Glucomin-XR
Generic Name
Metformin Hydrochloride Extended-Release
Manufacturer
Medi Pharma Ltd.
Country
Bangladesh
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Description
Overview of the medicine
Glucomin-XR is an oral antidiabetic medication belonging to the biguanide class. It is used to lower blood glucose levels in patients with type 2 diabetes mellitus, often in conjunction with diet and exercise. The extended-release formulation allows for once-daily dosing.
Uses & Indications
Dosage
Adults
Initial dose is 500 mg orally once daily with the evening meal. Dose can be increased by 500 mg weekly up to a maximum of 2000 mg once daily. Tablets should be swallowed whole and not crushed or chewed.
Elderly
Initiate with a low dose and titrate slowly. Monitor renal function regularly due to potential age-related decline.
Renal_impairment
Contraindicated in severe renal impairment (eGFR < 30 mL/min/1.73 m²). Dose adjustment required for moderate impairment (eGFR 30-45 mL/min/1.73 m²).
How to Take
Take orally with the evening meal. Swallow the tablet whole; do not crush, chew, or break it.
Mechanism of Action
Metformin primarily 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 and therefore does not cause hypoglycemia.
Pharmacokinetics
Onset
Gradual onset, typically within hours of first dose; full therapeutic effect may take several days.
Excretion
Excreted unchanged in the urine, primarily via renal tubular secretion.
Half life
Approximately 6.2 hours (for plasma elimination after oral administration of immediate-release formulation; XR has longer effective duration).
Absorption
Slow and incomplete absorption from the gastrointestinal tract. Food can affect the rate and extent of absorption. Bioavailability is approximately 50-60%.
Metabolism
Metformin is not metabolized in the liver.
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.
- Severe dehydration, acute or chronic heart failure, hepatic failure, acute myocardial infarction, severe infection, shock.
Drug Interactions
Alcohol
Potentiates the effect of metformin on lactate metabolism, increasing the risk of lactic acidosis.
Cimetidine
Increases metformin plasma concentration by decreasing its renal clearance.
Iodinated contrast agents
Temporarily discontinue Glucomin-XR 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.
Carbonic anhydrase inhibitors (e.g., topiramate, acetazolamide)
May increase the risk of lactic acidosis.
Storage
Store in a cool, dry place below 30°C. Protect from light and moisture. Keep out of reach of children.
Overdose
Metformin overdose has been reported, including ingestion of amounts greater than 50 grams. Hypoglycemia has been reported in approximately 10% of cases. The most significant adverse effect of metformin overdose is lactic acidosis. Treatment is primarily supportive. Hemodialysis is the most effective method for removing lactate and metformin from blood.
Pregnancy & Lactation
Not recommended during pregnancy unless clearly necessary, as adequate data on human pregnancy are lacking. Limited data suggest metformin is excreted into breast milk; however, the amount is small. Consult a doctor for individualized advice.
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.
- Severe dehydration, acute or chronic heart failure, hepatic failure, acute myocardial infarction, severe infection, shock.
Drug Interactions
Alcohol
Potentiates the effect of metformin on lactate metabolism, increasing the risk of lactic acidosis.
Cimetidine
Increases metformin plasma concentration by decreasing its renal clearance.
Iodinated contrast agents
Temporarily discontinue Glucomin-XR 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.
Carbonic anhydrase inhibitors (e.g., topiramate, acetazolamide)
May increase the risk of lactic acidosis.
Storage
Store in a cool, dry place below 30°C. Protect from light and moisture. Keep out of reach of children.
Overdose
Metformin overdose has been reported, including ingestion of amounts greater than 50 grams. Hypoglycemia has been reported in approximately 10% of cases. The most significant adverse effect of metformin overdose is lactic acidosis. Treatment is primarily supportive. Hemodialysis is the most effective method for removing lactate and metformin from blood.
Pregnancy & Lactation
Not recommended during pregnancy unless clearly necessary, as adequate data on human pregnancy are lacking. Limited data suggest metformin is excreted into breast milk; however, the amount is small. Consult a doctor for individualized advice.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
36 months from manufacturing date
Availability
Available in pharmacies and hospitals
Approval Status
Approved by regulatory authorities (e.g., FDA, DGDA)
Patent Status
Generic available, original patent expired
WHO Essential Medicine
YesClinical Trials
Extensive clinical trials have demonstrated the efficacy and safety of Metformin extended-release in reducing HbA1c and fasting plasma glucose levels in patients with type 2 diabetes. Trials typically involve dose-ranging studies, comparison with placebo and other antidiabetic agents, and long-term safety assessments.
Lab Monitoring
- Renal function (e.g., serum creatinine, eGFR) prior to initiation and at least annually thereafter (more frequently in elderly or renally impaired patients).
- HbA1c levels regularly to assess glycemic control.
- Hematologic parameters and vitamin B12 levels, especially in patients with risk factors for B12 deficiency.
Doctor Notes
- Prior to initiation, assess renal function (eGFR) and re-evaluate periodically.
- Educate patients on the symptoms of lactic acidosis and the importance of timely medical attention.
- Consider vitamin B12 monitoring in patients on long-term therapy, especially those with risk factors for deficiency.
Patient Guidelines
- Take Glucomin-XR exactly as prescribed by your doctor.
- Swallow the tablet whole with water, preferably with your evening meal.
- Do not crush, chew, or break the tablet, as this can affect the extended-release mechanism.
- Inform your doctor if you experience symptoms of lactic acidosis (e.g., unusual muscle pain, difficulty breathing, unusual stomach discomfort, dizziness, or lightheadedness).
Missed Dose Advice
If a dose is missed, 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 dosing schedule. Do not take a double dose to make up for a missed one.
Driving Precautions
Glucomin-XR alone 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 that can cause hypoglycemia, patients should be aware of the risk and take precautions.
Lifestyle Advice
- Maintain a healthy diet recommended by your doctor or a dietitian.
- Engage in regular physical activity to help manage blood sugar levels.
- Avoid excessive alcohol consumption, as it can increase the risk of lactic acidosis.
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