Diafit
Generic Name
Metformin Hydrochloride
Manufacturer
Example: Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| diafit 850 mg tablet | ৳ 6.00 | ৳ 60.00 |
Description
Overview of the medicine
Diafit 850 mg Tablet is an oral antidiabetic medicine used to manage blood sugar levels in people with type 2 diabetes mellitus. It helps improve the body's response to insulin, reducing glucose production in the liver and absorption from the intestines. It is often used in conjunction with diet and exercise.
Uses & Indications
Dosage
Adults
Initial dose: 500 mg once or twice daily, or 850 mg once daily, taken with meals. Gradually increase to a maximum of 2550 mg/day (e.g., 850 mg three times daily) or 2000 mg/day (extended-release), in divided doses, based on glycemic control and tolerability.
Elderly
A lower initial dose and careful monitoring of renal function are recommended due to potential for decreased renal function in the elderly. Dosage should be individualized.
Renal_impairment
Contraindicated if eGFR < 30 mL/min/1.73m². If eGFR 30-45 mL/min/1.73m², initiating metformin is not recommended; if already on metformin, assess benefits vs. risks and reduce dose by 50%. If eGFR 45-60 mL/min/1.73m², dose adjustment may be required, and monitoring of renal function more frequently.
How to Take
Take Diafit 850 mg Tablet orally with meals, typically with breakfast and/or dinner, to reduce gastrointestinal side effects.
Mechanism of Action
Metformin works by decreasing glucose production in the liver, decreasing intestinal absorption of glucose, and improving insulin sensitivity by increasing peripheral glucose uptake and utilization. It does not stimulate insulin secretion, thus it generally does not cause hypoglycemia when used alone.
Pharmacokinetics
Onset
Onset of action is within hours, but full therapeutic effect may take several days.
Excretion
Renal excretion is the primary route, with approximately 90% of the absorbed drug eliminated via the kidneys within 24 hours.
Half life
Plasma elimination half-life is approximately 6.2 hours.
Absorption
Relatively slow and incomplete from the gastrointestinal tract. Absolute bioavailability is approximately 50-60%. Food can decrease the extent and slightly delay absorption.
Metabolism
Metformin is not metabolized in the liver (no hepatic metabolism) and is excreted unchanged in the urine.
Side Effects
Contraindications
- Hypersensitivity to metformin or any component of the formulation.
- Severe renal impairment (eGFR < 30 mL/min/1.73m²).
- Acute or chronic metabolic acidosis (including diabetic ketoacidosis).
- Acute conditions with potential to alter renal function (e.g., dehydration, severe infection, shock).
- Acute or chronic disease that may cause tissue hypoxia (e.g., heart failure, recent myocardial infarction, severe respiratory failure).
- Hepatic impairment (severe).
Drug Interactions
Alcohol
Potentiates metformin's effect on lactate metabolism, increasing the risk of lactic acidosis, especially in fasting or malnourished patients.
Cimetidine
May increase metformin plasma levels due to competition for renal tubular secretion.
Corticosteroids
Can increase blood glucose levels, potentially counteracting metformin's effects.
Diuretics (Thiazide)
May increase blood glucose levels, potentially requiring metformin dose adjustment.
Iodinated Contrast Agents
Temporarily discontinue metformin at the time of, or prior to, an iodinated contrast imaging procedure in patients with eGFR between 30 and 60 mL/min/1.73m², in patients 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 procedure and restart metformin if renal function is stable.
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, which is a medical emergency. Symptoms include malaise, myalgia, respiratory distress, increased somnolence, and abdominal distress. Treatment involves supportive measures, correction of acidosis, and prompt removal of metformin by hemodialysis.
Pregnancy & Lactation
Pregnancy: Metformin is generally not the first-line treatment for diabetes in pregnancy; insulin is usually preferred. However, it may be used in specific cases under strict medical supervision. Lactation: Metformin is excreted into breast milk in small amounts. While generally considered compatible with breastfeeding by some experts, monitor the infant for any adverse effects.
Side Effects
Contraindications
- Hypersensitivity to metformin or any component of the formulation.
- Severe renal impairment (eGFR < 30 mL/min/1.73m²).
- Acute or chronic metabolic acidosis (including diabetic ketoacidosis).
- Acute conditions with potential to alter renal function (e.g., dehydration, severe infection, shock).
- Acute or chronic disease that may cause tissue hypoxia (e.g., heart failure, recent myocardial infarction, severe respiratory failure).
- Hepatic impairment (severe).
Drug Interactions
Alcohol
Potentiates metformin's effect on lactate metabolism, increasing the risk of lactic acidosis, especially in fasting or malnourished patients.
Cimetidine
May increase metformin plasma levels due to competition for renal tubular secretion.
Corticosteroids
Can increase blood glucose levels, potentially counteracting metformin's effects.
Diuretics (Thiazide)
May increase blood glucose levels, potentially requiring metformin dose adjustment.
Iodinated Contrast Agents
Temporarily discontinue metformin at the time of, or prior to, an iodinated contrast imaging procedure in patients with eGFR between 30 and 60 mL/min/1.73m², in patients 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 procedure and restart metformin if renal function is stable.
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, which is a medical emergency. Symptoms include malaise, myalgia, respiratory distress, increased somnolence, and abdominal distress. Treatment involves supportive measures, correction of acidosis, and prompt removal of metformin by hemodialysis.
Pregnancy & Lactation
Pregnancy: Metformin is generally not the first-line treatment for diabetes in pregnancy; insulin is usually preferred. However, it may be used in specific cases under strict medical supervision. Lactation: Metformin is excreted into breast milk in small amounts. While generally considered compatible with breastfeeding by some experts, monitor the infant for any adverse effects.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years from the date of manufacture, specific to manufacturer.
Availability
Available in pharmacies and hospitals
Approval Status
Approved by regulatory bodies worldwide, including FDA (US) and DGDA (Bangladesh)
Patent Status
Generic available
WHO Essential Medicine
YesClinical Trials
Metformin has been extensively studied in numerous clinical trials demonstrating its efficacy and safety in managing type 2 diabetes, reducing cardiovascular events in some patient populations, and contributing to long-term glycemic control.
Lab Monitoring
- Renal function (eGFR) should be assessed before initiation and at least annually thereafter (more frequently in elderly or renally impaired patients).
- HbA1c levels to monitor glycemic control every 3-6 months.
- Blood glucose levels (fasting and postprandial).
- Vitamin B12 levels should be measured periodically, especially in patients with risk factors for deficiency or prolonged use.
Doctor Notes
- Prior to initiation, assess renal function (eGFR). Re-evaluate eGFR at least annually.
- Educate patients on the symptoms of lactic acidosis and the importance of prompt medical attention if they occur.
- Temporarily discontinue metformin for iodinated contrast imaging procedures and certain surgical procedures.
- Consider periodic vitamin B12 monitoring, especially in patients with risk factors for deficiency or prolonged use.
Patient Guidelines
- Take Diafit 850 mg Tablet exactly as prescribed by your doctor, usually with meals.
- Inform your doctor if you have kidney problems, liver disease, or heart failure.
- Immediately report any symptoms of lactic acidosis (e.g., unusual muscle pain, trouble breathing, unusual sleepiness, stomach pain) to your doctor.
- Do not stop taking the medicine without consulting your doctor.
- Carry identification indicating you have diabetes and are taking metformin.
Missed Dose Advice
If you miss a dose, take it as soon as you remember, unless it is almost time for your next dose. In that case, skip the missed dose and take your next dose at the regular time. Do not double the dose to catch up.
Driving Precautions
Diafit 850 mg Tablet (Metformin) as monotherapy usually does not cause hypoglycemia and therefore does not affect the ability to drive or operate machinery. However, if used in combination with other antidiabetic agents (e.g., sulfonylureas, insulin) that can cause hypoglycemia, caution is advised.
Lifestyle Advice
- Maintain a balanced diet and regular exercise regimen as advised by your healthcare provider.
- Avoid excessive alcohol consumption.
- Monitor your blood glucose levels regularly as instructed.
- Maintain a healthy weight.
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