Diablo
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 |
|---|---|---|
| diablo 850 mg tablet | ৳ 6.00 | ৳ 60.00 |
Description
Overview of the medicine
Diablo 850 mg Tablet contains Metformin Hydrochloride, an oral antidiabetic drug used to manage type 2 diabetes mellitus, particularly in overweight patients, when diet and exercise alone do not provide adequate glycemic control. It helps lower blood sugar levels by reducing glucose production in the liver, decreasing intestinal absorption of glucose, and improving insulin sensitivity.
Uses & Indications
Dosage
Adults
Initially 500 mg twice daily or 850 mg once daily with meals. May increase gradually up to a maximum of 2550 mg daily in divided doses. Diablo 850 mg is often taken 1-2 times daily.
Elderly
Initial and maintenance doses should be conservative due to potential for decreased renal function. Renal function should be monitored regularly.
Renal_impairment
eGFR 45-60 mL/min/1.73m²: Max dose 1000 mg/day. eGFR <45 mL/min/1.73m²: Contraindicated.
How to Take
Diablo 850 mg Tablet should be taken orally with meals to reduce gastrointestinal side effects. Swallow the tablet whole with a glass of water, do not crush or chew.
Mechanism of Action
Metformin primarily acts by decreasing hepatic glucose production (gluconeogenesis) and increasing insulin sensitivity in peripheral tissues (e.g., muscle, fat) by enhancing glucose uptake and utilization. It also reduces glucose absorption from the gastrointestinal tract.
Pharmacokinetics
Onset
Within a few days, full effect in 1-2 weeks.
Excretion
Primarily renal excretion as unchanged drug.
Half life
Approximately 6.2 hours (plasma), up to 17.6 hours (blood).
Absorption
Oral bioavailability is 50-60%. Food delays and slightly decreases absorption.
Metabolism
Not metabolized in the liver; excreted unchanged.
Side Effects
Contraindications
- Hypersensitivity to Metformin
- Severe renal impairment (eGFR <30 mL/min/1.73m²)
- Acute or chronic metabolic acidosis, including diabetic ketoacidosis
- Dehydration, acute heart failure, severe infection, acute myocardial infarction
- Hepatic impairment
- Alcohol abuse
Drug Interactions
Alcohol
Potentiates metformin's effect on lactate metabolism, increasing the risk of lactic acidosis.
Diuretics (e.g., thiazides, loop diuretics)
May increase blood glucose levels, potentially requiring metformin dose adjustment.
Corticosteroids, sympathomimetics, phenothiazines, thyroid products, estrogens, oral contraceptives
May cause hyperglycemia, requiring increased metformin dosage.
Cationic drugs (e.g., cimetidine, ranitidine, amiloride, triamterene, procainamide, quinidine, trimethoprim, vancomycin)
May increase metformin concentration by competing for renal tubular secretion.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Overdose of metformin can lead to lactic acidosis, especially in patients with predisposing factors. Symptoms include gastrointestinal upset, muscle pain, respiratory distress, and somnolence. Management involves supportive care and hemodialysis to remove metformin from the blood.
Pregnancy & Lactation
Pregnancy Category B. Limited data suggest metformin may be used during pregnancy if clinically indicated. Consult a doctor. Metformin is excreted into breast milk; however, amounts are generally low, and adverse effects in breastfed infants are unlikely. Use with caution during lactation.
Side Effects
Contraindications
- Hypersensitivity to Metformin
- Severe renal impairment (eGFR <30 mL/min/1.73m²)
- Acute or chronic metabolic acidosis, including diabetic ketoacidosis
- Dehydration, acute heart failure, severe infection, acute myocardial infarction
- Hepatic impairment
- Alcohol abuse
Drug Interactions
Alcohol
Potentiates metformin's effect on lactate metabolism, increasing the risk of lactic acidosis.
Diuretics (e.g., thiazides, loop diuretics)
May increase blood glucose levels, potentially requiring metformin dose adjustment.
Corticosteroids, sympathomimetics, phenothiazines, thyroid products, estrogens, oral contraceptives
May cause hyperglycemia, requiring increased metformin dosage.
Cationic drugs (e.g., cimetidine, ranitidine, amiloride, triamterene, procainamide, quinidine, trimethoprim, vancomycin)
May increase metformin concentration by competing for renal tubular secretion.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Overdose of metformin can lead to lactic acidosis, especially in patients with predisposing factors. Symptoms include gastrointestinal upset, muscle pain, respiratory distress, and somnolence. Management involves supportive care and hemodialysis to remove metformin from the blood.
Pregnancy & Lactation
Pregnancy Category B. Limited data suggest metformin may be used during pregnancy if clinically indicated. Consult a doctor. Metformin is excreted into breast milk; however, amounts are generally low, and adverse effects in breastfed infants are unlikely. Use with caution during lactation.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years from manufacturing date.
Availability
Pharmacies, hospitals
Approval Status
Approved worldwide
Patent Status
Off-patent
WHO Essential Medicine
YesClinical Trials
Numerous clinical trials have established metformin's efficacy and safety in type 2 diabetes. Ongoing research explores its role in other conditions like polycystic ovary syndrome (PCOS) and certain cancers.
Lab Monitoring
- Renal function (eGFR) at least annually (more frequently in elderly or high-risk patients)
- Vitamin B12 levels (periodically in long-term users)
- Blood glucose (HbA1c) for glycemic control
Doctor Notes
- Advise patients on lactic acidosis symptoms and when to seek immediate medical attention.
- Regularly assess renal function before initiating and during treatment.
- Consider vitamin B12 supplementation for long-term metformin users, especially those with anemia or peripheral neuropathy.
- Emphasize lifestyle modifications as a cornerstone of diabetes management.
Patient Guidelines
- Take with food to minimize stomach upset.
- Do not stop taking without consulting your doctor.
- Inform your doctor about all other medications you are taking.
- Report any signs of lactic acidosis (e.g., unusual muscle pain, breathing difficulty, severe fatigue).
Missed Dose Advice
If you miss a dose, take it as soon as you remember with your next meal. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not double the dose to make up for a missed one.
Driving Precautions
Diablo 850 mg Tablet alone does not typically cause hypoglycemia and therefore usually does not affect the ability to drive or operate machinery. However, if used in combination with other antidiabetic agents that can cause hypoglycemia, caution is advised. Be aware of signs of hypoglycemia.
Lifestyle Advice
- Maintain a healthy diet and regular exercise regimen.
- Monitor blood sugar levels regularly as advised by your doctor.
- Limit alcohol intake.
- Stay hydrated, especially when ill.
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