Indication Adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus.

Pharmacology

Linagliptin: Inhibits DPP‑4 → increases incretin hormones (GLP‑1, GIP) → stimulates insulin release, reduces glucagon.
Empagliflozin: Inhibits SGLT2 → reduces renal glucose reabsorption → increases urinary glucose excretion.

Dosage & Administration

Recommended: Empagliflozin 10 mg + Linagliptin 5 mg once daily.
Increased: Empagliflozin 25 mg + Linagliptin 5 mg once daily.
Renal impairment: Do not initiate if eGFR < 45 mL/min/1.73 m².

Drug Interaction

Diuretics: ↑ urine volume → risk of dehydration.
Insulin/Secretagogues: ↑ risk of hypoglycemia.
Rifampin: ↓ Linagliptin efficacy.
SGLT2 inhibitors: Positive urine glucose test.

Contraindications

Severe renal impairment, ESRD, dialysis.
Hypersensitivity to Linagliptin or Empagliflozin.

Side Effects Pancreatitis, Ketoacidosis, Volume depletion, Urosepsis, Pyelonephritis, Hypoglycemia, Fournier’s gangrene, Genital infections, Hypersensitivity, Arthralgia, Bullous pemphigoid, Heart failure.

Pregnancy & Lactation Not recommended in 2nd & 3rd trimester. Limited data; risks unknown. Poorly controlled diabetes increases maternal/fetal risk.

Precautions & Warnings Pancreatitis, Hypotension, Ketoacidosis, Renal impairment, Urosepsis, Hypoglycemia, Genital infections, Hypersensitivity.