Glucophage (Metformin)

$ 111.94$ 215.08

Category: Diabetes
Commercial name: Glucophage
Active ingredient: Metformin
Production form: Pills
Available dosage: 500 mg, 850 mg, 1000 mg

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Description

Glucophage (Metformin). Dosage, Side Effects, Interactions

Glucophage (Metformin) is an active ingredient that is mainly used to treat type 2 diabetes mellitus, but also to treat polycystic ovary syndrome. The drug inhibits the formation of new glucose in the liver and leads to an improvement in glucose utilization in the periphery. Metformin alone does not cause hypoglycemia.

Applications of metformin are:

  • Type 2 diabetes mellitus , especially in obese patients
  • Polycystic ovary syndrome

How Glucophage (Metformin) works

After oral administration in diabetics, but not in people with a healthy metabolism, metformin dose-dependently reduces the blood sugar level as a result of inhibition of glycogenolysis and gluconeogenesis in the liver and leads to improved glucose utilization in the peripheral tissues. There is no release of insulin from the B cells.

 

Pharmacokinetics

  • Metformin reaches peak plasma concentrations after approximately 2.5 hours. Simultaneous food intake reduces the absorption of the active substance.
  • Elimination is mainly renal.
  • Renal clearance is greater than 400 mL/min, suggesting that metformin is cleared by glomerular filtration and tubular secretion.

Dosage of Glucophage (Metformin)

Adults with normal renal function (GFR ≥ 90 mL/min)

Monotherapy and combination with other oral antidiabetics : Usually the starting dose is 500 mg or 850 mg of metformin hydrochloride two or three times a day. After about 10 to 15 days, the dosage should be adjusted depending on the measurements of the blood sugar level. Slowly increasing the dose has a positive effect on the gastrointestinal tolerability of metformin. The maximum recommended daily dose is 3 g metformin hydrochloride divided into 3 doses. When switching from another oral antidiabetic to metformin, the previous drug should first be discontinued and then therapy with metformin hydrochloride 500 mg or 850 mg two or three times daily should be started.

Combination with insulin: Metformin and insulin can be combined to achieve better blood sugar control. Metformin hydrochloride is given in the usual starting dose of 500 mg or 850 mg two to three times a day, while the insulin dose is adjusted according to measured blood sugar levels.

Elderly patients

As renal function is often impaired in elderly patients, metformin dosage should be adjusted according to renal function. The renal function in elderly patients should be measured regularly.

renal dysfunction

GFR should be assessed prior to initiation of therapy with metformin-containing medicinal products and at least annually thereafter. In elderly patients and in patients at increased risk of further deterioration in renal function, renal function should be monitored more frequently, eg every 3-6 months. The maximum daily dose is 3 g at a GFR of 60-89 ml/min, 2 g at a GFR of 45-59 ml/min and 1 g of metformin hydrochloride at a GFR of 30-44 ml/min. The maximum daily doses are divided into 2 to 3 intakes per day. Metformin is contraindicated if the GFR is less than 30 mL/min.

children and young people

Monotherapy and combination with insulin: Metformin can be used in children from the age of 10 and in adolescents. Usually the starting dose is 500 mg or 850 mg metformin hydrochloride once daily. After about 10 to 15 days, the dosage should be adjusted depending on the measurements of the blood sugar level. Slowly increasing the dose has a positive effect on the gastrointestinal tolerability of metformin. The maximum recommended daily dose is 2 g metformin hydrochloride divided in 2 or 3 doses.

type of application

The film-coated tablets should be swallowed whole with sufficient liquid during or after meals.

 

Side effects of Glucophage (Metformin)

The most common side effects at the start of treatment are:

  • nausea
  • Vomit
  • Diarrhea
  • abdominal pain
  • loss of appetite

To avoid these symptoms, it is recommended to split the daily dose of metformin into several intakes and increase the dosage slowly.

 

Interactions

  • Alcohol ► increased risk of lactic acidosis
  • Contrast media containing iodine ► Accumulation of metformin and thus renal insufficiency possible
  • Drugs with intrinsic hyperglycaemic activity (e.g. systemically or locally applied glucocorticoids and sympathomimetics)
  • Diuretics (especially loop diuretics) ► Increased risk of lactic acidosis

Contraindication

Metformin must not be used in:

  • Hypersensitivity to the active substance
  • diabetic ketoacidosis
  • diabetic pre-coma
  • acute and unstable heart failure

Pregnancy/breastfeeding

It is recommended not to use metformin during pregnancy. Blood sugar levels should be controlled with insulin during pregnancy.

Metformin passes into breast milk. No side effects have been observed in breastfed newborns. However, due to the limited data, breastfeeding is not recommended during metformin therapy.

 

Driving ability

Metformin monotherapy has no influence on the ability to drive and use machines since metformin alone does not induce hypoglycaemia. However, when metformin is combined with other antidiabetics (e.g. sulfonylureas , insulin or glinides ), there is a risk of hypoglycaemia, about which patients should be informed.

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Additional information

Dosage

500 mg, 850 mg, 1000mg

Quantity

30, 60, 90, 120, 180

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