the product in the database has an inactive status
indications:
Type 2 diabetes, especially in obese patients, who can not get the proper level of Glucose in the blood using diet and exercise. It can be used alone or in combination with other oral antidiabetic medicines, as well as with insulin in adults and adolescents and children over 10 years of age. In adults with type 2 diabetes mellitus and overweight patients treated with Metformin as the first-line drug, a reduction in the incidence of diabetes complications has been demonstrated.
Composition:
1 tabl powl. contains 850 mg of metformin hydrochloride.
Action:
An oral antidiabetic drug from the group of biguanide derivatives. It reduces blood glucose both on an empty stomach and after a meal. It does not stimulate insulin secretion and therefore does not cause hypoglycaemia. Metformin works by three mechanisms: reduces hepatic glucose production by inhibiting gluconeogenesis and glycogenolysis, increases the insulin sensitivity of cells in the muscles, improves peripheral glucose uptake and its consumption, delays the absorption of glucose in the intestines. Metformin stimulates intracellular glycogen synthesis. Increases the ability to transport across the cell membrane of all types of glucose carriers. In addition, it has a beneficial effect on lipid metabolism - reduces total cholesterol, LDL and triglycerides. After oral administration, the absorption of the drug undergoes saturation and is incomplete. The absolute bioavailability is 50-60%. The maximum concentration of the drug in the blood occurs 2.5 h after administration. Food reduces and slightly delays the absorption of the drug. The binding to plasma proteins is insignificant. Metformin penetrates into erythrocytes. T0,5 in the final phase of elimination is about 6.5 hours. It is excreted unchanged in the urine. In the case of impaired renal function, metformin renal clearance decreases, the half-life is prolonged, resulting in increased plasma concentrations of the drug.
Contraindications:
Hypersensitivity to metformin or other components of the preparation. Diabetic ketoacidosis, pre-comedic condition in diabetes. Renal failure or renal impairment (creatinine clearance <60 ml / min). acute conditions that may potentially affect renal function, i.e. dehydration, severe infections, shock, intravascular administration of iodinated contrast media. Acute and chronic diseases that may cause hypoxia of organs and tissues, i.e. heart failure or respiratory failure, a recent myocardial infarction, shock. Hepatic failure, acute alcohol intoxication, alcoholism. Breast-feeding.
Precautions:
Cumulation of metformin may lead to lactic acidosis. Serum creatinine should be measured before initiation of therapy and regularly during treatment (at least once a year in patients with normal renal function, at least 2-4 times per year if creatinine is close to the upper limit of normal and in the elderly ). Particular care should be taken in situations where renal function may be impaired eg at the beginning of the use of antihypertensive, diuretic and NSAIDs. The drug should be discontinued before or at the time of radiological examination with iodinated contrast agents given intravascularly, and its administration can be resumed not earlier than 48 hours after the test and only if the kidney function is normal. Metformin should be discontinued 48 h before the planned surgery under general anesthesia, the drug may be resumed 48 hours after the procedure. Metformin alone does not cause hypoglycaemia, but caution should be exercised when using it with a sulphonylurea or insulin. When using the preparation in children and adolescents, caution should be exercised (in controlled clinical trials, no effect on growth and maturation, but no long-term studies), monitoring during metformin treatment is recommended. Special care should be taken in children aged 10 -12 years.
Pregnancy and lactation:
Metformin should not be used during the planned pregnancy and during pregnancy (the drug of choice is insulin). The drug is contraindicated during breastfeeding.
Side effects:
Very common: gastrointestinal disorders (nausea, vomiting, diarrhea, abdominal pain and loss of appetite). Common: taste disorders (metallic taste in the mouth). Very rare: decreased absorption of vitamin B12 and reducing its serum concentration during long-term treatment; lactic acidosis; skin reactions (erythema, pruritus, urticaria). Single reports: abnormal liver function tests or hepatitis disappearing after drug withdrawal. To prevent gastrointestinal side effects it is recommended to take the product in 2-3 doses per day during or after a meal. Slowly increasing the dose may improve the tolerance of the drug.
Dosage:
Orally.Adults. Monotherapy or combination therapy with other oral antidiabetic agents: the usual starting dose is 850 mg 2-3 times a day during or after a meal. After 10-15 days, the final dose should be determined based on blood glucose. The maximum daily dose is 3 g. If another oral antidiabetic medication is replaced with metformin hydrochloride, the previously used medicine should be discontinued and metformin hydrochloride should be used at the recommended doses. Combination therapy with insulin: the initial dose is 850 mg 2-3 times a day, while the insulin dose is determined based on the results of the blood glucose test.Youth and children over 10 years. Monotherapy or combination therapy with insulin: the usual starting dose is 500 mg or 850 mg once a day, during or after a meal. After 10-15 days, the final dose should be determined based on blood glucose. The maximum daily dose is 2 g in 2 or 3 divided doses. In elderly patients, the dose is determined based on the assessment of renal function. The gradual increase in the dose may improve the tolerance of the drug on the gastrointestinal tract.
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