Metformin pills 500mg №60

Active ingredient

Pharmacotherapeutic group

Hypoglycemic agent of the biguanide group for oral administration

Pharmacology

Metformin reduces hyperglycemia without causing hypoglycemia. Unlike sulfonylurea derivatives, does not stimulate insulin secretion and does not have
hypoglycemic effect in healthy individuals. Increases
peripheral insulin receptor sensitivity and glucose utilization by cells. Inhibits gluconeogenesis in the liver. Delays the absorption of carbohydrates in the intestines. Metformin stimulates glycogen synthesis by acting on glycogen synthase. Increases the transport capacity of all types of membrane glucose transporters. In addition, it has a beneficial effect on lipid metabolism: it lowers total cholesterol, low-density lipoprotein and triglycerides. While taking metformin, the patient's body weight either remains stable or decreases moderately.

Indications

Diabetes mellitus type 2, especially in patients with obesity, with the ineffectiveness of diet and exercise: in adults as monotherapy or in combination with other oral hypoglycemic agents, or insulin; in children from 10 years as monotherapy or in combination with insulin.

Contraindications

Hypersensitivity to metformin or to any excipient; diabetic ketoacidosis, diabetic precoma, coma; renal failure or impaired renal function (creatinine clearance (CC) less than 60 ml / min); acute conditions occurring with the risk of developing renal dysfunction: dehydration (with diarrhea, vomiting), serious infectious diseases, shock; clinically significant manifestations of acute or chronic diseases that can lead to the development of tissue hypoxia (including cardiac or respiratory failure, acute myocardial infarction); extensive surgery and trauma when insulin therapy is indicated; liver failure, abnormal liver function; chronic alcoholism, acute alcohol poisoning; pregnancy; lactic acidosis (including and in the anamnesis); use within less than 48 hours before and within 48 hours after radioisotope or x-ray examinations with the introduction of an iodine-containing contrast agent; compliance with low-calorie diets (less than 1000 kcal / day); children's age up to 10 years.

Dosage and administration

Tablets should be taken orally, swallowed whole, without chewing, during or immediately after a meal, drinking plenty of water. Adults: monotherapy and combination therapy in combination with other oral hypoglycemic agents: The usual initial dose is 500 mg or 850 mg 2-3 times per day after or during meals.Perhaps a further gradual increase in dose, depending on the concentration of glucose in the blood. Maintenance dose of the drug is usually 1500-2000 mg / day. To reduce the side effects of the gastrointestinal tract, the daily dose should be divided into 2-3 doses. The maximum dose is 3000 mg / day, divided into three doses. Slow increase in dose may contribute to improved gastrointestinal tolerance. Patients taking metformin in doses of 2000-3000 mg / day can be transferred to the reception of the drug 1000 mg. The maximum recommended dose is 3000 mg / day, divided into 3 doses. In case of planning a transition from taking another hypoglycemic agent: you must stop taking another means and start taking Metformin at the dose indicated above.
Combination with insulin: Metformin and insulin can be used as a combination therapy to achieve better blood glucose control. The usual initial dose of Metformin 500 mg or 850 mg is one pill 2-3 times a day, Metformin 1000 mg is one pill 1 time per day, while the insulin dose is selected based on the glucose concentration in the blood. Children and adolescents: in children from the age of 10, the drug Metformin can be used both in monotherapy and
combination with insulin. The usual initial dose is 500 mg or 850 mg 1 time per day after or during the meal. After 10-15 days, the dose must be adjusted based on the concentration of blood glucose.The maximum daily dose is 2000 mg, divided into 2-3 doses. Elderly patients: due to a possible decrease in kidney function, the dose of metformin must be selected under regular control of indicators of kidney function (determine the concentration of creatinine in the blood serum at least 2-4 times a year). The duration of treatment is determined by the doctor. It is not recommended to interrupt the administration of the drug without the indication of the attending physician.