Glucomet
Generic Name
Metformin
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
Loading images...
Description
Overview of the medicine
Metformin is an oral antidiabetic drug used to manage type 2 diabetes, often in combination with diet and exercise. It helps to lower blood glucose levels by reducing glucose production in the liver and improving insulin sensitivity.
Uses & Indications
Dosage
Adults
Initial dose: 500 mg twice daily or 850 mg once daily with meals. Titrate gradually to a maximum of 2550 mg/day in divided doses.
Elderly
Cautious dose titration due to potential for decreased renal function. Renal function should be monitored.
Renal_impairment
Contraindicated if eGFR < 30 mL/min/1.73 m². Dose reduction needed if eGFR 30-45 mL/min/1.73 m².
How to Take
Take orally with meals, usually once or twice daily depending on the dosage form and strength. Swallow tablets whole, do not crush or chew extended-release tablets.
Mechanism of Action
Metformin primarily 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.
Pharmacokinetics
Onset
Onset of action is within days, full effect within 2 weeks.
Excretion
Primarily excreted unchanged in the urine.
Half life
Plasma elimination half-life is approximately 6.2 hours.
Absorption
Bioavailability is 50-60% after oral administration. Food decreases the extent and slightly delays the absorption.
Metabolism
Not metabolized in the liver. Excreted unchanged.
Side Effects
Contraindications
- Severe renal impairment (eGFR < 30 mL/min/1.73 m²)
- Acute or chronic metabolic acidosis, including diabetic ketoacidosis
- Known hypersensitivity to metformin or any components of the formulation
- Severe liver impairment
- Heart failure requiring pharmacological treatment
Drug Interactions
Alcohol
Potentiates the effect of metformin on lactate metabolism, increasing the risk of lactic acidosis.
Cimetidine
May increase metformin plasma concentrations, increasing risk of lactic acidosis.
Diuretics (Thiazide, Loop)
May increase blood glucose, requiring dose adjustment of metformin.
Contrast Agents (Iodinated)
Temporarily discontinue before and for 48 hours after procedure due to increased risk of lactic acidosis with renal dysfunction.
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, a serious metabolic emergency that requires immediate medical attention. Symptoms include malaise, myalgia, respiratory distress, somnolence, and abdominal discomfort. Treatment involves supportive measures, correction of acidosis, and hemodialysis for severe cases.
Pregnancy & Lactation
Pregnancy: Limited data suggest no increased risk of major congenital malformations. However, insulin is generally preferred for glycemic control during pregnancy. Consult your doctor. Lactation: Metformin is excreted into breast milk. Monitor infants for hypoglycemia. Weigh benefits against risks.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
24-36 months from manufacturing date
Availability
Available in pharmacies nationwide
Approval Status
FDA Approved
Patent Status
Off-patent
WHO Essential Medicine
YesClinical Trials
Metformin has undergone extensive clinical trials demonstrating its efficacy in reducing HbA1c, improving insulin sensitivity, and reducing cardiovascular events in patients with type 2 diabetes, particularly in overweight individuals (e.g., UKPDS study).
Lab Monitoring
- Renal function (eGFR) before initiation and annually thereafter (more frequently in elderly or those at risk)
- Blood glucose levels (fasting and postprandial)
- HbA1c (every 3-6 months)
- Vitamin B12 levels (annually, especially in long-term users)
Doctor Notes
- Emphasize the importance of renal function monitoring, especially in elderly patients.
- Educate patients on the signs and symptoms of lactic acidosis and when to seek emergency care.
- Advise patients about potential GI side effects and strategies to mitigate them (e.g., taking with food, starting with a low dose).
Patient Guidelines
- Take metformin with meals to reduce gastrointestinal side effects.
- Monitor your blood glucose levels regularly as advised by your doctor.
- Be aware of the symptoms of lactic acidosis (e.g., unusual muscle pain, trouble breathing, stomach discomfort, dizziness) and seek immediate medical attention if they occur.
- Do not stop taking metformin without consulting your doctor.
Missed Dose Advice
If a dose is missed, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and resume your regular dosing schedule. Do not double the dose to catch up.
Driving Precautions
Metformin alone does not usually cause hypoglycemia, which affects 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 should be exercised. Monitor blood glucose levels before driving.
Lifestyle Advice
- Maintain a balanced diet and regular exercise routine as part of your diabetes management plan.
- Limit or avoid alcohol consumption to minimize the risk of lactic acidosis.
- Stay hydrated, especially when exercising or in hot weather.
Alternative Medicines in Bangladesh
Similar medicines available in the market
Global Brand Names
International brand names for this medicine. Click a brand to search for detailed information.