Metforshin 500
Metformin
Indication
Metformin is indicated as the first line drug for type 2 diabetes. It is used as monotherapy or in combination with other antidiabetic agents in patients with type 2 diabetes who cannot be controlled by diet or if patient is overweighed. It is useful in the prevention of type 2 diabetes in middle-ag...
Dosage and Administration
One tablet to be taken 2 - 3 times daily preferably with meal for control of diabetes mellitus. Initially, 500 mg once a day. If control is incomplete, maximum dosage is 3 g daily.
Composition
Each film-coated tablet contains:
Metformin Hydrochloride B.P ... 500 mg.
Description
Metformin hydrochloride tablet is an oral anti-hyperglycemic drug used in the management of non-insulin dependent diabetes mellitus. Chemically, it is (I, I-dimethyl biguanide hydrochloride) and its empirical formula is C4H12N5C I. Molecular weight is 165.62.
Clinical Pharmacology
The primary effect of metformin is to activate enzyme AMP-activated protein kinase and reduce hepatic glucose production. Metformin acts the following three mechanisms:
Increase peripheral utilization of glucose
Inhibit hepatic gluconeogenesis
Reduce absorption of glucose from the intestine.
Metformin can decrease body weight in some patients. Patients with type 2 diabetes have considerably less fasting hyperglycemia as well as lower postprandial hyperglycemia after administration of biguanides; however, hypoglycemia is rare. These agents are more approximately termed euglycemic agents.
Pharmacokinetics
It is absorbed mainly from the small intestine. Food decreases rate and extent of absorption. Metformin does not bound to plasma protein, not metabolized and its half-life is 1.5 - 3 hours. It is excreted by the kidney as the active compound. As a consequence of blockage of gluconeogenesis, metformi...
Contraindication
Metformin is contraindicated in patients who have the following conditions:
Diabetes coma and ketoacidosis
Impairment of Iiver and renal function
Chronic liver disease
Cardiac failure
Recent myocardial infarction Alcoholism (acute or chronic)
Hypoxaemia condition
History of lactic acidosis eg. shock or pulmonary insufficiency.
Precaution
Metformin is excreted by the kidney therefore regular monitoring of renal function should be advised in all diabetes patients. Metformin hydrochloride extended release alone does not cause hypoglycemia but occur with calorie intake is deficient or concomitant use with hypoglycemic agents (sulphonylu...
Adverse Effects
Common effects are gastrointestinal disturbances (anorexia, nausea, vomiting, metallic taste, abdominal discomfort and diarrhea) but it can be minimized by starting at low dose and slowly titrating the dose upward with food. It may have to be discontinued in 3 - 5% of patients because of persistent ...
Drug Interaction
increased Effect/ Toxicity: Frusemide and cimetidine may increase metformin blood levels. Cationic drugs (e.g. Amiloride, digoxin, morphine, procainamide, quinidine, quinine, ranitidine, triamterene, trimethoprim and vancomycin) which are eliminated by renal tubular secretion have the potential to i...
Herb/ Nutraceuticals: Caution with Chromium, garlic, gymnema (may cause hypoglycemia).
Storage
Store below 30°C in cool, dry place. Protect from light and moisture. Keep out of reach and sight of children.
Presentation
20 x 10's Blisters.