DPP-4 Inhibitor (Gliptin)

Linagliptin

Brand names: Trajenta

Linagliptin is an oral DPP-4 inhibitor ('gliptin') for type 2 diabetes — weight-neutral with a low risk of hypoglycaemia on its own.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

US labelling (FDA)

Reference — US labelling, may differ from UK

Individualize the starting dosage of JENTADUETO XR based on the patient's current regimen ( 2.1 ) The maximum recommended dosage is 5 mg linagliptin/2,000 mg metformin HCl once daily ( 2.1 ) Take orally once daily with a meal, with gradual dose escalation to reduce the gastrointestinal effects due to metformin ( 2.1 ) Swallow whole; do not split, crush, dissolve, or chew ( 2.1 ) Prior to initiation, assess renal function with estimated glomerular filtration rate (eGFR) ( 2.2 ) Do not use in patients with eGFR below 30 mL/min/1.73 m 2 Initiation is not recommended in patients with eGFR between 30 - 45 mL/min/1.73 m 2 Assess risk/benefit of continuing if eGFR falls below 45 mL/min/1.73 m 2 …

Source: US FDA prescribing information (openFDA / DailyMed), label dated 2024-05-24. Accessed 2026-06-12. US dosing and indications can differ from UK practice — use UK sources for prescribing decisions.

Clinical monograph

How it works

It inhibits dipeptidyl peptidase-4, raising endogenous incretin (GLP-1/GIP) levels and so increasing glucose-dependent insulin secretion and reducing glucagon.

Prescribing in practice

It is eliminated mainly via the bile, so — unlike other gliptins — it needs no dose adjustment in renal impairment.
Pancreatitis is a rare risk; rare bullous pemphigoid (a blistering skin condition) is reported.
Its low intrinsic hypoglycaemia risk rises when combined with a sulfonylurea or insulin.

Monitoring

Monitor glycaemic response; review for pancreatitis or blistering skin reactions.

Counselling the patient

It is generally well tolerated and weight-neutral.
Report severe abdominal pain or a blistering rash.

Evidence & guidelines

A weight-neutral oral option in type 2 diabetes (NICE NG28), convenient in renal impairment.

Reference: NICE NG28 (Type 2 DM); CARMELINA Trial (JAMA 2018); Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Curated clinical cross-links plus same-class fallbacks.

Calculators

Pathways