Formet
Generic Name
Metformin Hydrochloride
Manufacturer
Incepta Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| formet 850 mg tablet | ৳ 6.00 | ৳ 60.00 |
Description
Overview of the medicine
Metformin is an oral antidiabetic drug used to manage type 2 diabetes mellitus, especially in people who are overweight. It helps to lower blood glucose levels by decreasing glucose production in the liver, decreasing intestinal absorption of glucose, and improving insulin sensitivity.
Uses & Indications
Dosage
Adults
Initial dose is typically 500-850 mg once or twice daily with meals. Dosage can be gradually increased to a maximum of 2550 mg/day (e.g., 850 mg three times daily) with meals. Formet 850 mg tablet is usually taken 2-3 times daily.
Elderly
Lower initial dose and careful dose titration is recommended due to potential decreased renal function in the elderly. Renal function should be monitored regularly.
Renal_impairment
Contraindicated in severe renal impairment (eGFR < 30 mL/min/1.73 m²). Dose adjustment required for moderate impairment (eGFR 30-60 mL/min/1.73 m²).
How to Take
Take Formet 850 mg tablet orally with meals to minimize gastrointestinal side effects. Swallow the tablet whole with a glass of water; do not crush, chew, or break it.
Mechanism of Action
Metformin reduces hepatic glucose production by inhibiting gluconeogenesis and glycogenolysis. It also decreases intestinal absorption of glucose and 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
Glucose lowering effects may be seen within a few days, with full therapeutic effect typically observed within 1-2 weeks.
Excretion
Excreted unchanged by the kidneys. Renal clearance is approximately 3.5 times higher than creatinine clearance, indicating active tubular secretion.
Half life
Plasma elimination half-life is approximately 4-9 hours. In individuals with impaired renal function, the half-life is prolonged.
Absorption
Slowly and incompletely absorbed from the gastrointestinal tract. Absolute bioavailability is 50-60%. Peak plasma concentrations are reached in 2-3 hours.
Metabolism
Not metabolized in the liver. It 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/1.73 m²)
- Acute or chronic metabolic acidosis, including diabetic ketoacidosis, with or without coma
- Dehydration, severe infection, shock, acute myocardial infarction, acute congestive heart failure (conditions predisposing to lactic acidosis)
Drug Interactions
Alcohol
Potentiates the effect of metformin on lactate metabolism, increasing the risk of lactic acidosis, especially in fasting or malnourished individuals.
Cimetidine
Increases metformin plasma concentrations by reducing renal tubular secretion. Monitor blood glucose and adjust metformin dose if necessary.
Iodinated Contrast Agents
Temporarily discontinue metformin at the time of or prior to an iodinated contrast imaging procedure in patients with an 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.
Carbonic Anhydrase Inhibitors (e.g., Topiramate, Acetazolamide)
May increase the risk of lactic acidosis. Consider more frequent monitoring of patients.
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, increasing somnolence, and abdominal distress. Treatment is supportive and involves measures to correct metabolic acidosis, often requiring hemodialysis to remove metformin and lactate from the blood.
Pregnancy & Lactation
Pregnancy: Metformin is generally not recommended during pregnancy; insulin therapy is usually preferred to maintain blood glucose levels. Lactation: Metformin is excreted into breast milk in small amounts. Weigh the potential benefits of breastfeeding against the potential risks to the infant. Consult a doctor.
Side Effects
Contraindications
- Hypersensitivity to metformin or any component of the formulation
- Severe renal impairment (eGFR < 30 mL/min/1.73 m²)
- Acute or chronic metabolic acidosis, including diabetic ketoacidosis, with or without coma
- Dehydration, severe infection, shock, acute myocardial infarction, acute congestive heart failure (conditions predisposing to lactic acidosis)
Drug Interactions
Alcohol
Potentiates the effect of metformin on lactate metabolism, increasing the risk of lactic acidosis, especially in fasting or malnourished individuals.
Cimetidine
Increases metformin plasma concentrations by reducing renal tubular secretion. Monitor blood glucose and adjust metformin dose if necessary.
Iodinated Contrast Agents
Temporarily discontinue metformin at the time of or prior to an iodinated contrast imaging procedure in patients with an 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.
Carbonic Anhydrase Inhibitors (e.g., Topiramate, Acetazolamide)
May increase the risk of lactic acidosis. Consider more frequent monitoring of patients.
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, increasing somnolence, and abdominal distress. Treatment is supportive and involves measures to correct metabolic acidosis, often requiring hemodialysis to remove metformin and lactate from the blood.
Pregnancy & Lactation
Pregnancy: Metformin is generally not recommended during pregnancy; insulin therapy is usually preferred to maintain blood glucose levels. Lactation: Metformin is excreted into breast milk in small amounts. Weigh the potential benefits of breastfeeding against the potential risks to the infant. Consult a doctor.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 24 to 36 months from the date of manufacture, specific details on packaging.
Availability
Pharmacies, Hospitals
Approval Status
Approved worldwide
Patent Status
Generic available
WHO Essential Medicine
YesClinical Trials
Metformin has been extensively studied in numerous clinical trials, establishing its efficacy in reducing HbA1c, improving insulin sensitivity, and reducing cardiovascular events in patients with type 2 diabetes. The UKPDS (United Kingdom Prospective Diabetes Study) was a landmark trial demonstrating metformin's benefits.
Lab Monitoring
- Renal function (eGFR) at baseline and at least annually (more frequently in elderly or those with risk factors)
- HbA1c levels every 3-6 months to assess glycemic control
- Fasting plasma glucose and postprandial glucose levels
- Vitamin B12 levels periodically, especially in patients on long-term metformin therapy or those with risk factors for deficiency
Doctor Notes
- Emphasize the importance of renal function monitoring (eGFR) at baseline and periodically.
- Educate patients about the symptoms of lactic acidosis and to seek immediate medical attention if they occur.
- Consider vitamin B12 screening for patients on long-term metformin therapy, especially those with anemia or peripheral neuropathy.
- Advise patients to temporarily discontinue metformin if undergoing procedures involving iodinated contrast media or if severe dehydration/infection occurs.
Patient Guidelines
- Take your medicine with food to reduce stomach upset.
- Do not stop taking Formet 850 mg Tablet without consulting your doctor, even if you feel well.
- Inform your doctor about any planned surgeries or diagnostic procedures involving iodinated contrast agents.
- Be aware of the symptoms of lactic acidosis (e.g., severe tiredness, muscle pain, difficulty breathing, abdominal pain) and seek immediate medical attention if they occur.
Missed Dose Advice
If a dose is missed, take it as soon as you remember, unless it is almost time for your next scheduled dose. In that case, skip the missed dose and resume your regular dosing schedule. Do not double the dose to make up for a missed one.
Driving Precautions
Formet 850 mg Tablet alone does not usually cause hypoglycemia, so it is unlikely to affect your ability to drive or operate machinery. However, if used in combination with other antidiabetic agents that can cause hypoglycemia, monitor for symptoms like dizziness or confusion before driving.
Lifestyle Advice
- Maintain a healthy diet low in sugar and saturated fats.
- Engage in regular physical activity as advised by your doctor.
- Monitor your blood glucose levels regularly as instructed.
- Limit or avoid alcohol consumption.
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