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TRAJENTA®
Linagliptin
Dose & Administration
The simplicity of one dose, once daily to help lower HbA1c in your adult T2D patients1
TRAJENTA® can be used in a broad range of adult patients with a single recommended dose of 5mg, once daily, independent of:
TRAJENTA® can be taken with or without a meal at any time of the day
If a dose is missed, it should be taken as soon as the patient remembers. A double dose should not be taken on the same day.1
Footnotes
- *Pharmacokinetic studies suggest that no dose adjustment is required for patients with hepatic impairment but clinical experience in such patients is lacking (TRAJENTA® SmPC).
- †Sulphonylureas and insulin are known to cause hypoglycaemia. Therefore, caution is advised when linagliptin is used in combination with a sulphonylurea and/or insulin. A dose reduction of the sulphonylurea or insulin may be considered (TRAJENTA® SmPC).
Dosing with hepatic impairment: Studies suggest that no dose adjustment is required for patients with hepatic impairment but clinical experience in such patients is lacking.1
Dosing in the elderly: No dose adjustment is necessary based on age.1
Dosing with metformin: When TRAJENTA® is added to metformin, the dose of metformin should be maintained, and linagliptin administered concomitantly.1
Dosing with a sulphonylurea or with insulin: When TRAJENTA® is used in combination with a sulphonylurea or with insulin, a lower dose of sulphonylurea or insulin may be considered to reduce the risk of hypoglycaemia.1
Dosing with renal impairment: It is important to ensure that patients are treated according to the licensed indications of a drug, including dose recommendations and monitored in line with clinical guidance including the NICE guidelines on the management of type 2 diabetes and chronic kidney disease (NG28 and NG203).1,3-8
For individual guidance on DPP-4 inhibitor dosing in renal impairment please refer to the individual product SmPC.
| Dosing adjustment based on renal function as defined by SmPC‡ | ||||||
|---|---|---|---|---|---|---|
| Normal function | Mild impairment | Moderate impairment | Severe impairment/ESRD | |||
| TRAJENTA® Linagliptin1 | 5 mg OD | |||||
| sitagliptin3‡ | 100 mg OD | 100 mg OD GFR ≥60 to <90 ml/min |
| 25 mg OD GFR ≥15 to <30 ml/min; ESRD (GFR <15 ml/min) including on haemodialysis or peritoneal dialysis | ||
| vildagliptin4‡ | 50 mg BD‡‡ 50 mg OD with an SU | 50 mg BD‡‡ 50 mg OD with an SU CrCl 50 to <80 ml/min | 50 mg OD CrCl 30 to <50 ml/min | 50 mg OD CrCl <30 ml/min ESRD on haemodialysis: use with caution | ||
| saxagliptin5‡ | 5 mg OD | 5 mg OD GFR ≥60 to <90 ml/min |
| 2.5 mg OD** GFR <30 ml/min ESRD on haemodialysis: not recommended | ||
| alogliptin6‡**†† | 25 mg OD | 25 mg OD CrCl >50 to ≤80 ml/min | 12.5 mg OD CrCl ≥30 to ≤50 ml/min | 6.25 mg OD CrCl <30 ml/min Limited experience in renal dialysis. Not studied in peritoneal dialysis. | ||
Adapted from: 1. TRAJENTA® SmPC 3. Sitagliptin SmPC 4. Vildagliptin SmPC 5. Saxagliptin SmPC 6. Alogliptin SmPC.
GFR: Glomerular filtration rate CrCl: Creatinine Clearance (based on Cockcroft-Gault formula) OD: Once daily BD: Twice daily SU: Sulphonylurea ESRD: End-stage renal disease.
Footnotes
- ‡Summary of Product Characteristics for sitagliptin, alogliptin, vildagliptin and saxagliptin are available at: www.medicines.org.uk (GB) and www.emcmedicines.com/en-GB/northernireland/ (NI).
- **Assessment of renal function is recommended prior to initiation and periodically thereafter.
- ††Not indicated as monotherapy.
- ‡‡50mg in the morning and 50mg in the evening.
References
- TRAJENTA® (linagliptin) Summary of Product Characteristics. SmPCs available at EMC: www.medicines.org.uk (GB) and www.emcmedicines.com/en-GB/northernireland/ (NI).
- Lajara R, et al. Clin Ther. 2014;36(11):1595-605.
- Sitagliptin Summary of Product Characteristics. SmPCs available at EMC: www.medicines.org.uk (GB) and www.emcmedicines.com/en-GB/northernireland/ (NI).
- Vildagliptin Summary of Product Characteristics. SmPC available at EMC: www.medicines.org.uk (GB).
- Saxagliptin Summary of Product Characteristics. SmPCs available at EMC: www.medicines.org.uk (GB) and www.emcmedicines.com/en-GB/northernireland/ (NI).
- Alogliptin Summary of Product Characteristics. SmPCs available at EMC: www.medicines.org.uk (GB) and www.emcmedicines.com/en-GB/northernireland/ (NI).
- NICE guidance NG203 November 2021. Available at: https://www.nice.org.uk/guidance/NG203 (last accessed March 2022).
- NICE guidance NG28 February 2022. Available at: https://www.nice.org.uk/guidance/NG28 (last accessed March 2022).
PC-GB-105778 V2
August 2022