WHAT IS GLYXAMBI?
Glyxambi (empagliflozin and linagliptin) is a tablet that is taken orally in patients with type 2 diabetes mellitus to improve their blood sugar control. It is used in conjunction with diet and exercise.
HOW DOES GLYXAMBI WORK?
Glyxambi is a combination tablet. It contains empagliflozin, a sodium-glucose co-transporter (SGLT2) inhibitor and linagliptin, a dipeptidyl peptidase-4 (DPP-4) inhibitor. Empagliflozin reduces the amount of glucose that is reabsorbed from the kidneys and so lowers blood glucose concentrations in the blood. Linagliptin prevents the breakdown of incretin hormones. Incretin hormones increase the secretion of insulin and decrease the concentration of glucagon. By inhibiting the breakdown of incretin, there is a reduction in blood glucose levels in the blood.
WHAT ARE THE INDICATIONS FOR GLYXAMBI?
Glyxambi is indicated for the management of patients with type 2 diabetes mellitus. It is used in combination with diet and exercise to improve blood glucose concentrations.
WHAT IS THE DOSE OF GLYXAMBI?
The dose of Glyxambi is given as a 10/5 mg combination tablet. This contains 10 mg empagliflozin and 5 mg linagliptin and is taken once daily in the morning. If this dose is well-tolerated, it can be increased to a 25/5 mg combination tablet. This contains 25 mg empagliflozin and 5 mg linagliptin and is taken once daily in the morning.
WARNINGS AND PRECAUTIONS
Glyxambi has been reported to cause acute pancreatitis. This seems to be caused by linagliptin. Patients should be carefully monitored for this complication. If pancreatitis is diagnosed, Glyxambi should be stopped immediately.
Glyxambi has been reported to cause a reduction in blood volume, leading to low blood pressure. This seems to be caused by empagliflozin. This occurs more commonly in patients with renal impairment, older patients, and patients with preexisting low blood pressure.
Impaired renal function
Glyxambi causes an increase in serum creatinine. This is mediated by empagliflozin. It occurs more commonly in elderly patients and those with preexisting renal dysfunction.
Glyxambi, when used together with insulin or drugs that stimulate the secretion of insulin, can cause low blood sugar (hypoglycemia). A lower dose of insulin or insulin secretion stimulators should be used when used in combination with Glyxambi.
Genital fungal infections
Glyxambi increases the risk of developing fungal infections on the genitals.
Urinary tract infections
Glyxambi increases the risk of developing infections in the urinary tract.
There have been reports of severe hypersensitivity reactions in patients taking Glyxambi. These generally occur within three months of starting treatment.
Glyxambi has not been studied well in pregnant women. Evidence suggests that Glyxambi does not affect the fetus. Its use in pregnancy should only be considered if the benefits outweigh the potential fetal risk.
Glyxambi is excreted in breast milk. Only use Glyxambi if the benefits to the mother outweigh the possible risk to the infant.
The safety of Glyxambi in pediatric patients under the age of 18 has not been established.
When used in patients 75 years or older, there is an increased incidence of osmotic diuresis. This increases the risk of hypotension and renal failure.
In patients taking Glyxambi, renal function should be checked on a regular basis. It should not be started in patients with a renal function less than 45 ml/min/1.73 m2. If renal function deteriorates below with level, Glyxambi should be stopped.
Glyxambi can be safely used in patients with hepatic impairment.
Patients with any of the following should not be put on Glyxambi therapy:
- Severe renal impairment or renal failure
- Hypersensitivity to linagliptin or empagliflozin
Common side effects of Glyxambi include:
- Lack of appetite
- Stuffy nose
- Runny nose
- Sore throat
- Infections in the upper respiratory tract
Less common side effects include:
- Urinary tract infections
- Fungal infections on the genitals
- Feeling jittery
- Low blood pressure
- Problems with your kidneys
- Increased levels of cholesterol in your blood
- Acute pancreatitis
- Hypersensitivity reactions
- Swelling of your body, in particular your face or throat.
- Difficulty swallowing
- Difficulty breathing
- Skin rash and raised red areas
If any of these side effects are noticed, a doctor should be consulted urgently.
Certain drugs may interact with Glyxambi. These include:
- Insulin secretagogues
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