Zifam Linglip should not be used in patients with type 1 diabetes or for the treatment of diabetic ketoacidosis.
Linagliptin alone showed a comparable incidence of hypoglycaemia. When linagliptin was added to a sulphonylurea (on a background of metformin), the incidence of hypoglycaemia was increased over that of placebo. Sulphonylureas and insulin are known to cause hypoglycaemia. Therefore, caution is advised when linagliptin is used in combination with a sulphonylurea and/or insulin. A dose reduction of the sulphonylurea or insulin, may be considered. Use of DPP-4 inhibitors has been associated with a risk of developing acute pancreatitis. If pancreatitis is suspected, Zifam Linglip should be discontinued; if acute pancreatitis is confirmed, Zifam Linglip should not be restarted. Caution should be exercised in patients with a history of pancreatitis.