Comet-XR
Generic Name
Metformin Hydrochloride Extended-Release Tablet
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| comet xr 1000 mg tablet | ৳ 9.03 | ৳ 54.18 |
Description
Overview of the medicine
Comet-XR (Metformin Hydrochloride Extended-Release) is an oral antidiabetic medicine used to control high blood sugar levels in people with type 2 diabetes mellitus. It helps restore the body's proper response to the insulin it naturally produces. This medicine is often used in conjunction with diet and exercise.
Uses & Indications
Dosage
Adults
Initial dose is usually 500 mg extended-release tablet orally once daily with the evening meal. Dose may be increased gradually in increments of 500 mg weekly to a maximum of 2000 mg once daily. Comet-XR 1000 mg is typically taken once daily with the evening meal.
Elderly
Elderly patients should start with lower doses, and renal function should be closely monitored. Doses should be titrated carefully.
Renal_impairment
Contraindicated if eGFR < 30 mL/min/1.73 m². Dose adjustment required for eGFR 30-45 mL/min/1.73 m². Initiation is not recommended if eGFR is 30-45 mL/min/1.73 m².
How to Take
Take Comet-XR orally, once daily with the evening meal. Swallow the tablet whole; do not crush, chew, or break it, as this may affect its extended-release properties.
Mechanism of Action
Metformin reduces hepatic glucose production, decreases intestinal absorption of glucose, and improves insulin sensitivity by increasing peripheral glucose uptake and utilization. It does not stimulate insulin secretion and, therefore, does not cause hypoglycemia when used alone.
Pharmacokinetics
Onset
Clinical effects are typically observed within days, with maximal glucose-lowering effects developing over 1-2 weeks.
Excretion
Primarily renal elimination. Approximately 90% of the absorbed dose is eliminated via the kidneys within 24 hours.
Half life
The plasma elimination half-life is approximately 6.2 hours.
Absorption
Slowly and incompletely absorbed from the GI tract. Peak plasma concentrations (Cmax) are reached approximately 4-8 hours post-dose for the extended-release formulation. Absolute bioavailability is 50-60%.
Metabolism
Metformin is not metabolized in the liver and is excreted unchanged.
Side Effects
Contraindications
- Severe renal impairment (eGFR < 30 mL/min/1.73 m²).
- Metabolic acidosis, including diabetic ketoacidosis.
- Hypersensitivity to metformin hydrochloride or any component of Comet-XR.
Drug Interactions
Alcohol
Increases the risk of lactic acidosis. Advise patients to avoid excessive alcohol intake.
Iodinated contrast agents
Temporarily discontinue metformin at the time of or prior to imaging procedures. Re-evaluate eGFR 48 hours after the procedure; restart metformin if renal function is stable.
Cationic drugs (e.g., cimetidine, ranolazine, dolutegravir)
May increase metformin exposure and the risk of lactic acidosis by competing for renal tubular transport systems.
Carbonic Anhydrase Inhibitors (e.g., topiramate, acetazolamide)
May increase the risk of lactic acidosis.
Storage
Store in a cool and dry place, below 30°C. Protect from light and moisture. Keep out of reach of children.
Overdose
Overdose of metformin, particularly in the absence of coexisting conditions such as renal impairment or alcoholism, has been associated with lactic acidosis. Management includes hemodialysis to remove accumulated metformin from the blood.
Pregnancy & Lactation
Limited data on metformin use in pregnant women are insufficient to determine drug-associated risk for major birth defects or miscarriage. Generally, insulin is preferred for glycemic control during pregnancy. Metformin is excreted into breast milk; caution should be exercised when administered to a nursing woman.
Side Effects
Contraindications
- Severe renal impairment (eGFR < 30 mL/min/1.73 m²).
- Metabolic acidosis, including diabetic ketoacidosis.
- Hypersensitivity to metformin hydrochloride or any component of Comet-XR.
Drug Interactions
Alcohol
Increases the risk of lactic acidosis. Advise patients to avoid excessive alcohol intake.
Iodinated contrast agents
Temporarily discontinue metformin at the time of or prior to imaging procedures. Re-evaluate eGFR 48 hours after the procedure; restart metformin if renal function is stable.
Cationic drugs (e.g., cimetidine, ranolazine, dolutegravir)
May increase metformin exposure and the risk of lactic acidosis by competing for renal tubular transport systems.
Carbonic Anhydrase Inhibitors (e.g., topiramate, acetazolamide)
May increase the risk of lactic acidosis.
Storage
Store in a cool and dry place, below 30°C. Protect from light and moisture. Keep out of reach of children.
Overdose
Overdose of metformin, particularly in the absence of coexisting conditions such as renal impairment or alcoholism, has been associated with lactic acidosis. Management includes hemodialysis to remove accumulated metformin from the blood.
Pregnancy & Lactation
Limited data on metformin use in pregnant women are insufficient to determine drug-associated risk for major birth defects or miscarriage. Generally, insulin is preferred for glycemic control during pregnancy. Metformin is excreted into breast milk; caution should be exercised when administered to a nursing woman.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
36 months from the date of manufacture
Availability
Pharmacies, Hospitals
Approval Status
Approved by FDA/DGDA
Patent Status
Off-patent
WHO Essential Medicine
YesClinical Trials
Extensive clinical trials have established Metformin's efficacy and safety in type 2 diabetes management. Ongoing research explores its potential benefits in other conditions such as cardiovascular disease prevention and certain cancers.
Lab Monitoring
- Renal function (eGFR) should be assessed before initiation and at least annually thereafter.
- Vitamin B12 levels should be monitored periodically, especially in patients on long-term metformin therapy or with predisposing risk factors for B12 deficiency.
- Blood glucose and HbA1c levels should be monitored regularly to assess glycemic control.
Doctor Notes
- Always assess renal function (eGFR) before initiating metformin and at least annually thereafter. Discontinue if eGFR falls below 30 mL/min/1.73m².
- Counsel patients on the symptoms of lactic acidosis and emphasize the importance of seeking immediate medical attention if these symptoms occur.
- Consider periodic vitamin B12 level assessment, particularly in patients on prolonged metformin therapy or those with risk factors for B12 deficiency.
Patient Guidelines
- Take Comet-XR exactly as prescribed by your doctor, usually once daily with your evening meal.
- Swallow the tablet whole. Do not crush, chew, or break extended-release tablets.
- Report any unusual symptoms, especially unusual muscle pain, difficulty breathing, unusual stomach discomfort, or feeling very weak or tired, as these could be signs of lactic acidosis.
- Maintain your prescribed diet and exercise regimen.
Missed Dose Advice
If you miss a dose, take it as soon as you remember with food, unless it is almost time for your next dose. In that case, skip the missed dose and resume your regular dosing schedule. Do not double the dose to catch up.
Driving Precautions
Comet-XR (metformin) alone usually does not cause hypoglycemia, which could affect driving or operating machinery. However, if used in combination with other anti-diabetic medications that can cause hypoglycemia, caution is advised. Be aware of your individual response to the medication.
Lifestyle Advice
- Regular physical activity and a balanced, healthy diet are crucial for managing type 2 diabetes.
- Maintain a healthy body weight.
- Avoid excessive alcohol consumption.
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