Ilinpru (Linagliptin)

Ilinpru, a DPP‑4 inhibitor, is used in the treatment pathway of type 2 diabetes mellitus.

• Type 2 diabetes mellitus: improves glycaemic control when combined with diet and exercise.
• Adjunct therapy: used alongside metformin or other antidiabetic agents to achieve target HbA1c.
• Monotherapy: can be prescribed as initial therapy for patients inadequately controlled by lifestyle alone.

• Linagliptin selectively inhibits the dipeptidyl peptidase‑4 enzyme, preventing the degradation of incretin hormones such as GLP‑1 and GIP. By maintaining higher incretin levels, it enhances glucose‑dependent insulin secretion from pancreatic β‑cells and suppresses glucagon release from α‑cells, leading to reduced post‑prandial and fasting plasma glucose concentrations without causing hypoglycaemia when used alone.

Common and serious adverse reactions have been reported with linagliptin therapy.

Common Side Effects

• Nasopharyngitis: mild inflammation of the nose and throat.
• Headache: transient cranial pain.
• Upper respiratory tract infection: symptoms of cough and congestion.
• Urinary tract infection: dysuria or frequency.
• Dizziness: sensation of light‑headedness.
• Back pain: musculoskeletal discomfort.

Serious or Rare Side Effects

• Pancreatitis: severe abdominal pain with elevated enzymes.
• Severe allergic reactions: rash, angioedema, or anaphylaxis.
• Hepatic injury: jaundice or abnormal liver tests.
• Bullous pemphigoid: blistering skin disorder.
• Hypersensitivity reactions: fever, eosinophilia, or organ involvement.

When prescribing Ilinpru, clinicians should consider several precautionary measures.

• Renal impairment: dose adjustment is not required, but monitor renal function regularly.
• Hepatic impairment: use with caution in patients with moderate liver disease.
• Cardiovascular disease: assess risk as patients may have existing heart conditions.
• Elderly patients: monitor for dehydration and orthostatic hypotension.
• Pregnancy and lactation: safety not established; avoid unless benefit outweighs risk.
• Store at ambient temperature: keep below 25 °C, protect from moisture and light in original packaging.

Linagliptin may interact with other medicines, affecting its efficacy or safety.

Major Interactions (Avoid)

• Other DPP‑4 inhibitors: concurrent use can increase risk of adverse effects.
• Strong P‑glycoprotein inhibitors (e.g., ketoconazole, itraconazole): may raise linagliptin plasma levels.
• Strong P‑glycoprotein inducers (e.g., rifampin): may reduce linagliptin exposure.

Moderate Interactions (Monitor Closely)

• Insulin or sulfonylureas: increased risk of hypoglycaemia, adjust dose as needed.
• Diuretics: monitor renal function and electrolytes.
• NSAIDs: may affect renal function, especially in dehydrated patients.