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Erli Plus SpecificationRequires Prescription (YES/NO)YesGenericsEmpagliflozin , Metformin HClUsed ForDiabetesHow it worksMetformin hydrochloride is an antihyperglycemic agent which improves glucose tolerance in patients with type 2 diabetes mellitus, lowering both basal and postprandial plasma glucose. Metformin decreases hepatic glucose production, decreases intestinal absorption of glucose, and improves insulin sensitivity by increasing peripheral glucose uptake and utilization. Empagliflozin Sodium-glucose co-transporter 2 (SGLT2) is the predominant transporter responsible for reabsorption of glucose from the glomerular filtrate back into the circulation. Empagliflozin is an inhibitor of SGLT2. By inhibiting SGLT2, Empagliflozin reduces renal reabsorption of filtered glucose and lowers the renal threshold for glucose, and thereby increases urinary glucose excretion.Erli Plus Usage And SafetyDosageEmpagliflozin , Metformin HClSide EffectsMost common adverse reactions associated with empagliflozin (5% or greater incidence) were urinary tract infection and female genital mycotic infections. Most common adverse reactions associated with metformin (>5%) are diarrhea, nausea/vomiting, flatulence, abdominal discomfort, indigestion, asthenia, and headache.Drug InteractionsDiuretics , Positive Urine Glucose Test , Interference with 1,5-anhydroglucitol (1,5-AG) Assay , ranolazine, vandetanib, dolutegravir, and cimetidine , zonisamide, acetazolamide or dichlorphenamide , corticosteroids, phenothiazines, thyroid products, estrogens, oral contraceptives, phenytoin, nicotinic acid, sympathomimetics, calcium channel blocking drugs, and isoniazid , NifedipineIndicationIt is a combination of empagliflozin, a sodium-glucose co-transporter 2 (SGLT2) inhibitor and metformin, a biguanide, indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus who are not adequately controlled on a regimen containing empagliflozin or metformin, or in patients already being treated with both empagliflozin and metformin.When not to UseIt should not be used when Renal Impairment, ESRD, or on dialysis, Metabolic acidosis, including diabetic ketoacidosis, History of serious hypersensitivity reaction to empagliflozin or metformin.Erli Plus PrecautionsPrecautionKeep all medicines out of the reach and sight of children. Store in a cool, dry place, away from direct heat and light.Erli Plus WarningsWarning 1Lactic Acidosis: There have been postmarketing cases of Metformin-associated lactic acidosis, including fatal cases. These cases had a subtle onset and were accompanied by nonspecific symptoms such as malaise, myalgias, abdominal pain, respiratory distress, or increased somnolence; however, hypothermia, hypotension, and resistant bradyarrhythmias have occurred with severe acidosis.Warning 2Hypotension: Empagliflozin causes intravascular volume contraction. Symptomatic hypotension may occur after initiating Empagliflozin particularly in patients with renal impairment, the elderly, in patients with low systolic blood pressure, and in patients on diuretics. Before initiating this medicine , assess for volume contraction and correct volume status if indicated. Monitor for signs and symptoms of hypotension after initiating therapy and increase monitoring in clinical situations where volume contraction is expected.Warning 3Ketoacidosis: Ketoacidosis, a serious life-threatening condition require urgent hospitalization in patients with type 1 and type 2 diabetes mellitus receiving sodium glucose co-transporter-2 (SGLT2) inhibitors, including Empagliflozin. Fatal cases of ketoacidosis have been reported in patients taking Empagliflozin.These medicines are not indicated for the treatment of patients with type 1 diabetes mellitus.Erli Plus Additional InformationPregnancy categoryAlways consult your physician before using any medicine.Storage (YES/NO)Store this medicine at room temperature, away from direct light and heat.

Erlina Tablets SpecificationRequires Prescription (YES/NO)YesGenericsEmpagliflozin + LinagliptinUsed ForDiabetesHow it worksEmpagliflozin Sodium-glucose co-transporter 2 (SGLT2) is the predominant transporter responsible for reabsorption of glucose from the glomerular filtrate back into the circulation. Empagliflozin is an inhibitor of SGLT2. By inhibiting SGLT2, Empagliflozin reduces renal reabsorption of filtered glucose and lowers the renal threshold for glucose, and thereby increases urinary glucose excretion. Linagliptin Linagliptin is an inhibitor of DPP-4, an enzyme that degrades the incretin hormones glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP). Thus, Linagliptin increases the concentrations of active incretin hormones, stimulating the release of insulin in a glucose-dependent manner and decreasing the levels of glucagon in the circulation. Both incretin hormones are involved in the physiological regulation of glucose homeostasis. GLP-1 and GIP increase insulin biosynthesis and secretion from pancreatic beta cells in the presence of normal and elevated blood glucose levels. Furthermore, GLP-1 also reduces glucagon secretion from pancreatic alpha cells, resulting in a reduction in hepatic glucose output.Erlina Tablets Usage And SafetyDosageEmpagliflozin + LinagliptinSide EffectsCommon: Urinary tract infection (including pyelonephritis and urosepsis), vaginal moniliasis, vulvovaginitis, balanitis and other genital infections, nasopharyngitis, hypoglycaemia (when used with sulphonylurea or insulin), thirst, cough, pruritus, rash, increased urination, amylase increased and lipase increased. Uncommon: Hypersensitivity, angioedema, urticarial, pancreatitis, volume depletion, dysuria, hematocrit increased, serum lipids increased and blood creatinine increased/glomerular filtration rate decreased. Not known: Necrotising fasciitis of the perineum (Fournier?s gangrene) and bullous pemphigoid.Drug InteractionsDiuretics : Coadministration of Empagliflozin with diuretics resulted in increased urine volume and frequency of voids, which might enhance the potential for volume depletion. Before initiating Empagliflozin + Linagliptin , assess volume status and renal function. In patients with volume depletion, correct this condition before initiating therapy. Monitor for signs and symptoms of volume depletion and renal function after initiating therapy. Interference with 1,5-anhydroglucitol (1,5-AG) Assay Measurements of 1,5-AG are unreliable in assessing glycemic control in patients taking SGLT2 inhibitors. Monitoring glycemic control with 1,5-AG assay is not recommended. Use alternative methods to monitor glycemic control. Inducers of P-glycoprotein or CYP3A4 Enzymes Rifampin decreased Linagliptin exposure, suggesting that the efficacy of Linagliptin may be reduced when administered in combination with a strong P-gp or CYP3A4 inducer. Use of alternative treatments is strongly recommended when Linagliptin is to be administered with a strong P-gp or CYP3A4 inducer.IndicationEmpagliflozin + Linagliptin are indicated as an adjunct to diet and exercise in adults aged 18 years and older with type 2 diabetes mellitu s: to improve glycemic control when metformin and/or sulphonylurea (SU) and monotherapy of either of Empagliflozin and Linagliptin do not provide adequate glycemic control. - when already being treated with the free combination of Empagliflozin and Linagliptin. Empagliflozin is indicated to reduce the risk of cardiovascular death in adults with type 2 diabetes mellitus and established cardiovascular disease.When not to UseThe combination of Empagliflozin + Linagliptin is contraindicated in patients with hypersensitivity to the active substances, to any other Sodium-Glucose-Co-Transporter-2 (SGLT2) inhibitor, to any other Dipeptidyl-Peptidase-4 (DPP-4) inhibitor, or to any of the excipients of the product.Erlina Tablets PrecautionsPrecautionUse of dipeptidyl peptidase-4 (DPP-4) inhibitors has been associated with a risk of developing acute pancreatitis. Acute pancreatitis has been observed in patients taking Linagliptin. If pancreatitis is suspected, Empagliflozin + Linagliptin Tablets should be discontinued; if acute pancreatitis is confirmed, Empagliflozin + Linagliptin should not be restarted. Caution should be exercised in patients with a history of pancreatitis.Erlina Tablets WarningsWarning 1Caution should be exercised in patients for whom an Empagliflozin-induced drop in blood pressure could pose a risk, such as patients with known cardiovascular disease, patients on anti-hypertensive therapy (e.g. thiazide and loop diuretics with a history of hypotension or patients aged 75 years and older).Warning 2An increase in cases of lower limb amputation (primarily of the toe) has been observed. Like for all diabetic patients it is important to counsel patients on routine preventative foot-care.Warning 3Treatment with SGLT2 inhibitors increases the risk for urinary tract infections. Evaluate patients for signs and symptoms of urinary tract infections and treat promptly, if indicated .Erlina Tablets Additional InformationPregnancy categoryAlways consult your physician before using any medicine.Storage (YES/NO)Store this medicine at room temperature, away from direct light and heat.