Trijardy XR is a prescription medication combining empagliflozin, linagliptin, and metformin, and is used alongside diet and exercise to manage high blood sugar in individuals with type 2 diabetes. Effective diabetes management is crucial for preventing severe health complications such as kidney damage, blindness, nerve issues, limb loss, and sexual dysfunction, as well as reducing the risk of heart attack and stroke. This medication helps the body respond effectively to its own insulin production and boosts incretins, natural substances that enhance insulin release, particularly after meals.
How to Take Trijardy XR
Trijardy XR should be taken orally once daily with the morning meal, following your doctor's directions. The tablets should be swallowed whole and not crushed, dissolved, or chewed to avoid the rapid release of the drug, which can increase the risk of side effects. Consistent daily intake at the same time helps ensure the medication's effectiveness. Your doctor will determine the appropriate dosage based on your medical condition, treatment response, and other medications you are taking. To minimize potential side effects like diarrhea and nausea, the doctor may start with a low dose and gradually increase it.
Common Side Effects
Some common side effects include nausea, vomiting, stomach upset, diarrhea, bloating/gas, headache, or weakness. If these symptoms persist or worsen, it is important to inform your doctor promptly. Stomach symptoms that reappear after several days or weeks of consistent dosage should also be reported immediately. If you notice undissolved tablets in your stool, notify your doctor.
Serious Side Effects and Precautions
Lactic Acidosis
Metformin, one of the components of Trijardy XR, can cause a rare but serious condition known as lactic acidosis, which involves a buildup of lactic acid in the blood. Lactic acidosis can be fatal. The risk is higher in older adults and people with kidney or liver disease, dehydration, heart failure, or a history of heavy alcohol use. It is also a concern during surgery or X-ray procedures involving iodinated contrast. If you experience symptoms such as dizziness, severe drowsiness, slow/irregular heartbeat, persistent nausea/vomiting, abdominal pain, or shortness of breath, seek immediate medical attention.
Dehydration
Trijardy XR can lead to dehydration, potentially causing kidney damage. To prevent this, drink plenty of fluids. Seek immediate medical attention if you experience symptoms of dehydration, such as decreased urination, unusual dry mouth/thirst, rapid heartbeat, or dizziness/lightheadedness/fainting. Conditions that exacerbate dehydration, such as fever, vomiting, or diarrhea, should be promptly managed. If prolonged diarrhea or vomiting occurs, stop taking the medication and consult your doctor immediately.
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Ketoacidosis
This medication can cause ketoacidosis, a serious condition requiring hospital treatment that can be life-threatening. This risk is higher for people with type 1 diabetes, type 2 diabetes, or pancreas problems. Ketoacidosis can occur even if blood sugar levels are below 250 mg/dL. Symptoms include nausea, vomiting, stomach pain, confusion, and unusual fatigue. Stop taking Trijardy XR and seek immediate medical help if you experience these symptoms.
Genital Infections and Necrotizing Fasciitis
Trijardy XR may increase the risk of yeast infections in the vagina or penis. Symptoms of a vaginal yeast infection include unusual discharge, burning, itching, or odor. Symptoms of a penile yeast infection include redness, itching, swelling, or unusual discharge. A rare but severe bacterial infection, necrotizing fasciitis of the perineum, can also occur. Seek immediate medical attention if you experience pain, tenderness, redness, or swelling in the genital or anal area, accompanied by fever or a general feeling of being unwell.
Amputations
This medication may increase the risk of lower limb amputation, particularly of the toe and foot, especially in individuals with poor blood flow in the legs, nerve problems, foot ulcers, or a history of amputation. Contact your healthcare provider immediately if you develop new pain or tenderness, sores, ulcers, or infections in your leg or foot. Proper foot care is essential.
Pancreatitis
Inflammation of the pancreas (pancreatitis) can occur, which may be severe and lead to death. If you experience severe, persistent abdominal pain that may radiate to your back, with or without vomiting, discontinue Trijardy XR and contact your healthcare provider immediately.
Hypoglycemia and Hyperglycemia
While Trijardy XR does not typically cause low blood sugar (hypoglycemia), it can occur when taken with other diabetes medications, or if you do not consume enough calories, or engage in unusually heavy exercise. Symptoms include sudden sweating, shaking, fast heartbeat, hunger, blurred vision, dizziness, or tingling in the hands/feet. Carrying glucose tablets or gel is advisable. High blood sugar (hyperglycemia) symptoms include increased thirst and urination. If these occur, consult your doctor promptly.
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Allergic Reactions
Although rare, a severe allergic reaction is possible. Seek immediate medical attention if you experience symptoms such as rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, or difficulty breathing.
Other Potential Side Effects
- Low Vitamin B12 (Vitamin B12 Deficiency): Long-term metformin use can decrease vitamin B12 levels.
- Joint Pain: Some individuals may experience severe joint pain.
- Skin Reaction: Bullous pemphigoid, a skin reaction that may require hospitalization, can occur.
- Heart Failure: Trijardy XR can cause heart failure. Before starting this medication, inform your healthcare provider if you have a history of heart failure or kidney problems.
Precautions
Before taking Trijardy XR, inform your doctor or pharmacist about any allergies you have, especially to empagliflozin, linagliptin, or metformin. Discuss your medical history, particularly if you have kidney or liver disease, heart problems, dehydration, or a history of alcohol abuse.
Surgery and X-ray Procedures
Inform your doctor or dentist about all medications you are taking, including Trijardy XR, before undergoing surgery or any X-ray/scanning procedure using iodinated contrast. You may need to temporarily discontinue this medication.
Pregnancy and Breastfeeding
Trijardy XR should only be used during pregnancy when clearly necessary, due to potential harm to the unborn baby. Discuss blood sugar management plans with your doctor if you are pregnant or planning to become pregnant. It is unknown whether empagliflozin or linagliptin passes into breast milk. Consult your healthcare provider about the best way to feed your baby while taking Trijardy XR. Metformin can cause changes in the menstrual cycle and increase the risk of pregnancy.
Drug Interactions
Inform your doctor and pharmacist about all medications you are taking, including prescription, nonprescription, and herbal products, to avoid potential drug interactions. Beta-blockers may mask the symptoms of hypoglycemia. Many drugs can affect blood sugar levels, so consult your doctor or pharmacist before starting, stopping, or changing any medication.
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Dosage and Administration
Take Trijardy XR by mouth once daily with a meal in the morning. Swallow the tablets whole; do not break, cut, crush, dissolve, or chew them. Your healthcare provider will determine the appropriate dosage and may prescribe Trijardy XR along with other diabetes medications. If you miss a dose, take it as soon as you remember, unless it is almost time for your next dose. Do not take two doses at the same time.
Lifestyle Considerations
When your body is under stress due to fever, trauma, infection, or surgery, your diabetes medication needs may change. Avoid excessive alcohol consumption.
Monitoring and Follow-Up
Regular lab tests, including kidney/liver function tests, blood sugar levels, hemoglobin A1c, complete blood counts, cholesterol, vitamin B12, and ketone levels, should be conducted before and during treatment with Trijardy XR. Keep all medical and lab appointments.
Storage
Store Trijardy XR at room temperature, away from light and moisture. Do not store it in the bathroom. Dispose of the medication properly when it is expired or no longer needed.
Important Note
This information is a summary and does not include all possible information about Trijardy XR. It is not a substitute for professional medical advice. Always consult your healthcare provider for personalized medical advice and treatment.