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Yet Another Diabetes Drug: Linagliptin

On May 2, 2011, the U.S. Food and Drug Administration approved the use of linagliptin for adults with type 2 diabetes.  It’s in the class called DPP-4 inhibitors.  You’ll see it sold in the U.S. as Tradjenta

How do they come up with names like Tradjenta?  The manufacturer wants it unique, so there are no claims of copyright infringement.  You also want to avoid sounding like another drug on the market, to avoid mixing up the drugs.  A committee is usually involved to consider all the angles, especially marketing.

How Does Linagliptin Work?

It’s complicated.  It inhibits an enzyme, dipeptidyl peptidase-4, ultimately leading to insulin release from the pancreas into the bloodstream, and lowered glucagon levels. 

Any Side Effects?

Linagliptin may slightly increase the risk of pancreatitis.  It seems to be pretty well tolerated overall, with the most common adverse effects being a runny or stuffy nose, or sore throat.  When given with an insulin secretagogue drug, like sulfonylureas, linagliptin can increase the odds of hypoglycemia.  Due to an interaction, it’s best not to use linagliptin with rifampin.

What’s the Dose?

Only one: 5 mg by mouth daily.  No need to adjust the dosage for underlying kidney or liver disease or age.

Usage

It’s for adults with type 2 diabetes.  It may be used as the sole diabetic drug along with diet and exercise.  It can also be used in combination with metformin, a sulfonylurea, or pioglitazone.  It’s not been studied in people taking insulin, in pregnancy, or in nursing mothers, so it’s best to avoid those settings for now.

Steve Parker, M.D.

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