Deformin
Generic Name
Metformin Hydrochloride
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| deformin 500 mg tablet | ৳ 3.00 | ৳ 30.00 |
Description
Overview of the medicine
Deformin 500 mg Tablet is an oral antidiabetic medicine containing Metformin Hydrochloride. It is used to lower blood glucose levels in adults with type 2 diabetes mellitus, especially in those who are overweight, when diet and exercise alone are not sufficient.
Uses & Indications
Dosage
Adults
Initial dose is usually 500 mg once or twice daily with or after meals. The dose should be gradually increased to a maximum of 2000-2500 mg per day in divided doses. Follow physician's advice.
Elderly
Elderly patients should start with a lower initial dose and renal function should be regularly assessed due to potential for decreased renal function.
Renal_impairment
Metformin is contraindicated in patients with eGFR < 30 mL/min/1.73m². Use with caution and dose adjustment if eGFR 30-45 mL/min/1.73m².
How to Take
Take Deformin 500 mg Tablet orally with or just after meals to minimize gastrointestinal side effects.
Mechanism of Action
Metformin works by decreasing hepatic glucose production (gluconeogenesis), decreasing intestinal absorption of glucose, and by improving insulin sensitivity (increasing peripheral glucose uptake and utilization). It does not stimulate insulin secretion and therefore does not cause hypoglycemia in monotherapy.
Pharmacokinetics
Onset
Glycemic control improvement is usually seen within 1-2 weeks, with full effect taking several weeks.
Excretion
Excreted unchanged in the urine. Renal clearance is approximately 3.5 times higher than creatinine clearance, indicating tubular secretion.
Half life
The plasma elimination half-life is approximately 4-9 hours.
Absorption
Absolute bioavailability of a 500 mg Metformin tablet taken under fasting conditions is approximately 50-60%. Food decreases the extent and slightly delays the absorption.
Metabolism
Metformin is not metabolized in the liver.
Side Effects
Contraindications
- Hypersensitivity to metformin or any component of the tablet.
- Any type of acute metabolic acidosis (such as lactic acidosis, diabetic ketoacidosis).
- Severe renal failure (eGFR < 30 mL/min/1.73m²).
- Acute conditions with potential to alter renal function (e.g., dehydration, severe infection, shock).
- Acute or chronic disease which may cause tissue hypoxia (e.g., cardiac or respiratory failure, recent myocardial infarction, shock).
- Hepatic insufficiency, acute alcohol intoxication, alcoholism.
Drug Interactions
Alcohol
Increases the risk of lactic acidosis, especially in cases of fasting, malnutrition or hepatic impairment.
Iodinated contrast agents
Temporary renal impairment after intravascular administration of iodinated contrast agents may increase the risk of lactic acidosis. Metformin should be discontinued at the time of or prior to the procedure and withheld for 48 hours afterward, and reinstituted only after renal function has been re-evaluated and found to be normal.
Glucocorticoids, sympathomimetics, diuretics
May decrease glycemic control.
Cationic drugs (e.g., cimetidine, amiloride, digoxin, morphine, procainamide, quinidine, ranitidine, triamterene, trimethoprim, vancomycin)
May compete for renal tubular transport, increasing metformin concentration.
Storage
Store below 30°C in a dry place, away from direct light and moisture. Keep out of reach of children.
Overdose
Overdose of metformin can lead to lactic acidosis, which is a medical emergency. Symptoms include severe gastrointestinal upset, muscle pain, malaise, and difficulty breathing. Management involves supportive measures and prompt hemodialysis to remove metformin.
Pregnancy & Lactation
For pregnancy, insulin is generally the preferred treatment for diabetes. Metformin may be considered in some cases under strict medical supervision. Metformin is excreted in breast milk in small amounts; generally considered compatible with breastfeeding, but consult a physician.
Side Effects
Contraindications
- Hypersensitivity to metformin or any component of the tablet.
- Any type of acute metabolic acidosis (such as lactic acidosis, diabetic ketoacidosis).
- Severe renal failure (eGFR < 30 mL/min/1.73m²).
- Acute conditions with potential to alter renal function (e.g., dehydration, severe infection, shock).
- Acute or chronic disease which may cause tissue hypoxia (e.g., cardiac or respiratory failure, recent myocardial infarction, shock).
- Hepatic insufficiency, acute alcohol intoxication, alcoholism.
Drug Interactions
Alcohol
Increases the risk of lactic acidosis, especially in cases of fasting, malnutrition or hepatic impairment.
Iodinated contrast agents
Temporary renal impairment after intravascular administration of iodinated contrast agents may increase the risk of lactic acidosis. Metformin should be discontinued at the time of or prior to the procedure and withheld for 48 hours afterward, and reinstituted only after renal function has been re-evaluated and found to be normal.
Glucocorticoids, sympathomimetics, diuretics
May decrease glycemic control.
Cationic drugs (e.g., cimetidine, amiloride, digoxin, morphine, procainamide, quinidine, ranitidine, triamterene, trimethoprim, vancomycin)
May compete for renal tubular transport, increasing metformin concentration.
Storage
Store below 30°C in a dry place, away from direct light and moisture. Keep out of reach of children.
Overdose
Overdose of metformin can lead to lactic acidosis, which is a medical emergency. Symptoms include severe gastrointestinal upset, muscle pain, malaise, and difficulty breathing. Management involves supportive measures and prompt hemodialysis to remove metformin.
Pregnancy & Lactation
For pregnancy, insulin is generally the preferred treatment for diabetes. Metformin may be considered in some cases under strict medical supervision. Metformin is excreted in breast milk in small amounts; generally considered compatible with breastfeeding, but consult a physician.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2 to 3 years from the date of manufacture, consult the specific product packaging for exact date.
Availability
Available in pharmacies and hospitals
Approval Status
Approved (Widely established)
Patent Status
Off-patent (Generic)
WHO Essential Medicine
YesClinical Trials
Metformin has undergone extensive clinical trials over decades, establishing its efficacy and safety profile for the management of type 2 diabetes mellitus. Ongoing research explores its potential in other conditions.
Lab Monitoring
- Renal function (eGFR) should be assessed before initiating treatment and at least annually thereafter (more frequently in elderly or patients with impaired renal function).
- HbA1c and blood glucose levels should be regularly monitored.
- Vitamin B12 levels should be measured periodically in patients on long-term metformin therapy.
Doctor Notes
- Crucial to monitor renal function (eGFR) before and during metformin therapy due to lactic acidosis risk.
- Educate patients on the signs and symptoms of lactic acidosis and to seek immediate medical attention if they occur.
- Consider vitamin B12 supplementation in patients on long-term metformin, especially if symptoms of deficiency arise.
- Advise lifestyle modifications (diet, exercise) as foundational therapy for type 2 diabetes.
Patient Guidelines
- Take your medicine regularly as prescribed by your doctor, preferably with or after meals.
- Inform your doctor if you experience any unusual symptoms, especially severe gastrointestinal upset, muscle pain, or difficulty breathing (potential signs of lactic acidosis).
- Do not stop taking Deformin without consulting your doctor.
- Inform your doctor about any other medications, supplements, or herbal products you are taking.
- Carry identification indicating you have diabetes.
Missed Dose Advice
If a dose is missed, take it as soon as you remember, unless it is almost time for your next dose. Do not take a double dose to make up for a forgotten dose.
Driving Precautions
Deformin monotherapy does not usually cause hypoglycemia and thus has no effect on the ability to drive or use machines. However, if used in combination with other antidiabetic agents (e.g., sulfonylureas, insulin) that can cause hypoglycemia, patients should be warned about the risks of hypoglycemia affecting driving ability.
Lifestyle Advice
- Maintain a balanced diet and follow a healthy eating plan.
- Engage in regular physical activity as advised by your healthcare provider.
- Monitor your blood glucose levels regularly as instructed.
- Limit alcohol consumption.
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