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Jentadueto (Linagliptin and Metformin) - Oral

What Is Jentadueto? Jentadueto is a combination tablet containing the dipeptidyl peptidase-4 (DPP-4) inhibitor linagliptin and the biguanide metformin. It is used to lower blood sugar in adults with type 2 diabetes.Both linagliptin and metformin

  • Posted on 16th Apr, 2022 15:10 PM
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Jentadueto (Linagliptin and Metformin) - Oral Image

What Is Jentadueto?

Jentadueto is a combination tablet containing the dipeptidyl peptidase-4 (DPP-4) inhibitor linagliptin and the biguanide metformin. It is used to lower blood sugar in adults with type 2 diabetes.

Both linagliptin and metformin help lower blood sugar through complementary mechanisms. Linagliptin stimulates the release of insulin in a glucose-dependent manner. Metformin decreases the amount of glucose produced by your liver, increases insulin sensitivity in tissues, and reduces intestinal glucose absorption.

Jentadueto is available by prescription as an oral tablet.

Drug Facts

Generic Name: Linagliptin and metformin

Brand Name(s): Jentadueto, Jentadueto XR

Drug Availability: Prescription

Therapeutic Classification: Hypoglycemic DPP-4 inhibitor/biguanide combination

Available Generically: No

Controlled Substance: N/A

Administration Route: Oral

Active Ingredient: Linagliptin and metformin

Dosage Form(s): Tablet, extended-release tablet

What Is Jentadueto Used For?

The Food and Drug Administration (FDA) approved Jentadueto to treat adults with type 2 diabetes who need adjunctive (add-on) therapy to diet and exercise to improve blood sugar control when both linagliptin and metformin are appropriate

Jentadueto should not be used in adults with type 1 diabetes or for treatment of diabetic ketoacidosis. It has not been studied in people with a history of pancreatitis.

How to Take Jentadueto

Take Jentadueto every day as prescribed with meals to help reduce stomach upset. Do not chew or crush extended-release tablets. You should also stay on your prescribed diet and exercise regimen while taking your medication. Your healthcare provider may recommend that you check your blood sugar.

Storage

Store Jentadueto tablets at room temperature (between 68 degrees and 72 degrees Fahrenheit), and protect from light and moisture.

How Long Does Jentadueto Take to Work?

If you are new to both active ingredients in Jentadueto (linagliptin and metformin), it can take at least a month to see the full effects of Jentadueto. This is because the dose of Jentadueto is gradually increased over the course of a month to minimize gastrointestinal side effects. You won't see the full blood-sugar-lowering effects of Jentadueto until you are on the full dose.

If you have already been taking metformin and are switched to Jentadueto, you can expect to see an improvement in blood sugars in one to two weeks.

What Are the Side Effects of Jentadueto?

This is not a complete list of side effects and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your pharmacist or a healthcare provider. You may report side effects to the FDA at fda.gov/medwatch or 1-800-FDA-1088.

Common Side Effects

Common side effects of Jentadueto include:

  • Cough
  • Decreased appetite
  • Diarrhea
  • Nasopharyngitis
  • Nausea
  • Vomiting

Severe Side Effects

Call your healthcare provider right away if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

  • Heart failure
  • Hypoglycemia
  • Pancreatitis
  • Anaphylaxis; hypersensitivity reaction
  • Bullous pemphigoid

Long-Term Side Effects

Long-term metformin use can cause vitamin B12 deficiency. Generally, this decrease in vitamin B12 levels does not cause any symptoms but can rarely result in anemia or neurologic manifestations. It is easily corrected by stopping metformin or vitamin B12 supplementation.

Report Side Effects

Jentadueto may cause other side effects. Call your healthcare provider if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your provider may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting Program or by phone (800-332-1088).

(800) 332-1088

Dosage: How Much Jentadueto Should I Take?

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The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For oral dosage form (extended-release tablets):
    • For type 2 diabetes:
      • Adults:
        • Patients taking metformin alone—The metformin dose is the same as the dose you are already taking plus 5 milligrams (mg) of linagliptin. Your doctor may adjust your dose until your blood sugar is controlled. However, the dose is usually not more than 5 mg of linagliptin and 2000 mg of metformin once a day.
        • Patients taking linagliptin alone—At first, one tablet containing 5 mg of linagliptin and 1000 mg of metformin once a day. Your doctor may gradually increase your dose until your blood sugar is controlled. However, the dose is usually not more than 5 mg of linagliptin and 2000 mg of metformin once a day.
        • Patients taking linagliptin and metformin as separate components or Jentadueto® tablets—The metformin dose is the same as the dose you are already taking plus 5 mg of linagliptin. Your doctor may adjust your dose until your blood sugar is controlled. However, the dose is usually not more than 5 mg of linagliptin and 2000 mg of metformin once a day.
      • Children—Use and dose must be determined by your doctor.
  • For oral dosage form (tablets):
    • For type 2 diabetes:
      • Adults:
        • Patients taking metformin alone—The metformin dose is the same as the dose you are already taking. Your doctor may adjust your dose until your blood sugar is controlled. However, the dose is usually not more than 2.5 milligrams (mg) of linagliptin and 1000 mg of metformin 2 times a day.
        • Patients taking linagliptin alone—At first, 1 tablet containing 2.5 mg of linagliptin and 500 mg of metformin 2 times a day. Your doctor may gradually increase your dose until your blood sugar is controlled. However, the dose is usually not more than 2.5 mg of linagliptin and 1000 mg of metformin 2 times a day.
        • Patients taking linagliptin and metformin as separate components—The linagliptin and metformin dose are the same as the dose you are already taking. Your doctor may adjust your dose until your blood sugar is controlled. However, the dose is usually not more than 2.5 mg of linagliptin and 1000 mg of metformin 2 times a day.
      • Children—Use and dose must be determined by your doctor.

Modifications

Certain people may need to use caution when taking Jenatdueto or discuss potential modifications with their healthcare provider.

Pregnancy

Safe use of Jentadueto in pregnancy has not been established. The decision to use it during pregnancy should include a consideration of the benefits and potential risks to the pregnant person and fetus. 

While there is an increasing amount of published studies on the safety and effectiveness of metformin in pregnancy, there are no published studies to date on the safety of linagliptin in pregnancy. Clinical practice guidelines recommend insulin as the first-line treatment of diabetes in pregnancy, with metformin as an acceptable second-line agent. Linagliptin is not included as an accepted oral treatment in pregnancy due to a lack of data.

Breastfeeding

Published studies and case reports on the use of metformin during lactation indicate that it is present in breastmilk at low levels but appears to be compatible with breastfeeding. There is no published data on the use of linagliptin in breastfeeding, but it is known to be a highly protein-bound drug that should decrease the amount passed into breast milk. The decision to take Jentadueto while breastfeeding should include a consideration of the available data for metformin and linagliptin.

Age

The safety and efficacy of Jentadueto have not been established in children and adolescents.

No substantial difference in its effectiveness has been observed in older adults (aged 65 years and above) compared to younger adults. Because older adults may have a higher incidence of decreased kidney function, they may need to use Jentadueto with caution and more frequent monitoring.

Missed Dose

If you miss a dose of Jentadueto, take it as soon as you remember. If it is almost time for the next dose, skip the missed dose and take the next dose at the regularly scheduled time. Do not take an extra dose to make up for the missed dose.

Overdose: What Happens If I Take Too Much Jentadueto?

Overdoses of Jentadueto should be treated symptomatically. Overdoses of linagliptin up to 600 milligrams (120 times the recommended daily dose) caused no dose-related clinical adverse drug reactions in controlled clinical trials of healthy people. Overdoses of metformin have resulted in hypoglycemia (low blood sugar levels) in about 10% of cases and lactic acidosis in about a third of overdose cases.

Symptoms of overdose may include:

  • Malaise (general sense of feeling ill)
  • Myalgias
  • Abdominal (stomach) pain
  • Respiratory distress
  • Drowsiness
  • Low blood pressure
  • Low heart rate

Treatment of overdose should be symptomatic and supportive. Metformin can be removed from the body with hemodialysis.

What Happens if I Overdose on Jentadueto?

If you think you or someone else may have overdosed on Jentadueto, call your healthcare provider or the Poison Control Center. 
If someone collapses or isn’t breathing after taking Jentadueto, call 911.

911

Precautions

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It is very important that your doctor check your progress at regular visits, especially during the first few weeks that you take this medicine. Blood and urine tests may be needed to check for unwanted effects.

Under certain conditions, too much metformin can cause lactic acidosis. It usually occurs when other serious health problems are present, such as a heart attack or kidney failure. Symptoms of lactic acidosis include: stomach discomfort, decreased appetite, diarrhea, fast or shallow breathing, a general feeling of discomfort, muscle pain or cramping, and unusual sleepiness, tiredness, or weakness. If you have more than one of these symptoms together, you should get immediate emergency medical help.

Do not let yourself get dehydrated. Be sure to drink extra fluids when you exercise or increase your activity, or if you have vomiting or diarrhea.

Pancreatitis may occur while you are using this medicine. Check with your doctor right away if you have a sudden and severe stomach pain, chills, constipation, nausea, vomiting, loss of appetite, fever, or lightheadedness.

Check with your doctor right away if you have chest pain or tightness, decreased urine output, dilated neck veins, extreme fatigue, irregular breathing, irregular heartbeat, swelling of the face, fingers, feet, or lower legs, trouble breathing, or weight gain. These may be signs of heart failure.

Make sure any doctor or dentist who treats you knows that you are using this medicine. You may need to stop using this medicine before having a major surgery or diagnostic tests, especially tests that use a contrast dye.

It is very important to carefully follow any instructions from your health care team about:

  • Alcohol—Drinking alcohol may cause severe low blood sugar. Discuss this with your health care team.
  • Other medicines—Do not take other medicines unless they have been discussed with your doctor. This especially includes nonprescription medicines, such as aspirin, and medicines for appetite control, asthma, colds, cough, hay fever, or sinus problems.
  • Counseling—Other family members need to learn how to prevent side effects or help with side effects if they occur. Also, patients with diabetes may need special counseling about the changes in the dosing of their diabetes medicine that might occur with lifestyle changes, such as changes in exercise or diet. Furthermore, counseling on contraception and pregnancy may be needed, because of the problems that can occur in patients with diabetes during pregnancy.
  • Travel—Keep a recent prescription and your medical history with you. Be prepared for an emergency as you would normally. Make allowances for changing time zones and keep your meal times as close as possible to your usual meal times.
  • In case of emergency—There may be a time when you need emergency help for a problem caused by your diabetes. You need to be prepared for these emergencies. It is a good idea to wear a medical identification (ID) bracelet or neck chain at all times. Also, carry an ID card in your wallet or purse that says you have diabetes and that lists all of your medicines.

This medicine may cause hypoglycemia (low blood sugar). This is more common when this medicine is taken together with certain medicines. Low blood sugar must be treated before it causes you to pass out (unconsciousness). . People feel different symptoms of low blood sugar. It is important that you learn which symptoms you usually have so you can treat it quickly. Some symptoms of low blood sugar include: behavior changes that are similar to being drunk, blurred vision, cold sweats, confusion, cool, pale skin, difficulty with thinking, drowsiness, excessive hunger, a fast heartbeat, headaches that continue, nausea, shakiness, slurred speech, or unusual tiredness or weakness. Talk to your doctor about how to treat low blood sugar.

Hyperglycemia (high blood sugar) may occur if you do not take enough or skip a dose of your medicine, overeat or do not follow your meal plan, have a fever or infection, or do not exercise as much as usual. High blood sugar can be very serious and must be treated right away. It is important that you learn which symptoms you have in order to treat it quickly. Talk to your doctor about the best way to treat high blood sugar.

This medicine may cause severe and disabling joint pain. Call your doctor right away if you have severe joint pain while using this medicine.

This medicine may cause bullous pemphigoid. Tell your doctor right away if you have large, hard skin blisters while you are using this medicine.

Limit the amount of alcohol you drink while you are using this medicine. Heavy alcohol use can increase your chances of serious side effects.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

What Are Reasons I Shouldn’t Take Jentadueto?

Do not take Jentadueto if you have:

  • Severe kidney impairment (eGFR less than 30 milliliters/minute)
  • Acute or chronic metabolic acidosis (including diabetic ketoacidosis)
  • A history of hypersensitivity to linagliptin or metformin

Before starting Jentadueto, talk to your healthcare provider about your medical history.

Additionally, you may need to stop Jentadueto temporarily if you:

  • Become dehydrated
  • Plan to have a surgery
  • Plan to get an injection of dye or contrast agent for an X-ray procedure

Notify your provider if any of the above situations apply to you.

What Other Medications Interact With Jentadueto?

Jenatdueto is a combination of two active ingredients: metformin and linagliptin. Both of these drugs may interact with other medications.

Drug interactions with metformin include:

  • Carbonic anhydrase inhibitors (e.g., topiramate, zonisamide, acetazolamide): Using Jentadueto with a carbonic anhydrase inhibitor may increase the risk of lactic acidosis and warrant more frequent monitoring.
  • Drugs that decrease the clearance of metformin (e.g., ranolazine, dolutegravir, cimetidine): These drugs may increase levels of metformin and increase the risk of side effects.
  • Alcohol: Excessive alcohol intake may increase blood levels of lactate which may increase the risk for lactic acidosis. 

Drug interactions with linagliptin include:

  • Drugs that can reduce linagliptin levels (e.g., rifampin, phenobarbital, phenytoin, carbamazepine, St. John’s wort, and more): These drugs can reduce how well linagliptin works. You may need to use an alternative medication.
  • Other drugs affecting glycemic control: Insulin and sulfonylureas (e.g. glipizide, glyburide, glimepiride) may increase the risk of low blood sugar when used with Jentadueto. Monitor blood sugars and adjust doses of insulin or sulfonylureas if needed.

What Medications Are Similar?

Jentadueto contains the biguanide metformin and the DPP-4 inhibitor linagliptin (brand name Tradjenta as a single agent). People may take additional diabetes medications with different mechanisms of action to achieve their goal blood sugars but should only take one DPP-4 inhibitor at a time.

Other DPP4-inhibitors include:

Frequently Asked Questions

  • How does Jentadueto work?

    Jentadueto contains two active ingredients that lower blood sugar through complementary mechanisms. Linagliptin stimulates the release of insulin in a glucose-dependent manner. Metformin decreases glucose production in the liver and increases insulin sensitivity in tissues.

  • What side effects can I expect while taking Jentadueto?

    The most common side effects of Jentadueto are diarrhea and nasopharyngitis.

  • How much will Jentadueto improve my blood sugars?

    In clinical trials, the average glycated hemoglobin (HbA1c) lowering of Jentadueto at the maximum dose after 24 weeks was -1.6% compared to placebo. For people already taking metformin, switching to Jentadueto resulted in a mean HbA1c lowering of 0.5%.

How Can I Stay Healthy While Taking Jentadueto?

Be aware of the warning symptoms of lactic acidosis, a rare but serious adverse reaction to Jentadueto. Stop the medication and contact a healthcare provider if you experience:

  • Unexplained rapid breathing
  • Malaise
  • Myalgia
  • Unusual somnolence
  • Slow or irregular heartbeat
  • A sensation of feeling cold

Jentadueto is cleared by the kidneys and requires normal kidney function to prevent the buildup of the drug. Kidney function should be monitored at least annually. Talk to your healthcare provider about temporarily stopping the medication before surgery or radiological imaging studies (e.g. a CT scan) with injectable dye, and restart once normal kidney function is restored. 

You should also look out for signs of hypoglycemia (when your blood sugar gets too low), such as:

  • Shakiness
  • Fast heartbeat
  • Anxiety
  • Hunger

If your blood sugar gets dangerously low, you may experience symptoms such as:

  • Confusion
  • Vision difficulties
  • Behavioral changes
  • Seizures
  • Loss of consciousness

Follow your healthcare provider’s advice for eating a healthy diet and doing regular physical activity. These non-medication therapies are important components for overall diabetes management. 

When considering taking a combination medication such as Jentadueto, you may want to add the individual components to your medication regimen one at a time before switching to a combination tablet. This allows you to monitor your response and any potential side effects from one new medication at a time. Communicate what you are feeling with your healthcare provider to ensure you are getting the full benefit from your medication regimen.

Medical Disclaimer

Verywell Health's drug information is meant for educational purposes only and is not intended as a replacement for medical advice, diagnosis, or treatment from a healthcare professional. Consult your doctor before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.

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