Glucium
Generic Name
Metformin Hydrochloride Extended-Release
Manufacturer
Reputable Pharmaceutical Co. Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| glucium 750 mg tablet | ৳ 12.00 | ৳ 120.00 |
Description
Overview of the medicine
Glucium 750 mg Tablet (Extended-Release) contains Metformin Hydrochloride, an oral antidiabetic medication used to manage type 2 diabetes mellitus. It helps to lower blood glucose levels by improving insulin sensitivity and reducing glucose production.
Uses & Indications
Dosage
Adults
Initial dose is usually 500 mg or 750 mg once daily with the evening meal. The dose can be gradually titrated based on glycemic response, up to a maximum of 2000 mg once daily.
Elderly
Use with caution. Dosage adjustments may be necessary due to potential age-related decrease in renal function. Renal function should be monitored regularly.
Renal_impairment
Not recommended for use in severe renal impairment (eGFR < 30 mL/min). Dose adjustment and careful monitoring are required for eGFR between 30-60 mL/min. Discontinue if eGFR falls below 30 mL/min.
How to Take
Take Glucium 750 mg orally, usually once daily with your evening meal. Swallow the tablet whole; do not crush, chew, or break it. Take it at approximately the same time each day.
Mechanism of Action
Metformin works by decreasing hepatic glucose production (gluconeogenesis), decreasing intestinal absorption of glucose, and improving insulin sensitivity by increasing peripheral glucose uptake and utilization. It does not stimulate insulin secretion.
Pharmacokinetics
Onset
Glycemic control improvement is typically observed within days, with maximal effects after 1-2 weeks of consistent dosing.
Excretion
Approximately 90% of the absorbed drug is eliminated via the renal route within 24 hours. Renal clearance is approximately 3.5 times greater than creatinine clearance, indicating tubular secretion.
Half life
The plasma elimination half-life of Metformin is approximately 4 to 9 hours.
Absorption
Slowly and incompletely absorbed from the gastrointestinal tract. Peak plasma concentrations are reached in approximately 4-8 hours for extended-release formulations.
Metabolism
Metformin is not metabolized in the liver or excreted via biliary elimination. It is excreted unchanged in the urine.
Side Effects
Contraindications
- Severe renal impairment (eGFR < 30 mL/min/1.73 m²)
- Known hypersensitivity to metformin hydrochloride or any component of Glucium
- Acute or chronic metabolic acidosis, including diabetic ketoacidosis, with or without coma
- Heart failure requiring pharmacological treatment
- Severe liver disease
- Dehydration, shock, acute myocardial infarction, or septicemia
Drug Interactions
Alcohol
Increases the risk of lactic acidosis, especially in fasting, malnourished, or renally impaired patients.
Cimetidine
May increase metformin plasma concentrations, potentially increasing the risk of lactic acidosis.
Corticosteroids
May increase blood glucose levels, requiring an increase in metformin dosage.
Iodinated Contrast Agents
Temporarily discontinue Glucium before or at the time of an iodinated contrast imaging procedure and for 48 hours afterward. Re-evaluate renal function before restarting.
Diuretics (Thiazides, Loop diuretics)
Can decrease renal clearance of metformin and increase blood glucose levels, potentially requiring metformin dose adjustment.
Storage
Store in a cool, dry place below 30°C, protected from light and moisture. Keep out of the reach and sight of children.
Overdose
Overdose of Metformin can lead to lactic acidosis, a medical emergency that requires prompt treatment. Symptoms may include extreme fatigue, unusual muscle pain, trouble breathing, stomach pain, dizziness, or irregular heartbeat. In case of suspected overdose, seek immediate medical attention. Hemodialysis is the most effective means of removing lactate and metformin from blood.
Pregnancy & Lactation
Pregnancy: Limited data on metformin use in pregnant women are insufficient to determine a drug-associated risk for major birth defects or miscarriage. Generally, insulin is preferred for managing diabetes during pregnancy. Consult your doctor. Lactation: Metformin is excreted into human breast milk. Consult your doctor to weigh the benefits of breastfeeding against potential risks.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
36 months from the date of manufacture.
Availability
Pharmacies nationwide
Approval Status
Approved by FDA and DGDA
Patent Status
Off-patent
WHO Essential Medicine
YesClinical Trials
Metformin, the active ingredient in Glucium 750 mg, has been extensively studied in numerous clinical trials. These studies have consistently demonstrated its efficacy in reducing HbA1c levels and improving glycemic control in patients with type 2 diabetes. Its safety profile, including the risk of lactic acidosis, has also been thoroughly investigated.
Lab Monitoring
- Renal function (eGFR) should be assessed before initiating Glucium and at least annually thereafter. More frequent monitoring is advised in elderly patients and those with impaired renal function.
- Blood glucose and HbA1c levels should be monitored regularly to assess glycemic control.
- Vitamin B12 levels should be measured periodically, especially in patients on long-term therapy or those with risk factors for B12 deficiency.
Doctor Notes
- Prioritize patient education on the signs and symptoms of lactic acidosis, and emphasize the importance of seeking immediate medical attention if they occur.
- Regularly assess renal function (eGFR) before and during metformin therapy, especially in elderly patients and those with risk factors for renal impairment.
- Consider periodic monitoring of vitamin B12 levels, particularly in patients on long-term metformin therapy or those with conditions predisposing to B12 deficiency.
Patient Guidelines
- Take Glucium 750 mg exactly as prescribed by your doctor. Do not change your dose or stop taking the medicine without consulting your doctor.
- Inform your doctor about all your medical conditions and all medications you are taking, including over-the-counter drugs, vitamins, and herbal supplements.
- If you need to undergo any radiological procedure involving iodinated contrast agents, inform your doctor as Glucium may need to be temporarily discontinued.
- Report any symptoms of lactic acidosis immediately, such as unusual muscle pain, difficulty breathing, stomach pain, dizziness, or extreme tiredness.
Missed Dose Advice
If you miss a dose of Glucium 750 mg, take it as soon as you remember, unless it is almost time for your next 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
Glucium 750 mg (Metformin) alone usually does not cause hypoglycemia and therefore does not affect the ability to drive or operate machinery. However, if Glucium is used in combination with other antidiabetic agents (e.g., sulfonylureas, insulin) that can cause hypoglycemia, patients should be warned about the risk of hypoglycemia and advised to take precautions.
Lifestyle Advice
- Maintain a balanced diet and engage in regular physical activity as advised by your healthcare provider. These are crucial for managing type 2 diabetes.
- Limit your intake of sugary foods and beverages.
- Avoid excessive alcohol consumption, as it can increase the risk of lactic acidosis.
- Stay well-hydrated, especially during illness or warm weather.
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