Dosing

Name: Dosing
Creator: Boehringer Ingelheim
Keywords: Dosing

Publication: CARMELINA Elderly Subgroup Analysis1

Review the long-term safety profile of Trajenta® among age groups.

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Publication: CAROLINA Asian Subgroup Analysis2

Review the long-term safety profile of Trajenta® in Asian patients.

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Simple. Every Day.

When a DPP4i is needed, choose the Simplicity of Trajenta®.

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10 Years of Simplicity

Browse through an interactive infographic showcasing the clinical development and significant accomplishments for Trajenta®.

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Trajenta®

(Linagliptin)

One Dose, Once Daily. Always.*^,3

Dosing of Trajenta as one dose, once daily, always is independent of many factors

A systematic review^# of 83 RCTs to compare the safety and efficacy of different DPP4i in patients with T2D and inadequate glycaemic control, demonstrated that Trajenta® was on par with the other DPP4i in its ability to effectively reduce HbA_1c levels.⁵ Treatment with Trajenta® showed a weighted mean change in HbA_1c of 0.74%.

(No head to head trials. Direct comparison of studies should be interpreted with caution due to differences in study design, populations, and methodology.)

Lowest Kidney Excretion.³

Unlike most DPP4i, Trajenta® is primarily excreted via a non-kidney route.^3-7 In fact, only about 5% of Trajenta® is excreted via kidneys. In contrast, for each of the other globally-available DPP4i, 75% or more of the drug is excreted via kidneys. As a result, dose adjustment is required for each of these other DPP4i in patients with kidney impairment and/or drug related kidney monitoring.^4-7 In contrast, for Trajenta®, there is no need for additional drug-related kidney function monitoring and no dose adjustment required in patients with kidney impairment.³ One Dose, always. Simple. Trajenta®.

Graph comparing the proportion of each DPP4 inhibitor that is excreted via the kidney

Most Convenient Dosing Schedule.^3-7

Trajenta® is the only approved DPP4i that does not require dose reduction based on kidney function.^3-7 As kidney function declines for diabetes patients, it may need to be more frequently monitored for patients taking other DPP4i, but not Trajenta®. As patients enter moderate or severe kidney impairment, or end stage kidney disease, the dose of each other DPP4i has to be adjusted or in some cases discontinued. Not with Trajenta®. One dose, always. Simplicity.

Graph showing the required dose of each DPP4 inhibitor with declining kidney function

Required DPP4i dose with declining kidney function, as defined by SmPC
Illustration only. May not be an actual representation of the size, color, or shape of the tablets.

Extensive Subgroup Analysis of CVOT Patients

An assortment of images showing the various available resources for Trajenta

Footnotes

BID: twice daily; BMI: body mass index; CrCl: creatinine clearance; DPP4i: dipeptidyl peptidase-4 inhibitor; ESRD: end stage renal disease; GFR: glomerular filtration rate; KI: kidney impairment; QD: once daily; T2D: type 2 diabetes
*
Indicated for use in adult patients. Trajenta® is contraindicated in those with hypersensitivity to any of the active substances or excipients, is not licensed for paediatric use and should not be used in pregnant women.
†
Pharmacokinetic studies suggest that no dose adjustment is required for patients with hepatic impairment but clinical experience in such patients is lacking.
‡
Combination therapies studied with linagliptin were: Linagliptin as add-on to metformin therapy; Linagliptin as add-on to a combination of metformin and sulphonylurea therapy; Linagliptin as add-on to a combination of metformin and empagliflozin; Linagliptin as add-on to insulin therapy.
§
No dose adjustment is necessary based on age.
#
GFR ≥ 90.
**
For sitagliptin and saxagliptin, GFR ≥60 to 90 mL/min; for vildagliptin and alogliptin, CrCl >50 to ≤80 mL/min.
††
For sitagliptin, 100 mg QD at GFR ≥45 to 60 mL/min and 50 mg QD at GFR ≥30 to 45 mL/min; for saxagliptin, 5 mg QD at GFR ≥45 to 60 mL/min and 2.5 mg QD at GFR ≥30 to 45 mL/min; for vildagliptin, CrCl ≥30 to <50 mL/min; for alogliptin, CrCl ≥30 to ≤50 mL/min.
‡‡
For sitagliptin, GFR ≥15 to 30 mL/min; for saxagliptin, approximately GFR < 30 mL/min; for vildagliptin and alogliptin, CrCl <30mL/min.
§§
For sitagliptin, GFR <15 mL/min; for saxagliptin, ESRD on haemodialysis; for vildagliptin, ESRD on haemodialysis: use with caution; for alogliptin, limited experience in kidney dialysis: not studied in peritoneal dialysis.
##
Saxagliptin is not recommended for use in patients with ESRD requiring haemodialysis.