Linagliptin belongs to the group of diabetes medications called DPP-4 inhibitors. It works by increasing the amount of incretin available in the body. Incretin is a hormone that raises insulin levels when blood sugar is high (especially after a meal) and decreases the amount of sugar made by the body.

Linagliptin is used alone or in combination with other medications to improve blood sugar levels for adults with type 2 diabetes. This medication should be used as part of an overall diabetes management plan that includes a diet and exercise program.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

The usual dose of this medication is 5 mg daily.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

Linagliptin can be taken with or without food.

It is important to take this medication exactly as prescribed by your doctor. If you miss a dose, take it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store this medication at room temperature and keep it out of the reach of children.

Each light red, round, biconvex, bevelled-edged, film-coated tablet, marked on one side with the Boehringer Ingelheim company symbol and "D5" on the other, contains 5 mg of linagliptin. Nonmedicinal ingredients: mannitol, pregelatinised starch, maize starch, copovidone, and magnesium stearate; film coating: hypromellose, titanium dioxide, talc, macrogol, and iron oxide red.

Do not take this medication if you:

• are allergic to linagliptin or any ingredients of this medication
• have ketoacidosis (a complication of diabetes associated with high blood sugar, weight loss, nausea, or vomiting)
• have type 1 diabetes

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

• back pain
• constipation
• cough
• diarrhea
• headache
• sore throat
• stuffy or runny nose

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

• hives
• mouth sores
• severe joint pain
• skin blisters
• skin rash, itching
• symptoms of low blood sugar (e.g., headache, drowsiness, weakness, dizziness, confusion, irritability, hunger, fast heartbeat, sweating, and feeling jittery)

Stop taking the medication and seek immediate medical attention if any of the following occur:

• signs of muscle damage (e.g., muscle pain, tenderness, or weakness, or brown or discoloured urine) - especially if you also have a fever or a general feeling of being unwell
• signs of a severe skin reaction such as blistering, peeling, a rash covering a large area of the body, a rash that spreads quickly, or a rash combined with fever or discomfort
• symptoms of a serious allergic reaction (such as swelling of the face, lips, tongue, or throat; skin rash; hives; or difficulty breathing)
• symptoms of pancreatitis (e.g., prolonged, severe abdominal pain with or without vomiting)

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Blood sugar: Hypoglycemia (low blood sugar) can occur when linagliptin is used in combination with metformin and a sulfonylurea (e.g., glyburide, gliclazide). Your doctor may suggest a lower dose of the sulfonylurea when you start this medication.

If you experience low blood sugar (e.g., headache, drowsiness, weakness, dizziness, confusion, irritability, hunger, fast heartbeat, sweating, and feeling jittery) contact your doctor.

During times of stress (e.g., fever, trauma, surgery, infection), your doctor may suggest that you temporarily stop this medication and use insulin to help control your blood sugar levels.

Congestive heart failure and heart disease: Heart failure has occurred for people taking medications similar to linagliptin. If you have CHF or heart disease, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether this medication is appropriate for you.

Immune system: Linagliptin can reduce the number of cells that fight infection in the body (white blood cells). This side effect may be more of a concern for people who already have a weakened immune system due to certain medical conditions or medications. If this applies to you, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Kidney function: There is limited information about the safety and effectiveness of the use of this medication by people with severely reduced kidney function. If you have reduced kidney function or kidney disease, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

This medication is not recommended if you have severely reduced kidney function.

Liver function: There is limited information about the safety and effectiveness of this medication when it is used by people with reduced liver function. If you have reduced liver function or liver disease, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. This medication is not recommended if you have severely reduced liver function.

Pancreatitis: This medication may cause or worsen pancreatitis (inflammation of the pancreas). If you have a history of pancreatitis, gallstones, alcoholism, or high triglycerides, you may be more at risk of experiencing this and should be closely monitored by your doctor while taking this medication.

If you experience symptoms of pancreatitis (e.g., upper left abdominal pain, back pain, nausea, fever, chills, rapid heartbeat, swollen abdomen or prolonged and severe abdominal pain with or without vomiting), contact your doctor immediately.

Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.

Breast-feeding: It is not known if linagliptin passes into breast milk. If you are a breast-feeding mother and are taking this medication, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of using this medication have not been established for children.

Seniors: There is limited information about the safety and effectiveness of this medication for people 75 years and older. Seniors may be more likely to experience side effects of this medication.

There may be an interaction between linagliptin and any of the following:

• acetylsalicylic acid (ASA)
• androgens (e.g., testosterone)
• angiotensin converting enzyme inhibitors (ACEIs; captopril, enalapril, ramipril)
• apalutamide
• atypical antipsychotics (e.g., aripiprazole, clozapine, olanzapine, quetiapine, risperidone)
• "azole" antifungals (e.g., itraconazole, ketoconazole, voriconazole)
• basiliximab
• bosentan
• buserelin
• carbamazepine
• chloroquine
• oral corticosteroids (e.g., dexamethasone, hydrocortisone, prednisone)
• cyproterone
• dabrafenib
• danazol
• deferasirox
• other diabetes medications (e.g., dapagliflozin, glyburide, insulin, lixisenatide, metformin, rosiglitazone)
• disopyramide
• diuretics (e.g., furosemide, hydrochlorothiazide, indapamide)
• enzalutamide
• elagolix
• eliglustat
• epinephrine
• eslicarbazepine
• estrogens (e.g., conjugated estrogen, estradiol, ethinyl estradiol)
• everolimus
• flibanserin
• glucagon
• goserelin
• hepatitis C antivirals (e.g., glecaprevir and pibrentasvir, sofosbuvir, velpatasvir, voxilaprevir)
• HIV non-nucleoside reverse transcriptase inhibitors (NNRTIs; e.g., efavirenz, etravirine, nevirapine)
• HIV protease inhibitors (e.g., atazanavir, indinavir, ritonavir, saquinavir)
• hydroxychloroquine
• lanreotide
• lapatinib
• leuprolide
• lumacaftor and ivacaftor
• mifepristone
• mitotane
• modafinil
• monoamine oxidase inhibitors (MAOIs; e.g., moclobemide, phenelzine, rasagiline, selegiline, tranylcypromine)
• niacin
• nilotinib
• octreotide
• pasireotide
• pegvisomant
• phenobarbital
• phenytoin
• primidone
• progestins (e.g., dienogest, levonorgestrel, medroxyprogesterone, norethindrone, progesterone)
• quinine
• quinolone antibiotics (e.g., ciprofloxacin, norfloxacin, ofloxacin)
• rifabutin
• rifampin
• St. John's wort
• sarilumab
• selective serotonin reuptake inhibitors (SSRIs; e.g., citalopram, fluoxetine, paroxetine, sertraline)
• siltuximab
• sirolimus
• somatropin
• sulfonamide antibiotics ("sulfas"; e.g., sulfisoxazole, sulfamethoxazole)
• sunitinib
• tacrolimus
• temsirolimus
• tocilizumab
• tramadol
• venetoclax
• vorinostat

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking.

Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.