Glympa 25/5 Tablet

Combination of an SGLT2 inhibitor and a DPP-4 inhibitor for adults with type 2 diabetes, with diet and exercise, when metformin and/or one of these medicines does not control blood sugar, or to replace separate tablets. Empagliflozin also reduces cardiovascular death risk in diabetes with heart disease.

Adults: one tablet (empagliflozin 10 mg + linagliptin 5 mg) once daily in the morning, with or without food; may be increased to 25 mg/5 mg once daily.

• Not for blood-sugar lowering when eGFR is below 30 (empagliflozin less effective).
• When used with insulin or a sulphonylurea, their doses may need lowering.
• Not for children under 18.

• Allergy to empagliflozin, linagliptin or other SGLT2/DPP-4 inhibitors
• Type 1 diabetes, diabetic ketoacidosis
• Dialysis

Common: genital fungal infections, urinary tract infections, passing more urine, thirst, nasopharyngitis, cough, low blood sugar (with insulin/sulphonylureas).

Less common: dehydration, dizziness, itching, raised lipase.

Rare but serious: ketoacidosis even with normal sugar (emergency), pancreatitis, Fournier's gangrene, bullous pemphigoid (blisters), angioedema, severe kidney infection.

• Stop before planned surgery (3 days) and during acute illness, fasting, vomiting or diarrhoea.
• Drink enough fluids; elderly and on diuretics: watch for dehydration.
• Stop and seek help for severe persistent abdominal pain or blisters.
• Keep the genital area clean.

Not recommended in pregnancy or breastfeeding.

• Loop/thiazide diuretics (dehydration)
• Insulin, sulphonylureas (low sugar)
• Rifampicin (reduces linagliptin effect)
• Lithium (levels may fall)

Increased urine and dehydration; low sugar with other drugs. Supportive care.

Store below 30°C.