Dipeptidyl peptidase 4 (DPP-4) inhibitor – gliptin
ATC code: A10BH05 (Linagliptin)
Brand names
Tradjenta, Jentadueto, Glyxambi
Selective reversible DPP-4 inhibitor – the enzyme that degrades incretins GLP-1 and GIP. Raises active incretin levels 2–3 fold, enhancing glucose-dependent insulin release and suppressing glucagon. Hypoglycaemia is rare because effect is glucose-dependent. Unique among gliptins – minimal renal clearance (5%), excreted mostly via bile, so no dose adjustment for renal impairment.
Second line
Linagliptin is second-line DPP-4 inhibitor for type 2 diabetes. redGDPS 2024 recommends linagliptin as an option in patients with chronic kidney disease (eGFR below 45 mL/min) when metformin is contraindicated and a drug without dose adjustment is needed. No significant cardiovascular risk reduction (neutral profile per CARMELINA 2018).
Opens the checker prefilled with this drug. Pick the second one from your regimen.
Pregnancy data limited. Switch to insulin when planning pregnancy.
Limited milk data. Breastfeeding not recommended.
Reference information, not a clinical decision. Discuss feeding pauses or changes with your physician or an IBCLC.
Linagliptin is evaluated for the following indications with varying evidence strength: Type 2 diabetes mellitus (evidence tier A). See the full indication matrix with dosing and citations above on this page.
Common side effects of Linagliptin (≥ 1 in 100): Nasopharyngitis, Hypersensitivity with rash, Hypoglycaemia (rare, more often combined with insulin or sulfonylurea). See the Safety section for uncommon and serious reactions.
FDA category B. Pregnancy data limited. Switch to insulin when planning pregnancy.
Limited milk data. Breastfeeding not recommended.
Linagliptin is contraindicated in: Known linagliptin hypersensitivity; Type 1 diabetes; Diabetic ketoacidosis. Full list in the Safety section.