Uses of Trajenta Duo

Trajenta Duo belongs to the group of hormone drugs, hormones, is made in the form of film-coated tablets, used to support blood sugar control for patients with type 2 diabetes.

Trajenta Duo has the active ingredient: Linagliptin and metformin. The drug is indicated for:
Treatment of type 2 diabetes in adults should be co-administered with linagliptin and metformin; inadequate glycemic control on metformin alone; is having good glycemic control with linagliptin and metformin alone; Treatment of type 2 diabetes in adults with inadequate glycemic control when using metformin and a maximally tolerated sulphonylurea in combination with a sulphonylurea. Trajenta Duo is contraindicated:
Hypersensitivity to active ingredients and excipients of the drug; Diabetic patients with ketoacidosis; People with diabetic pre-coma; People with moderate (stage 3b) and severe renal failure, renal dysfunction; Acute conditions that may affect renal function: Severe infection, dehydration, shock, use of intravenous iodinated contrast; Diseases that can cause tissue hypoxia, such as decompensated heart failure, recent myocardial infarction, shock, respiratory failure; People with liver failure; Alcoholics ; People with acute alcohol poisoning.

How to use: Take with meals, increase dose slowly to reduce side effects on the gastrointestinal tract.
Recommended dose of linagliptin/metformin hydrochloride: 2.5/500mg, 2.5/850mg or 2.5/100mg twice daily.
The dose should be selected based on the current treatment regimen, effectiveness, and tolerability in each patient. The maximum recommended daily dose is: 5mg linagliptin and 2000mg metformin.
Specify the specific dose of Trajenta Duo as follows:
Patients who have not recently been treated with metformin: The starting dose is 2.5mg linagliptin/500mg metformin hydrochloride x 2 times/day; Patients who do not have good glycemic control with the maximum dose of metformin monotherapy: The starting dose is linagliptin 2.5mg x 2 times/day (5mg total dose/day) and the current dose of metformin; Patients switching from combination linagliptin + metformin alone: ​​The starting dose is the dose of linagliptin and metformin being used; Patients with inadequate glycemic control on a 2-drug combination regimen including metformin + 1 sulphonylurea at the maximum tolerable dose: 2.5 mg linagliptin twice daily (total dose 5 mg/day) and 1 dose of metformin the patient is currently taking. When Trajenta Duo is combined with a sulphonylurea, a lower dose of the sulphonylurea may be required (due to the risk of hypoglycemia); Patients with renal impairment: Trajenta Duo can be used in patients with moderate renal impairment, stage 3a (creatinine clearance 45 - 59 mg/min or estimated glomerular filtration rate 45 - 59 mL/min/1.73 m2). in the absence of factors that increase the risk of lactic acidosis. Dosage is as follows: The maximum dose of metformin is 500mg twice daily. The patient's renal function should be closely monitored. If creatinine clearance is less than 45 - 59 mg/min or glomerular filtration rate is less than 45 - 59 mL/min/1.73 m2, Trajenta Duo should be discontinued immediately.
Patients with hepatic impairment: Trajenta Duo is contraindicated in patients with hepatic impairment (due to its metformin component).
Elderly: Because metformin is eliminated by the kidneys, the elderly often have reduced renal function, so it is necessary to monitor renal function regularly in the elderly taking Trajenta Duo.
Children and adolescents: Do not use Trajenta Duo on children under 18 years of age.
Missed dose: If you miss a dose of Trajenta Duo, take it as soon as you remember. Be careful not to take a double dose at the same time, so skip the missed dose.
Overdose: Implement supportive treatment measures (remove unabsorbed drugs from the gastrointestinal tract, clinical monitoring, dialysis treatment,...).

When using Trajenta Duo, patients may experience some side effects such as: nasopharyngitis, hypersensitivity reactions, cough, decreased appetite, diarrhea, nausea, vomiting, pancreatitis, itchy skin,... When experiencing these side effects, the patient should immediately notify the doctor.

Some notes users need to remember when using Trajenta Duo:
Do not use Trajenta Duo for patients with type 1 diabetes or diabetic ketoacidosis; Use caution when using the drug in pregnant women, nursing mothers, children under 18 years old; Combined use with drugs that cause hypoglycemia: Linagliptin/metformin in combination with drugs that stimulate insulin secretion and insulin will increase the risk of hypoglycaemia; Complications of lactic acidosis can occur during treatment with Trajenta Duo (due to the accumulation of metformin), which can easily lead to death. Physicians should educate patients to recognize symptoms of lactic acidosis; There is a risk of pancreatitis with the use of linagliptin (the active ingredient in Trajenta Duo). If pancreatitis is suspected, the patient should discontinue the drug and receive appropriate treatment; Serious hypersensitivity reactions may occur in patients receiving linagliptin (active ingredient in Trajenta Duo). Reactions include: Angioedema, anaphylaxis, skin peeling. If a serious hypersensitivity reaction is suspected, the patient should discontinue Trajenta Duo and choose an alternative diabetes treatment; Using metformin (an active ingredient in Trajenta Duo) can cause a decrease in vitamin B12 levels in the body. Therefore, hematological parameters should be checked periodically in patients receiving Trajenta Duo; Alcohol enhances the effect of metformin on lactate metabolism, so patients should limit alcohol use while taking Trajenta Duo; Cardiovascular collapse of any cause is associated with lactic acidosis, which can cause prerenal uremia. Patients being treated with Trajenta Duo should discontinue the drug as soon as these events occur; Because metformin hydrochloride is eliminated by the kidneys, serum creatinine should be determined prior to initiating therapy. After that, periodically check once a year in people with normal kidney function; 2-4 times/year in people with creatinine levels above the upper limit of normal and elderly people. Use with caution when using Trajenta Duo in the elderly; Patients with heart failure are at increased risk for hypoxia and renal failure. Patients with stable chronic heart failure can use Trajenta Duo but need to regularly monitor heart and kidney function. Do not use the drug for patients with acute heart failure and unstable heart failure; The use of intravenous iodinated contrast agents in radiographic examinations can lead to renal failure. Patients should stop taking Trajenta Duo during the survey period as directed by the doctor; Discontinue metformin hydrochloride 48 hours before surgery under general, epidural, or spinal anesthesia. The drug can be used after 48 hours after surgery or the patient is back on oral nutrition with normal kidney function.

Some drug interactions Trajenta Duo patients need to pay attention to:
Combination of multiple doses of linagliptin (10mg x 1 time/day) and metformin (850mg x 2 times/day) in healthy people does not have much effect on pharmacokinetics study of linagliptin and metformin; Using Trajenta Duo in combination with other hypoglycemic agents, ethanol: May cause hypoglycemia; In combination with topiramate: May cause metabolic acidosis, exacerbating the risk of lactic acidosis; Cationic drugs such as cimetidine may interact with metformin; Caution should be exercised when Trajenta Duo is administered with topiramate or carbonic anhydrase inhibitors (zonisamide, acetazolamide, dichlorphenamide) because it reduces serum bicarbonate, causes hyperchloremic metabolic acidosis, and increases the risk of lactic acidosis; Avoid taking Trajenta Duo with alcohol and drugs containing alcohol. Trajenta Duo has strict dosing indications. Patients should take the drug exactly as advised by the doctor to ensure effective treatment, minimize the risk of adverse reactions. Follow Vinmec International General Hospital website to get more health, nutrition and beauty information to protect the health of yourself and your loved ones in your family.