the product in the database has an inactive status
indications:
Type 2 (non-insulin dependent) diabetes mellitus in adults, especially in obese patients, when a strictly observed diet and exercise can not achieve normal blood glucose. It can be used alone or in combination with other oral antidiabetic medicines or with insulin.
Composition:
1 tabl contains 500 mg or 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, increases peripheral glucose uptake and its consumption, delays the absorption of glucose in the intestines. Metformin stimulates intracellular glycogen synthesis by acting on glycogen synthase. Increases the ability to transport across the 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 is incomplete. 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 drug is not significantly bound to plasma proteins. Metformin penetrates into erythrocytes. T0,5 it is about 6.5 hours. It is excreted unchanged in the urine, about 20-30% of the dose - with faeces. In the case of impaired renal function, metformin renal clearance decreases, the elimination half-life in the terminal elimination phase increases, leading to increased plasma drug levels.
Contraindications:
Hypersensitivity to metformin hydrochloride or other ingredients of the preparation. Diabetic ketoacidosis and pre-comistic conditions in diabetes. Renal failure or renal impairment (creatinine clearance <60 ml / min). acute conditions associated with the risk of renal dysfunction: dehydration, severe infections, shock. Radiological tests requiring intravascular administration of iodinated contrast agents. Acute or chronic diseases that may cause tissue hypoxia such as 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. Particular care should be taken in situations where kidney function may be impaired, such as when starting a blood pressure-reducing or diuretic, and at the beginning of NSAIDs. The drug should be discontinued prior to radiological examination with iodinated iodinated contrast agents and its administration may be resumed not earlier than 48 hours after the test and only after evaluation of renal function and confirmation that it is normal. Metformin hydrochloride should be discontinued 48 h before the planned surgery under general anesthesia, the drug may be resumed not earlier than 48 h after the procedure. Metformin alone does not cause hypoglycaemia, but caution should be exercised when using it simultaneously with a sulphonylurea or insulin. Do not use in children due to lack of data.
Pregnancy and lactation:
Metformin should not be used during the planned pregnancy and during pregnancy (insulin should be used). The drug is contraindicated during breastfeeding.
Side effects:
Very common: gastrointestinal disorders (nausea, vomiting, diarrhea, abdominal pain, decreased appetite) - these symptoms occur most often at the beginning of treatment and go away spontaneously. Common: metallic aftertaste. Very rare: erythema, pruritus, urticaria, decreased absorption of vitamin B12 and reduction of its serum concentration during long-term treatment with Metformin, lactic acidosis. Isolated cases: abnormal liver function tests, hepatitis.
Dosage:
Orally.Adults. Monotherapy or combination therapy with other oral antidiabetic agents: the usual starting dose is 500 mg or 850 mg 2-3 times a day during or after a meal. After 10-15 days, the dose should be adjusted based on the blood glucose level. The maximum daily dose is 3 g. Combination therapy with insulin: the initial dose is 500-850 mg 2-3 times a day, while the insulin dose is determined based on the results of the blood glucose test. 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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