Product Information:

DIAMPA L XR 10+5+1000mg Tablets is a triple-combination antidiabetic medication containing:

1. Dapagliflozin 10mg (SGLT2 inhibitor)
2. Linagliptin 5mg (DPP-4 inhibitor)
3. Metformin Hydrochloride Extended-Release (XR) 1000mg

This once-daily tablet targets three complementary pathways of glucose regulation:

1. Dapagliflozin promotes urinary glucose excretion via SGLT2 inhibition in the kidneys.
2. Linagliptin enhances incretin activity (GLP-1, GIP), stimulating insulin release and suppressing glucagon.
3. Metformin XR reduces hepatic glucose production and improves insulin sensitivity with minimized gastrointestinal side effects due to extended-release formulation.

Uses of (DIAMPA L XR 10+5+1000MG TABLETS):

1. Triple therapy for adults with type 2 diabetes mellitus inadequately controlled on dual therapy
2. Patients requiring simplified regimen adherence with three mechanisms in one tablet
3. Those with high HbA1c despite metformin + DPP-4 or metformin + SGLT2 inhibitor
4. Cardio-renal risk reduction in diabetic patients with established cardiovascular or kidney disease

Key Benefits of (DIAMPA L XR 10+5+1000MG TABLETS):

1. Triple-action glucose control with complementary mechanisms
2. Once-daily dosing improves compliance and reduces pill burden
3. Metformin XR minimizes nausea, diarrhea, and abdominal discomfort
4. Dapagliflozin provides cardio-renal protection (reduced heart failure hospitalization, slowed CKD progression)
5. Linagliptin is weight-neutral and has low hypoglycemia risk
6. No dose adjustment needed for linagliptin in renal impairment

How To Use (DIAMPA L XR 10+5+1000MG TABLETS):

Take one tablet once daily with the evening meal to reduce GI side effects from metformin. Swallow whole—do not crush, chew, or split. Continue diet and exercise. Monitor HbA1c, renal function, and blood pressure regularly. Not for type 1 diabetes or diabetic ketoacidosis.

When Not to Use (DIAMPA L XR 10+5+1000MG TABLETS):

Do not use if you have:

1. Hypersensitivity to dapagliflozin, linagliptin, metformin, or any excipients
2. Severe renal impairment (eGFR <30 mL/min) or end-stage renal disease
3. Acute or chronic metabolic acidosis (including diabetic ketoacidosis)
4. History of Fournier’s gangrene or serious hypersensitivity to SGLT2 inhibitors
5. Hepatic impairment or acute alcohol intoxication

Side Effects of (DIAMPA L XR 10+5+1000MG TABLETS):

Common: Genital mycotic infections, urinary tract infections, increased urination, mild GI upset (less with XR), nasopharyngitis.

Serious (rare):

1. Lactic acidosis (metformin-related—symptoms: muscle pain, weakness, rapid breathing, drowsiness)
2. Fournier’s gangrene (severe genital/perineal pain, redness, swelling—seek emergency care)
3. Pancreatitis (linagliptin class risk—abdominal pain, vomiting)
4. Hypotension, acute kidney injury, or euglycemic ketoacidosis
5. Discontinue and seek immediate medical help if these occur.

Dosage: (DIAMPA L XR 10+5+1000MG TABLETS):

1. Standard adult dose: One tablet once daily with evening meal
2. Only for patients already controlled on equivalent individual doses
3. Avoid if eGFR <45 mL/min; discontinue if eGFR persistently <30 mL/min
4. Not for initiation of triple therapy—step-up from dual regimens only

Who It’s For (DIAMPA L XR 10+5+1000MG TABLETS):

Adults with type 2 diabetes uncontrolled on dual oral therapy (e.g., metformin + DPP-4 or metformin + SGLT2 inhibitor). Ideal for those needing regimen simplification. Not for children, type 1 diabetes, or severe organ dysfunction.

Warnings & Precautions:

1. Assess volume status and renal function before starting
2. Monitor for genital infections, UTIs, and signs of pancreatitis
3. Temporarily discontinue before iodinated contrast imaging or major surgery
4. Counsel on symptoms of lactic acidosis and ketoacidosis
5. May cause false-positive urine glucose tests due to glucosuria

Drug Interactions:

1. Diuretics, ACE inhibitors: Increased risk of hypotension or renal impairment
2. Insulin or sulfonylureas: Low hypoglycemia risk, but possible
3. Alcohol: Increases lactic acidosis risk
4. Cimetidine: May increase metformin levels
5. Always disclose all medications to your healthcare provider.

Additional Information:

Store below 30°C in a dry place, protected from light and moisture. Keep out of reach of children. Do not use after the expiration date on the blister pack. Available by prescription in Pakistan.