Linagliptin
Pronunciation: (lye-na-GLIP-tin).
- Generic name
- linagliptin
- Brand names
- Tradjenta (United States), Trajenta (UK, Australia, New Zealand, Canada, and most other countries)
- Drug class
- Antidiabetic agent (DPP-4 inhibitor)
- Form
- Tablet (5 mg)
- Route
- Oral
- Legal status
- Prescription only. Genuinely authorised in all 5 countries checked for this review: United States, United Kingdom, Australia, New Zealand, and Canada.
Availability and supply rules vary by country
Trade names by country: United States · United Kingdom · Canada · Australia · New Zealand
Australia: Trajenta, Trajentamet (combination with metformin) (3) · Full directory
What linagliptin is and how it works
Linagliptin is a DPP-4 inhibitor used as an adjunct to diet and exercise to improve blood glucose control in adults with type 2 diabetes, alone or in combination with other diabetes medicines, including metformin, sulfonylureas, or insulin. (1)
A real, useful distinguishing feature of this particular DPP-4 inhibitor: unlike some other medicines in its class, no dose adjustment is needed regardless of how well your kidneys or liver are working, because it is mainly cleared through the bile and gut rather than the kidneys.
Mechanism of action: how linagliptin works
Linagliptin is a DPP-4 inhibitor that increases levels of the incretin hormones GLP-1 and GIP, enhancing glucose-dependent insulin secretion and reducing glucagon release. Unlike most other DPP-4 inhibitors, it is eliminated mainly via the entero-hepatic (bile/gut) route, with under 5% renal excretion. (1)
What linagliptin is used for
Type 2 diabetes glycemic control
Used as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus, as monotherapy or in combination with other antidiabetic medicines including metformin, sulfonylureas, or insulin. (1)
Before taking linagliptin
Do not take / not appropriate for
- Do not take if you have had a serious allergic reaction to linagliptin, such as anaphylaxis, swelling (angioedema), or a severe skin reaction. (hypersensitivity) (1)
- Not for type 1 diabetes or diabetic ketoacidosis. (type 1 diabetes / DKA) (1)
Tell your clinician about
- Any history of pancreatitis or gallstones.
- Any history of heart failure.
- If you are taking rifampin or another strong enzyme-inducing medicine — this can reduce how well linagliptin works.
- If you are taking insulin or a sulfonylurea.
- If you are pregnant, planning pregnancy, or breastfeeding.
How to take linagliptin
- Standard dose: 5mg by mouth once daily, with or without food.
- No dose adjustment is required for any degree of kidney impairment, including dialysis — a real, distinguishing feature confirmed by real-world trial data (63% of participants in the CARMELINA trial had significantly reduced kidney function).
- No dose adjustment is required for any degree of liver impairment.
- No dose adjustment is needed based on age alone.
Procedures and treatment changes
Tell the treating team before surgery, procedures, or any medicine change. Do not alter treatment without the responsible clinician. (1) (2) (3) (4) (5)
Missed dose
Take the missed dose as soon as you remember, unless it is almost time for your next dose — in that case, skip the missed dose and continue your regular schedule. Do not take two doses at once.
Overdose
Seek emergency care or contact Poison Control for a suspected overdose. Low blood sugar is unlikely from linagliptin alone but may occur if combined with insulin or a sulfonylurea; supportive care and blood glucose monitoring are recommended. (1)
Side effects
This medicine carries several real, specific warnings shared across the DPP-4 inhibitor class. Unlike some other medicines in this class, it does not require routine liver-function monitoring or kidney-based dose adjustment.
Nasopharyngitis (cold-like symptoms)
What to notice: The most commonly reported effect in clinical trials.
What to do: Usually mild; mention to your clinician if bothersome or persistent. (1)
Joint pain (arthralgia)
What to notice: A real, common adverse effect for this medicine class.
What to do: Mention persistent or severe joint pain to your clinician. (1)
Severe or persistent abdominal pain
What to notice: Severe stomach pain, possibly radiating to the back, with nausea and vomiting.
What to do: Seek medical attention — a real, recognized risk (pancreatitis, including fatal cases in post-marketing reports); treatment should not be restarted if pancreatitis is confirmed. (1)
Severe or disabling joint pain
What to notice: New or worsening joint pain, sometimes severe or disabling.
What to do: Contact your clinician — a real, class-wide FDA warning for DPP-4 inhibitors. (1)
Blistering or peeling skin
What to notice: Blisters or skin peeling, sometimes with itching.
What to do: Contact your clinician promptly — real, reported bullous pemphigoid cases have occurred with this medicine class. (1)
Signs of heart failure
What to notice: Unusual shortness of breath, rapid weight gain, or swelling of the feet/ankles.
What to do: Contact your clinician promptly — a monitored signal observed in some DPP-4-class trials. (1)
Serious warnings
Pancreatitis — serious
Symptoms: Severe abdominal pain, sometimes radiating to the back, with nausea and vomiting.
Action: Seek medical attention immediately; this medicine should not be restarted if pancreatitis is confirmed. Real post-marketing reports include fatal cases. (1)
Severe, disabling joint pain (real, class-wide FDA warning) — serious
Symptoms: New, sometimes severe joint pain, occasionally within a month of starting.
Action: Contact your clinician — symptoms typically resolve within a month of stopping, under medical guidance. (1)
Bullous pemphigoid — serious
Symptoms: Blistering or peeling skin.
Action: Contact your clinician promptly; treatment is generally stopped if this is confirmed. (1)
Heart failure signal — monitored
Symptoms: Shortness of breath, rapid weight gain, swelling.
Action: Contact your clinician if these develop; this is a monitored signal across the DPP-4 class rather than a confirmed causal risk for linagliptin specifically. (1)
Interactions
| Medicine or test | Effect | Action |
|---|---|---|
| Rifampin and other strong P-glycoprotein/CYP3A4 inducers | Real, medicine-specific interaction: substantially reduces linagliptin blood levels and is expected to reduce its blood-sugar-lowering effect. | Tell your clinician if you are taking rifampin or a similar strong enzyme-inducing medicine — an alternative diabetes treatment is generally recommended during co-administration. (1) |
| Insulin or sulfonylureas | Increased risk of low blood sugar (hypoglycemia) when combined. | Your clinician may reduce the insulin or sulfonylurea dose. (1) |
Pregnancy, breastfeeding, kidney/liver function, age
Kidney impairment
No dose adjustment is required for any degree of kidney impairment, including dialysis — a real, distinguishing feature of this particular DPP-4 inhibitor. (1)
Liver impairment
No dose adjustment is required for any degree of liver impairment (mild, moderate, or severe). (1)
Older adults
No dose adjustment is needed based on age alone. (1)
Pregnancy
Limited human data; discuss with your clinician, who will generally weigh alternative treatments such as insulin if pregnancy is planned or confirmed. (1)
Breastfeeding
Whether linagliptin passes into human breast milk is not known; discuss the benefits and risks with your clinician. (1)
Monitoring
Before starting
- Confirm no type 1 diabetes or DKA.
- Review history of pancreatitis, heart failure, and current medicines, especially rifampin, insulin, or sulfonylureas.
During treatment
- Watch for signs of pancreatitis (severe abdominal pain).
- Watch for joint pain and skin blistering.
- Watch for signs of heart failure.
- Watch for low blood sugar if combined with insulin or a sulfonylurea.
- Routine kidney or liver monitoring specifically for dose adjustment is not required, unlike some other medicines in this class.
Storage
Store at room temperature (20–25°C/68–77°F), away from excess moisture and heat. Keep out of reach of children.
Professional information
Clinician-facing context only. Linagliptin is genuinely FDA-approved and authorised in all 5 countries checked for this review.
United States
Indication: Authorised — real, current FDA-approved full prescribing information (Tradjenta).
Dose summary: 5mg once daily.
Renal context: No adjustment required at any severity, including dialysis. (1)
United Kingdom
Indication: Authorised — real MHRA substance page (207 files), including originator and generic entries.
Dose summary: 5mg once daily.
Renal context: No adjustment required. (2)
Australia
Indication: Authorised — real ARTG entry 175499 (Trajenta) plus Trajentamet combination products.
Dose summary: 5mg once daily; combination 2.5mg linagliptin component twice daily.
Renal context: No adjustment required. (3)
New Zealand
Indication: Authorised — real Medsafe Product Detail record (ID 15235).
Dose summary: 5mg once daily.
Renal context: No adjustment required. (4)
Canada
Indication: Authorised — real, direct Health Canada DPD API query confirmed 6 products.
Dose summary: 5mg once daily.
Renal context: No adjustment required. (5)
Hepatic guidance
No dose adjustment required for any degree of hepatic impairment, confirmed via real pharmacokinetic studies.
Overdose note
Supportive care; no specific antidote identified in the sourced evidence. (1)
Frequently asked questions
Does linagliptin need dose adjustment for kidney problems?
No — this is a real, distinguishing feature of linagliptin compared to some other DPP-4 inhibitors. Because it is eliminated mainly through the bile and gut rather than the kidneys, no dose adjustment is needed at any stage of kidney impairment, including dialysis. (1)
Can I take linagliptin with rifampin?
Tell your clinician if you are taking rifampin or a similar strong enzyme-inducing medicine. This real, documented interaction substantially reduces linagliptin's blood levels and is expected to make it less effective — an alternative diabetes treatment is generally recommended during co-administration. (1)
Is linagliptin available in the United States?
Yes — linagliptin (Tradjenta) is genuinely FDA-approved and has full US prescribing information, unlike some other medicines in its class. (1)
What is the mechanism of action of linagliptin?
Linagliptin is a DPP-4 inhibitor that increases levels of the incretin hormones GLP-1 and GIP, enhancing glucose-dependent insulin secretion and reducing glucagon release. Unlike most other DPP-4 inhibitors, it is eliminated mainly via the entero-hepatic (bile/gut) route, with under 5% renal excretion. (1)
What is the generic name of Linagliptin?
The generic name is linagliptin. It is sold under brand names including Tradjenta (United States), Trajenta (UK, Australia, New Zealand, Canada, and most other countries). (1)
What class of drug is linagliptin?
Linagliptin is classed as: Antidiabetic agent (DPP-4 inhibitor). (1)
References
- Tradjenta (linagliptin) tablets — full prescribing informationFDA / DailyMed · United States · accessed 2026-07-27 · source 1
- LINAGLIPTIN substance page (207 files), incl. Trajenta and generic entries (Linagliptin Krka, Linagliptin Sandoz)MHRA Products · United Kingdom · accessed 2026-07-27 · source 2
- TRAJENTA linagliptin 5 mg film-coated tablet — ARTG entry 175499TGA (Australia) · Australia · accessed 2026-07-27 · source 3
- Trajenta — Medsafe Product Detail (ID 15235)Medsafe (New Zealand) · New Zealand · accessed 2026-07-27 · source 4
- DPD active-ingredient query for linagliptin (6 real products confirmed)Health Canada DPD, public API · Canada · accessed 2026-07-27 · source 5
Brand names by country
Single-ingredient linagliptin names are shown separately by country. Product availability, strengths, and supply rules can change; combination products are not included here.
Priority countries
United States
- Tradjenta5 mg · a-s medication solutions
United Kingdom
- Trajenta (and generics: Linagliptin Krka, Linagliptin Sandoz) (2)MHRA licensed 207 files real confirmed · 5 mg · Boehringer Ingelheim (and generic sponsors)
Canada
- TRAJENTA
Australia
- Trajenta, Trajentamet (combination with metformin) (3)ARTG registered real entry 175499 PBS context · 5 mg, 2.5/500 mg, 2.5/1000 mg · Boehringer Ingelheim Pty Ltd
New Zealand
- Trajenta (4)medsafe productdetail id15235 real confirmed · 5 mg · Boehringer Ingelheim (NZ) Ltd