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Empagliflozin, Lingliptin, and Metformin

Name of generic: empagliflozin, linagliptin, and metformin EM-pagli FLOE-zin, LIN’-a-GL and-met-FOR-min[EM-pa-gli-FLOE-zin [ EM-pa-gli-FLOE-zin, LIN a-GL]

The brand name is Trijardy XR.
Dosage format:mg–2.5 oral tablet, extended release (10 mg–5 mg–1000 mg; 12.5 mg–2.5 mg–1000 mg) 25 mg–5 mg–1000 5- mg–1000 mg)
The class of drugs: antidiabetic combinations

What are Empagliflozin, Lingliptin, and Metformin?

Empagliflozin, Lingliptin, and metformin (Trijardy XR) are combination medications that are used in conjunction with exercise and diet to help improve blood sugar control in people suffering from type 2 diabetes mellitus.Trijardy XR can also be used to reduce the chance of death from stroke, heart attack, or heart failure in people who suffer from type 2 diabetes and also suffer from heart disease.Trijardy XR does not work as a suitable treatment for treating type 1 diabetes.Empagliflozin, Lingliptin, and metformin are also used for other purposes that are not mentioned in this medication guide.

Side effects of Empagliflozin, Lingliptin, and Metformin

Seek medical attention immediately. If you are experiencing symptoms that indicate an allergy, such as itching, peeling,  or flaking skin; difficulty swallowing; difficulty breathing; or swelling of your lips, face, and tongue,Get medical attention promptly if you are experiencing indications of a serious genital ailment (penis or vagina):itching, burning, itching and odor, bleeding, redness, tenderness, pain or swelling in the rectal or genital region, fever, or not feeling well. The symptoms could worsen quickly.Stop taking empagliflozin, metformin, and linagliptin. Contact your doctor immediately in the event that you are suffering from:

  • A lightheaded sensation, similar to when you're about to pass out.
  • Persistent or severe joint pain;
  • Acidosis—unusual muscle pain pain, and breathing difficulties stomach pain vomiting,dizziness, an an dizziness, irregular heartbeat, or sensation of a cold, or feeling tired or weak
  • Serious skin reaction: blisters, itching, breaking of the skin's outer layer;
  • Ketoacidosis (too much acid in the blood) ketoacidosis (too many acids in the blood) nausea, stomach pain, vomiting, confusion, sleepiness, or difficulty breathing;
  • Pancreatitis: severe discomfort in your upper stomach that spreads into your back; nausea and vomiting
  • Dehydration—dizziness, confusion, feeling very thirsty, less urination;
  • Indications of signs of bladder infections: pain or burning pain when you pee or urinate; the presence of blood in your urine Symptoms of a bladder infection include pain in the back or pelvis;
  • Signs of heart failure symptoms of heart failure include breathing problems (even in a position of lying down), swelling in your feet or legs, and rapid weight gain.

Common adverse effects of empagliflozin, metformin, and linagliptin could include:

  • Stomach pain, diarrhea, constipation;
  • A bladder infection;
  • Headache or
  • Signs of a cold, such as a runny nose, nasal stuffiness, coughing, or irritation of the throat.

This is not a comprehensive list of possible side effects, and other side effects could occur. Consult your physician to seek medical advice on the effects. You can report symptoms to the FDA at 1-800-FDA-1088.


Stop taking this medicine immediately and consult your physician immediately when you experience symptoms of a serious adverse reaction that are severe, like stomach discomfort (which may be aggravated over your entire back), nausea, fatigue, or breathing problems.Consult your physician if you have a stomach ache or diarrhea. Also, tell your doctor if you have a less nutritious diet or drink than normal.Seek medical attention immediately. If you experience signs of lactic acidosis like abnormal muscle pain, difficulty breathing, or irregular heartbeats, as well as if you're feeling extremely weak,This medicine may cause serious infections in the vagina or penis. Get medical help immediately if you experience irritation, burning, odor, discharge, pain, swelling, redness, tenderness of the rectal or genital region, fever, or are not feeling well.

Before you take this drug

It is not recommended to use empagliflozin, linagliptin, or metformin if you have an allergy to empagliflozin, linagliptin, or metformin. Also, if you are suffering from

  • Severe kidney-related disease (or if you're dialysis-dependent);
  • A history of a severe allergic or skin reaction following the use of linagliptin or
  • Metabolic acidosis or diabetic ketoacidosis (call your doctor for treatment).

If you have to undergo an operation or another scan, such as x-rays or a CT scan that uses the injection of a dye into your veins, you might have to stop temporarily taking this medication. It is important to inform your doctor beforehand that you're taking Trijardy XR.Inform your doctor if you have been experiencing:

  • Kidney or liver disease;
    an infection of the bladder or problems with urination;
  • A pancreas disorder;
  • Congestive heart, stroke, or heart attack
  • Gallstones;
  • A genital ailment (penis or vagina);
  • Alcoholism, or if you are currently drinking a lot of alcohol.
  • High cholesterol or triglycerides
  • If you're on a diet low in salt
  • If you're 65 years old or older,

There is a chance that you will develop the condition known as lactic acidosis. It is a serious buildup of lactic acid in your blood. Engage with your doctor regarding any potential risks.Follow the instructions of your physician about the use of this medicine if you are expecting or are planning to get pregnant. Controlling diabetes is crucial during pregnancy.It is not recommended to use Trijardy XR during the second or third trimester of pregnancy.Metformin can stimulate ovulation in premenopausal women and increase the chance of an unplanned pregnancy. Discuss with your physician the risks.Do not breastfeed.Not permitted for use by anyone under 18.

How to take  Empagliflozin, Lingliptin, and Metformin?

Follow the directions on the prescription label and read the medication guide or instructions sheets. Your doctor may alter the dosage. Follow the medication precisely as directed.Trijardy XR is typically consumed in the morning after breakfast.Take the tablet in its entirety, and don't crush or chew it. Break, chew, or dissolve it. Consult your physician if you encounter difficulty eating the tablet.Parts of the tablet's shell could be found in your stool, but this won't reduce the effectiveness of the medication.Your blood sugar level will need to be monitored regularly, and you might need to test the levels of ketones present in your urine. The ketoacidosis that is caused by empagliflozin can be life-threatening (too high levels of acid in the blood). Even if the blood sugar level is normal, consult your physician in the event that a urine test shows ketones that are high in your urine.

The blood sugar level can be affected by illness, stress, surgery, alcohol consumption, or eating infrequently.Blood sugar levels that are low (hypoglycemia) may cause you to feel thirsty, dizzy, upset, or shakey. To speedily manage hypoglycemia, consume or drink crackers, hard candy or raisins, juice from fruit, and non-diet drinks. Your physician may recommend the glucagon injection in cases of extreme hypoglycemia.Inform your doctor if you are experiencing frequent symptoms related to excessive blood sugar (hyperglycemia), like increased thirst or frequent urination. Ask your doctor before changing your medication dosage.It is possible to become dehydrated from an illness that lasts for a long time. Contact your physician if you have a stomach ache or diarrhea or take fewer calories or drinks than normal.This medication may affect the results of certain tests. Be sure to inform any doctor treating you that you're taking Trijardy XR.Your doctor may suggest you take additional vitamin B12 when you take Trijardy XR. You should only take your vitamin B12 dosage as your doctor has advised.Place it in a cool, dry place free of heat and moisture.

Details on dosage

Usual Adult Dose for Diabetes Type 2:

Make an individualized dose based on the patient's current regimen.
For patients taking metformin, whether with or without linagliptin, begin using a dose similar to that of metformin together with empagliflozin (10 mg) and linagliptin (5 mg) orally at least once per day.
For patients taking metformin and any regimen containing empagliflozin, including or not containing linagliptin: Begin with a similar dosage of metformin. It is the exact empagliflozin dose, and linagliptin (5 mg) is taken orally every day.
Assess the effectiveness and tolerability of the medication and adjust the dosage as needed so as not to exceed the doses allowed by law.
Empagliflozin may be administered up to 25 mg daily; Linagliptin 5 mg; Metformin 2000 mg.
If used in conjunction with the hormone insulin or an insulin secretagogue, a lower dosage of insulin or an insulin secretagogue must be considered to decrease the risk of hypoglycemia.
Correct volume loss prior to starting treatment.
It is not recommended for patients suffering from type 1 diabetes mellitus. It may cause a higher risk for ketoacidosis among these patients.
This drug has not been evaluated in patients who have a history of pancreatitis. Consequently, it is not known whether patients with a history of pancreatitis may be at greater risk of developing pancreatitis after taking this medication.
As an aid to exercise and diet, it can enhance glycemic control among people suffering from type 2 diabetes mellitus.
Empagliflozin has been shown to lower the chance of heart disease (CV) death in people who suffer from type 2 diabetes mellitus as well as well-established CV disease.

What happens if I miss the dose?

You should take the medication as quickly as you are able, but avoid your missed dosage if you are nearing the time to take the next dose.Make sure that you do not take two doses at the same time.

What happens if I overdose?

For medical emergencies, seek emergency medical attention or contact the Poison Help Line toll-free at 1-800-222-1222.An overdose may cause lactic acidosis. The symptoms could include muscle pain that is unusual and breathing problems, as well as irregular heartbeats or if you feel weak.

What should be avoided?

Do not drink alcohol. It could increase your chances of developing lactic acidosis.

Interaction with other drug

Other drugs can also alter or enhance the effects of empagliflozin, metformin, and linagliptin on decreasing your blood sugar. Inform your doctor of all the medicines you currently take and all the ones you begin or stop using, in particular:

  • Insulin, or any other oral diabetes medication;
  • Rifampin (to cure tuberculosis);
  • A diuretic is also known as a "water pill."

This list isn't complete. Other medications may interact with empagliflozin, linagliptin, and metformin, which include medications that are prescribed and available over the counter, vitamins, and herbal supplements. There are many possible interactions between drugs that are included here.