linagliptin

(redirected from Tradjenta)
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linagliptin

(lin-a-glip-tin) ,

Tradjenta

(trade name),

Trajenta

(trade name)

Classification

Therapeutic: antidiabetics
Pharmacologic: dipeptidyl peptidase4 ddp4 inhibitors
Pregnancy Category: B

Indications

Adjunct to diet and exercise in the management of type 2 diabetes mellitus.

Action

Inhibits the enzyme dipeptidyl peptidase-4 (DPP-4), which slows the inactivation of incretin hormones, resulting in increased levels of active incretin hormones. These hormones are released by the intestine throughout the day, and are involved in regulation of glucose. Increased/prolonged incretin levels increase insulin release and decrease glucagon levels.

Therapeutic effects

Improved control of blood glucose.

Pharmacokinetics

Absorption: 30% absorbed following oral administration.
Distribution: Extensively distributed to tissues.
Metabolism and Excretion: Approximately 90% excreted unchanged in urine; mininally metabolized.
Half-life: >100 hr (due to saturable binding to DPP-4).

Time/action profile

ROUTEONSETPEAKDURATION
POunknown1.5 hr†24 hr
† Blood level.

Contraindications/Precautions

Contraindicated in: Hypersensitivity. Cross-sensitivity may occur with sitagliptin;Type 1 diabetes mellitus;Diabetic ketoacidosis.
Use Cautiously in: History of pancreatitis; Geriatric: Elderly may have greater sensitivity to drug effects; Obstetric: Use during pregnancy only if clearly needed; Lactation: Excretion in breast milk unknown, use cautiously; Pediatric: Safety and effectiveness not established.

Adverse Reactions/Side Effects

Respiratory

  • bronchial hyperreactivity

Gastrointestinal

  • pancreatitis (life-threatening)

Dermatologic

  • localized exfoliation
  • urticaria

Metabolic

  • hypoglycemia
  • hypertriglyceridemia

Miscellaneous

  • hypersensitivity reactions including angioedema

Interactions

Drug-Drug interaction

↑ risk of hypoglycemia with sulfonylureas or insulin ; dose ↓ of sulfonylurea or insulin may be necessary.Concurrent use of P-glycoprotein or CYP3A4 inducers, including rifampin may ↓ blood levels and effectiveness and should be avoided.

Route/Dosage

Oral (Adults) 5 mg once daily.

Availability

Tablets: 5 mg
In combination with: metformin (Jentadueto). See combination drugs.

Nursing implications

Nursing assessment

  • Observe patient for signs and symptoms of hypoglycemic reactions (abdominal pain, sweating, hunger, weakness, dizziness, headache, tremor, tachycardia, anxiety).
  • Monitor for signs of pancreatitis (nausea, vomiting, anorexia, persistent severe abdominal pain, sometimes radiating to the back) during therapy. If pancreatitis occurs, discontinue linagliptin and monitor serum and urine amylase, amylase/creatinine clearance ratio, electrolytes, serum calcium, glucose, and lipase.
  • Lab Test Considerations: Monitor hemoglobin A1C prior to and periodically during therapy.
    • May cause ↑ uric acid levels.

Potential Nursing Diagnoses

Imbalanced nutrition: more than body requirements (Indications)
Noncompliance (Patient/Family Teaching)

Implementation

  • Patients stabilized on a diabetic regimen who are exposed to stress, fever, trauma, infection, or surgery may require administration of insulin.
  • Oral: May be administered without regard to food.

Patient/Family Teaching

  • Instruct patient to take linagliptin as directed. Take missed doses as soon as remembered, unless it is almost time for next dose; do not double doses. Advise patient to read the Patient Package Insert before starting and with each Rx refill; new information may be available.
  • Explain to patient that linagliptin helps control hyperglycemia but does not cure diabetes. Therapy is usually long term.
  • Instruct patient not to share this medication with others, even if they have the same symptoms; it may harm them.
  • Encourage patient to follow prescribed diet, medication, and exercise regimen to prevent hyperglycemic or hypoglycemic episodes.
  • Review signs of hypoglycemia and hyperglycemia with patient. If hypoglycemia occurs, advise patient to take a glass of orange juice or 2–3 tsp of sugar, honey, or corn syrup dissolved in water, and notify health care professional.
  • Instruct patient in proper testing of blood glucose and urine ketones. These tests should be monitored closely during periods of stress or illness and health care professional notified if significant changes occur.
  • Advise patient to notify health care professional promptly if signs and symptoms of pancreatitis or if rash; hives; or swelling of face, lips, or throat occur.
  • Advise patient to notify health care professional of all Rx or OTC medications, vitamins, or herbal products being taken and to consult with health care professional before taking other medications, especially other oral hypoglycemic medications.
  • Advise patient to notify health care professional if pregnancy is planned or suspected or if breast feeding.

Evaluation/Desired Outcomes

  • Improved hemoglobin A1C, fasting plasma glucose and 2–hr post-prandial glucose levels.
Drug Guide, © 2015 Farlex and Partners

linagliptin

(lĭn′ə-glĭp′tn)
n.
An oral hypoglycemic drug, C25H28N8O2, used to treat type 2 diabetes.
The American Heritage® Medical Dictionary Copyright © 2007, 2004 by Houghton Mifflin Company. Published by Houghton Mifflin Company. All rights reserved.
References in periodicals archive ?
The study assessed Tradjenta safety over the longest period ever studied in a DPP-4 inhibitor cardiovascular outcome trial, with a median follow-up of more than 6 years.
Linagliptin (5 mg, once-daily) is marketed in the US as Tradjenta (linagliptin) tablets, as Trajenta across Europe and Canada, and Trazenta in Japan, as well as in further markets.
Food and Drug Administration (FDA) approved Tradjenta (linagliptin) tablets, used with diet and exercise, to improve blood glucose control in adults with Type 2 diabetes.
Boehringer Ingelheim and Eli Lilly announced CAROLINA met its primary endpoint, defined as non-inferiority for Tradjenta versus glimepiride in time to first occurrence of cardiovascular death, non-fatal myocardial infarction or non-fatal stroke.
CV outcomes trials for the two other approved DPP-4 inhibitors--sitagliptin (Januvia) and linagliptin (Tradjenta)--are ongoing.
Alogliptin (Nesina), a dipeptidyl peptidase-4 inhibitor, is in the same pharmacologic class as linagliptin (Tradjenta), saxagliptin (Onglyza), and sitagliptin (Januvia).
M2 EQUITYBITES-August 20, 2012-Eli Lily and Boehringer Ingelheim announces FDA approval of a sNDA for Tradjenta tablets(C)2012 M2 COMMUNICATIONS http://www.m2.com
M2 PHARMA-August 20, 2012-Eli Lily and Boehringer Ingelheim announces FDA approval of a sNDA for Tradjenta tablets(C)2012 M2 COMMUNICATIONS
Meanwhile, in the lucrative field of diabetes treatments, Lilly and development partner Boehringer Ingelheim got approval for Tradjenta, a DPP-4 inhibitor, and Jentadueto, a combo of Tradjenta and metformin.
CARMELINA, the "CArdiovascular safety and Renal Microvascular outcomE with LINAgliptin in patients with type 2 diabetes at high vascular risk" trial, met its primary endpoint, defined as time to first occurrence of cardiovascular death, non-fatal myocardial infarction or non-fatal stroke, with Tradjenta demonstrating similar cardiovascular safety compared with placebo, reported Boehringer Ingelheim and Eli Lilly.
The dipeptidyl peptidase-4 inhibitors, such as sitagliptin (Januvia) and linagliptin (Tradjenta), are good tertiary oral drugs, as they are also weight neutral.
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