Diablo
Generic Name
Metformin Hydrochloride
Manufacturer
Pharmaco Global Inc.
Country
Global
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| diablo 500 mg tablet | ৳ 4.00 | ৳ 40.00 |
Description
Overview of the medicine
Diablo 500 mg tablet contains Metformin Hydrochloride, an oral antidiabetic medication used to manage type 2 diabetes mellitus. It helps to lower blood glucose levels by decreasing glucose production in the liver, decreasing glucose absorption from the intestine, and improving insulin sensitivity.
Uses & Indications
Dosage
Adults
Initial dose: 500 mg once or twice daily with meals. Gradually increase to a maximum of 2000-2550 mg daily, divided into 2-3 doses. Maximum effective dose for regular release is 2000mg/day.
Elderly
Dose adjustments may be needed based on renal function. Initiate with lower doses.
Renal_impairment
Contraindicated in severe renal impairment (eGFR < 30 mL/min/1.73 m²). Dose reduction required for eGFR 30-45 mL/min/1.73 m².
How to Take
Take orally with meals to reduce gastrointestinal side effects. Swallow the tablet whole; do not crush or chew.
Mechanism of Action
Metformin primarily acts by decreasing hepatic glucose production (gluconeogenesis) and intestinal absorption of glucose. It also improves insulin sensitivity by increasing peripheral glucose uptake and utilization. It does not stimulate insulin secretion and therefore does not cause hypoglycemia in monotherapy.
Pharmacokinetics
Onset
Onset of action is usually within days; full effect within 2 weeks.
Excretion
Excreted unchanged in the urine, primarily via renal tubular secretion.
Half life
Plasma elimination half-life is approximately 6.2 hours.
Absorption
Bioavailability is 50-60% after oral administration. Food decreases the extent and slightly delays the absorption.
Metabolism
Not metabolized in the liver (no hepatic metabolism).
Side Effects
Contraindications
- Severe renal impairment (eGFR < 30 mL/min/1.73 m²)
- Metabolic acidosis (including diabetic ketoacidosis)
- Hypersensitivity to metformin
- Acute or chronic metabolic acidosis, including diabetic ketoacidosis, with or without coma
- Heart failure requiring pharmacological intervention
Drug Interactions
Iodinated contrast agents
Temporarily discontinue metformin before or at the time of an iodinated contrast imaging procedure in patients with eGFR between 30 and 60 mL/min/1.73 m², those with a history of liver disease, alcoholism, or heart failure, or in patients who will be administered intra-arterial iodinated contrast. Re-evaluate eGFR 48 hours after the imaging procedure, and restart metformin if renal function is stable.
Cimetidine, trimethoprim, ranolazine, dolutegravir, isavuconazole, vandetanib, or diuretics
May increase metformin plasma concentrations by competing for renal tubular secretion, potentially increasing risk of lactic acidosis.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Metformin overdose can lead to lactic acidosis, a serious metabolic complication. Symptoms include malaise, myalgia, respiratory distress, somnolence, and abdominal distress. Treatment involves supportive care and hemodialysis to remove metformin and correct acidosis.
Pregnancy & Lactation
Metformin is generally considered safe during pregnancy for managing gestational diabetes or pre-existing type 2 diabetes, but treatment should be individualized in consultation with a healthcare provider. Small amounts are excreted into breast milk, but generally considered compatible with breastfeeding with caution.
Side Effects
Contraindications
- Severe renal impairment (eGFR < 30 mL/min/1.73 m²)
- Metabolic acidosis (including diabetic ketoacidosis)
- Hypersensitivity to metformin
- Acute or chronic metabolic acidosis, including diabetic ketoacidosis, with or without coma
- Heart failure requiring pharmacological intervention
Drug Interactions
Iodinated contrast agents
Temporarily discontinue metformin before or at the time of an iodinated contrast imaging procedure in patients with eGFR between 30 and 60 mL/min/1.73 m², those with a history of liver disease, alcoholism, or heart failure, or in patients who will be administered intra-arterial iodinated contrast. Re-evaluate eGFR 48 hours after the imaging procedure, and restart metformin if renal function is stable.
Cimetidine, trimethoprim, ranolazine, dolutegravir, isavuconazole, vandetanib, or diuretics
May increase metformin plasma concentrations by competing for renal tubular secretion, potentially increasing risk of lactic acidosis.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Metformin overdose can lead to lactic acidosis, a serious metabolic complication. Symptoms include malaise, myalgia, respiratory distress, somnolence, and abdominal distress. Treatment involves supportive care and hemodialysis to remove metformin and correct acidosis.
Pregnancy & Lactation
Metformin is generally considered safe during pregnancy for managing gestational diabetes or pre-existing type 2 diabetes, but treatment should be individualized in consultation with a healthcare provider. Small amounts are excreted into breast milk, but generally considered compatible with breastfeeding with caution.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
24 to 36 months from manufacturing date
Availability
Available in pharmacies worldwide
Approval Status
Approved by regulatory bodies worldwide
Patent Status
Generic available; Patent expired
WHO Essential Medicine
YesClinical Trials
Metformin has been extensively studied in numerous clinical trials demonstrating its efficacy in reducing HbA1c, fasting plasma glucose, and improving cardiovascular outcomes, especially in overweight or obese patients with type 2 diabetes.
Lab Monitoring
- Renal function (eGFR) periodically (at least annually or more frequently in elderly or impaired patients)
- HbA1c levels
- Fasting plasma glucose
- Vitamin B12 levels (especially in long-term users or those with risk factors)
Doctor Notes
- Advise patients on lifestyle modifications.
- Educate patients on symptoms of lactic acidosis and when to seek immediate medical attention.
- Regularly assess renal function before initiating and during therapy.
- Consider vitamin B12 supplementation for long-term metformin users, especially those with anemia or peripheral neuropathy.
Patient Guidelines
- Take metformin with food to reduce stomach upset.
- Inform your doctor if you experience symptoms of lactic acidosis (e.g., severe tiredness, muscle pain, difficulty breathing, stomach pain).
- Do not stop taking metformin without consulting your doctor.
- Regularly monitor blood sugar levels as advised by your doctor.
Missed Dose Advice
If a dose is missed, take it as soon as you remember, unless it is almost time for your next dose. In that case, skip the missed dose and continue with your regular dosing schedule. Do not double the dose.
Driving Precautions
Metformin alone does not usually cause hypoglycemia, so it is unlikely to impair driving ability. However, if used in combination with other antidiabetic agents that can cause hypoglycemia, caution is advised. Be aware of symptoms of hypoglycemia (e.g., dizziness, confusion) and avoid driving if experiencing them.
Lifestyle Advice
- Maintain a balanced diet and regular physical activity.
- Avoid excessive alcohol consumption.
- Regularly check blood glucose levels.
- Attend all scheduled doctor appointments and lab tests.
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