Formet
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 |
|---|---|---|
| formet 500 mg tablet | ৳ 4.00 | ৳ 40.00 |
Description
Overview of the medicine
Metformin is an oral anti-diabetic drug used to manage type 2 diabetes mellitus, especially in overweight patients, and also for polycystic ovary syndrome (PCOS).
Uses & Indications
Dosage
Adults
Initial dose: 500 mg once or twice daily with meals. Gradually increase in weekly increments of 500 mg to a maximum of 2000-2500 mg daily, divided in 2-3 doses.
Elderly
Lower doses recommended due to potential for decreased renal function. Renal function should be monitored regularly.
Renal_impairment
Contraindicated if eGFR <30 mL/min/1.73m². Dose adjustment needed for eGFR 30-60 mL/min/1.73m² (e.g., maximum 1000 mg daily).
How to Take
Take Formet-500-mg-tablet orally with food, usually with the evening meal or as directed by your doctor, to reduce gastrointestinal side effects.
Mechanism of Action
Metformin primarily works by reducing hepatic glucose production (gluconeogenesis), decreasing intestinal glucose absorption, and improving insulin sensitivity by increasing peripheral glucose uptake and utilization.
Pharmacokinetics
Onset
Onset of glucose-lowering effect occurs within hours, but full therapeutic effect may take several days to weeks.
Excretion
Approximately 90% of the absorbed drug is eliminated unchanged via the renal route within 24 hours. Renal tubular secretion is the major route of elimination.
Half life
Plasma elimination half-life is approximately 6.2 hours.
Absorption
Absolute bioavailability of 50-60% after oral dose. Food decreases the extent and slightly delays the absorption of metformin.
Metabolism
Metformin is not metabolized by the liver in humans.
Side Effects
Contraindications
- Severe renal impairment (eGFR <30 mL/min/1.73m²)
- Metabolic acidosis (including diabetic ketoacidosis, lactic acidosis)
- Hypersensitivity to metformin or any excipients
- Severe dehydration
- Acute or chronic metabolic acidosis, including diabetic ketoacidosis, with or without coma
- Alcohol abuse
- Liver failure
- Acute heart failure (unstable or decompensated heart failure)
Drug Interactions
Alcohol
Increases the risk of lactic acidosis. Avoid excessive alcohol intake.
Iodinated Contrast Agents
Temporarily discontinue metformin before or at the time of an imaging procedure with iodinated contrast agents and for 48 hours afterward. Reinitiate only after renal function is stable.
Diuretics (Thiazides, Loop diuretics)
May increase blood glucose levels, potentially requiring metformin dose adjustment.
Cimetidine, Ranitidine, Amiloride, Triamterene, Furosemide, Nifedipine, Glucocorticoids, Sympathomimetics
Can alter metformin levels or affect blood glucose control. Close monitoring of blood glucose and metformin dosage adjustment may be necessary.
Storage
Store in a cool, dry place below 30°C. Protect 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, somnolence, and abdominal distress. Treatment involves supportive measures and prompt hemodialysis to remove metformin from the body.
Pregnancy & Lactation
Limited data on metformin use in pregnant women; generally not recommended unless clearly needed and benefits outweigh risks. Metformin is excreted into breast milk; use with caution and under medical supervision during lactation.
Side Effects
Contraindications
- Severe renal impairment (eGFR <30 mL/min/1.73m²)
- Metabolic acidosis (including diabetic ketoacidosis, lactic acidosis)
- Hypersensitivity to metformin or any excipients
- Severe dehydration
- Acute or chronic metabolic acidosis, including diabetic ketoacidosis, with or without coma
- Alcohol abuse
- Liver failure
- Acute heart failure (unstable or decompensated heart failure)
Drug Interactions
Alcohol
Increases the risk of lactic acidosis. Avoid excessive alcohol intake.
Iodinated Contrast Agents
Temporarily discontinue metformin before or at the time of an imaging procedure with iodinated contrast agents and for 48 hours afterward. Reinitiate only after renal function is stable.
Diuretics (Thiazides, Loop diuretics)
May increase blood glucose levels, potentially requiring metformin dose adjustment.
Cimetidine, Ranitidine, Amiloride, Triamterene, Furosemide, Nifedipine, Glucocorticoids, Sympathomimetics
Can alter metformin levels or affect blood glucose control. Close monitoring of blood glucose and metformin dosage adjustment may be necessary.
Storage
Store in a cool, dry place below 30°C. Protect 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, somnolence, and abdominal distress. Treatment involves supportive measures and prompt hemodialysis to remove metformin from the body.
Pregnancy & Lactation
Limited data on metformin use in pregnant women; generally not recommended unless clearly needed and benefits outweigh risks. Metformin is excreted into breast milk; use with caution and under medical supervision during lactation.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 36 months from the date of manufacture, when stored under recommended conditions.
Availability
Pharmacies, Hospitals
Approval Status
Approved by regulatory authorities worldwide
Patent Status
Off-patent
WHO Essential Medicine
YesClinical Trials
Metformin has been extensively studied in numerous clinical trials for its efficacy and safety in managing type 2 diabetes and conditions like PCOS. Studies have shown its effectiveness in reducing HbA1c, improving insulin sensitivity, and reducing cardiovascular risks.
Lab Monitoring
- Renal function (eGFR) should be assessed before initiating metformin and at least annually thereafter. More frequent monitoring may be needed in elderly patients and those at risk of renal impairment. HbA1c and blood glucose levels should be monitored regularly. Vitamin B12 levels should be measured periodically in patients on long-term metformin therapy.
Doctor Notes
- Emphasize the importance of renal function monitoring, especially in older patients and those with risk factors for renal impairment.
- Educate patients thoroughly about the symptoms of lactic acidosis and when to seek immediate medical attention.
- Counsel patients on lifestyle modifications (diet, exercise) as cornerstone of diabetes management.
Patient Guidelines
- Take Formet exactly as prescribed by your doctor.
- Do not stop taking Formet without consulting your doctor, even if you feel well.
- Inform your doctor if you experience any unusual symptoms, especially severe gastrointestinal upset or signs of lactic acidosis.
- Maintain a consistent diet and exercise program while on 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 continue with your regular schedule. Do not double the dose to catch up.
Driving Precautions
Metformin monotherapy usually does not cause hypoglycemia and therefore has no or negligible influence on the ability to drive or use machines. However, if used in combination with other anti-diabetic agents (e.g., sulfonylureas, insulin) that can cause hypoglycemia, patients should be warned of the risk.
Lifestyle Advice
- Maintain a healthy and balanced diet.
- Engage in regular physical activity.
- Monitor blood glucose levels as advised by your doctor.
- Avoid excessive alcohol consumption.
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