risk of lactic acidosis, requiring immediate medical treatment, which may include blood dialysis. This medication should be kept out of reach of children and stored away from moisture.

Serious side effects

Urticaria, severe swelling (edema), lactic acidosis, angioedema, pancreatitis, blistering dermatosis, liver function abnormalities (liver dysfunction, hepatitis, jaundice), fever, facial swelling, chest tightness, difficulty breathing, respiratory distress, asthma, acute myocardial infarction, unstable angina, cardiac arrest, acute kidney injury, end-stage kidney disease, acute cholangitis, acute cholecystitis, cholangitis, acute pyelonephritis, sepsis, acute myocardial infarction, headache, confusion of consciousness

Mild side effects

Taste disturbance, cough, reduced appetite, diarrhea, constipation, nausea, vomiting, abdominal pain, oral ulcer, liver function abnormalities, hepatitis, itching, erythema, rash, musculoskeletal and connective tissue disorders, increased lipase, increased amylase, rhinitis, hypersensitivity reactions, angioedema, abnormal Vitamin B12 absorption tests, hypoglycemia (when used with sulfonylureas), increased triglycerides, reduced hemoglobin, increased potassium levels, increased creatinine levels, blood

This medication should be stored in a tightly sealed container to prevent exposure to air or moisture. It is also safe to store it at room temperature between 1 degree and 30 degrees Celsius, avoiding extremely hot or cold places.

Appearance

Oval extended release tablet, white to almost white in color, engraved with N251 on one side

Package unit

28 tablets/box (7 tablets/PTP x 4), 30 tablets/bottle