Pharmaceutical class:

Combined oral blood sugar lowering drug

Drug form:

Tablet 2.5/500 and tablet 2.5/1000

Drug combinations:

Linagliptin and metformin

Mechanism of action of Liroprim:

Linagliptin contained in this drug reduces blood sugar by inhibiting dipeptidyl peptidase 4 enzyme and metformin contained in it reduces insulin resistance. Meanwhile, both compounds help to control blood sugar by reducing the production of glucose in the liver.
Indications: This drug is used along with diet and exercise to reduce blood sugar in adults with type 2 diabetes.

Use in pregnancy and breastfeeding Liroprim:

Pregnancy: Adequate and well-controlled studies have not been conducted in pregnant women. The use of this medicine during pregnancy should be done under the supervision of a specialist and carefully.
Lactation: Metformin is secreted in small amounts in breast milk, but the secretion of linagliptin in human milk is not known. Therefore, it is not recommended to use this medicine during pregnancy.

Regarding the correct way to use this medicine, pay attention to the following points:

1- Take this medicine exactly as prescribed by the doctor.
2- Take this medicine twice a day with food. Taking this medicine with food reduces the possibility of stomach irritation.
3- Do not stop taking the medicine without consulting your doctor.
4- While taking this medicine, continue your diet and make sure that the consumption of carbohydrates is evenly distributed throughout the day. If you are overweight, continue your energy-restricted diet as directed.
5- Simultaneous use of this drug with other antidiabetic drugs may be recommended by the doctor. In such a situation, blood sugar may drop.
6- In stressful conditions such as fever, trauma (such as a car accident), infection or surgery, the amount of medication may be changed.
7- The doctor may temporarily stop taking the drug in the following situations:
Dehydration (loss of a large volume of body fluids) caused by vomiting, diarrhea and severe fever or not drinking fluids.
Planning for surgery
Injection of dye or contrast material for X-ray radiology.
8- Consult your doctor about how to prevent, identify and control low blood sugar (hypoglycemia), high blood sugar (hyperglycemia) and problems related to diabetes.
9- If you forget to take a dose of medicine, take it immediately as soon as you remember. But if it is almost time to take the next dose, take only that dose and avoid doubling the amount of medicine.

Liroprim drug interactions:

In order to control the progress of the treatment, especially in the first few weeks of taking the medicine, visit your doctor at intervals. Strictly follow the doctor’s instructions regarding alcohol consumption, simultaneous use with other drugs and travel.
In cases of emergency assistance, it is necessary to meet the following conditions:
Permanent use of a bracelet or necklace containing medical information, as well as carrying a medical identification card containing information about this disease and the drugs used.
Bringing fast-acting sugars to lower blood sugar
In case of surgery and other medical tests with X-rays, inform your doctor about the use of this medicine. In such a situation, stopping the use of medicine for at least two days after surgery or medical tests may be recommended by the doctor. During this period, if blood sugar is not controlled by diet and exercise, it may be necessary to take insulin.
Taking too much metformin under certain conditions can cause lactic acidosis. The symptoms of lactic acidosis are severe and appear quickly and usually occur when it is accompanied by other diseases such as heart attack or kidney failure. These symptoms include diarrhea, rapid and short breathing, severe muscle pain or contraction, drowsiness, unusual fatigue or weakness.
If the symptoms of lactic acidosis occur, control the blood sugar level and take the patient to the emergency room quickly. In case of severe vomiting, inform the doctor.
Taking too much medicine can lead to hypoglycemia (low blood sugar).
Symptoms of hypoglycemia (low blood sugar) should be treated before anesthesia occurs. These symptoms are different in different people, so it is necessary to be aware of the common symptoms of hypoglycemia (low blood sugar) in order to treat it quickly.

These symptoms include the following:

Anxiety, change in behavior, blurred vision, cold sweat, impaired consciousness, cold pale skin, difficulty concentrating, drowsiness, excessive hunger, rapid heartbeat, headache, nausea, anger, nightmares, restless sleep, tremors, speech difficulties Abnormal tiredness or weakness.
Symptoms of hypoglycemia, which may develop rapidly, may be caused by the following reasons:
Delaying or missing a meal or eating snacks, excessive exercise, drinking large amounts of alcohol, taking certain medications, using large amounts of insulin and sulfonylurea drugs, as well as illness (especially with vomiting and diarrhea)
In case of low blood sugar (hypoglycemia) and feeling confused, avoid driving and working with equipment that requires full alertness.
Another problem related to the lack of control of diabetes is hyperglycemia (high blood sugar). Symptoms of hyperglycemia (high blood sugar) appear more slowly than symptoms of hyperglycemia (low blood sugar). If you see any of the symptoms of hyperglycemia (high blood sugar), call your doctor immediately. These symptoms can include the following:
Blurred vision, drowsiness, dry mouth, frequent urination and increased volume, loss of appetite, stomach pain, nausea or vomiting, fatigue, abnormal thirst.
If any of the symptoms of redness and dryness of the skin, the smell of Estonian breath, the presence of ketones in the urine, sudden anesthesia and difficulty in breathing (fast and deep) are observed, the patient should be taken to the emergency room immediately.
Symptoms of hyperglycemia (high blood sugar) may be caused by the following reasons:
Fever and infection, not taking enough medication or missing a dose, taking other medications that change blood sugar levels, not exercising enough, eating too much or not following a diet.
If high blood sugar occurs, the doctor may change the amount of antidiabetic drugs or diet plans. Symptoms of hyperglycemia (high blood sugar) must be corrected before it becomes serious.
Severe pancreatitis (inflammation of the pancreas) has been reported in some patients using this drug. If you experience severe or persistent stomach or back pain with or without nausea or vomiting, contact your doctor immediately.
While taking this medicine, perform tests related to kidney function, fasting blood sugar and hemoglobin A_1c. These tests are done to monitor the disease or control side effects. Therefore, see a doctor at regular intervals.

Precautions Liroprim:

Before taking this medicine, inform your doctor if you are using the following medicines:
Third, acute or chronic consumption of alcohol. Consuming large amounts of alcohol may increase the likelihood of hypoglycemia (low blood sugar), especially if it is not consumed with Ghosl.
Cimetidine, cationic drugs excreted through renal tubular transport (such as amiloride, digoxin, morphine, procainamide, quinidine, quinine, ranitidine, triamterene, trimethoprim, vancomycin and cephalexin) in the use of concomitant drugs, reducing the dosage of liroprim may be required.
Forsamide – in the use of co-medications, a reduction in the amount of liroprim may be required.
Calcium channel blockers, corticosteroids (oral inhalation, systemic), danazol, luteinizing hormones, hormone-releasing analogs, estrogens, hormonal contraceptives, isonizid, nicotinic acid, phenothiazines, phenytoin, carbamazepine, sympathomimetic drugs, thiazide diuretics, hormones Thyroid, somatropin – some drugs cause hyperglycemia (high blood sugar) and may reduce blood sugar control. If the use of these drugs is stopped in a patient treated with liroprim, it is necessary to carefully monitor the patient in terms of the occurrence of hypoglycemia (low blood sugar).
Androgens (other than danazol), hypoglycemic drugs (such as insulin, sulfonylureas), clofibrate, monoamine acidase inhibitors, probenecid, propramolol, rifabutin, rifampin, salicylates, long-acting sulfonamides, pegvisomant with concomitant use of drugs, hypoglycemic effect The blood of this drug may increase.
Iodinated contrast materials in patients treated with metformin, intravenous injection of iodinated contrast can cause acute renal tarses with lactic acid. Therefore, temporary discontinuation of metformin should be done before or during these tests and up to 48 hours after.
Nifedipine increases the amount of metformin in the blood and urine with simultaneous use of drugs.
Angiotensin-converting enzyme inhibitors Linagliptin may increase the side effects or toxic effects of these drugs, especially the risk of angioedema.
Bosentan, dabrafenib, deferasirox, ciltuximab, tocilizumab, with simultaneous use of drugs, the amount of linagliptin in the blood may decrease.
The amount of linagliptin in the blood may increase with the simultaneous use of Ritonavi.

Liroprim contraindications:

1- History of allergy to linagliptin (including anaphylaxis, angioedema, exfoliative dermatitis or peeling of the skin, urticaria or bronchial hyperactivity), metformin or any of the ingredients of this medicine
2- Illness or severe kidney failure that may be caused by cardiovascular collapse (shock), acute myocardial infarction and septicemia (blood infection).
3- Acute or chronic metabolic acidosis including diabetic ketoacidosis (increased amount of ketones in blood or urine) with or without coma
4- Type 1 diabetes mellitus
5- In patients undergoing radiology examinations with intravascular injection of iodinated contrast material
6- In situations where strict control of blood sugar is required, such as: – Severe burns due to dehydration (such as severe or resistant diarrhea, recurrent vomiting) – Severe infections (such as respiratory and urinary tract infections) – Major surgery – Severe blows
7- Severe, acute or chronic illness
8- Diseases that may cause tissue hypoxia (especially acute disease or exacerbation of chronic disease) such as heart failure, respiratory failure, recent myocardial infarction and shock

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