GoodMet Plus
Generic Name
goodmet
Manufacturer
MediCare Pharmaceuticals Ltd.
Country
Bangladesh
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Description
Overview of the medicine
Goodmet is an oral antidiabetic drug belonging to the biguanide class, primarily used to treat type 2 diabetes mellitus. 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 500 mg orally once daily with the evening meal. May be increased by 500 mg weekly up to a maximum of 2000 mg once daily. For extended-release: maximum 2000 mg once daily.
Elderly
Dose should be carefully titrated based on renal function, starting with lower doses. Monitor renal function regularly.
Renal_impairment
Contraindicated in severe renal impairment (eGFR < 30 mL/min/1.73 m²). Dose adjustment required for moderate impairment; usually not recommended if eGFR < 45 mL/min/1.73 m².
How to Take
Take orally, preferably with a meal, to reduce gastrointestinal side effects. Swallow tablets whole; do not crush, chew, or break them.
Mechanism of Action
Goodmet works by reducing hepatic glucose production (gluconeogenesis and glycogenolysis), 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 in monotherapy.
Pharmacokinetics
Onset
Onset of glucose-lowering effect typically within a few days, full effect within 2 weeks.
Excretion
Excreted unchanged in the urine.
Half life
Plasma elimination half-life is approximately 6.2 hours.
Absorption
Slowly and incompletely absorbed from the gastrointestinal tract. Peak plasma concentrations are reached around 7 hours for extended-release formulations. Bioavailability is approximately 50-60%.
Metabolism
Not metabolized in the liver or excreted via bile.
Side Effects
Contraindications
- Hypersensitivity to goodmet or any components 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.
- Acute conditions with potential for renal function impairment (e.g., dehydration, severe infection, shock).
- Hepatic impairment, acute alcohol intoxication.
Drug Interactions
Alcohol
Increases the risk of lactic acidosis.
Cimetidine
May increase goodmet plasma concentrations by reducing renal clearance.
Iodinated Contrast Media
Temporarily discontinue goodmet prior to or at the time of an iodinated contrast imaging procedure in patients with an eGFR between 30 and 60 mL/min/1.73 m², in patients 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 procedure; restart goodmet if renal function is stable.
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
Overdose of goodmet can lead to lactic acidosis, characterized by symptoms like malaise, myalgia, respiratory distress, somnolence, and abdominal distress. Management involves supportive care and prompt hospitalization. Hemodialysis is the most effective method to remove goodmet and lactate from the blood.
Pregnancy & Lactation
Goodmet is generally not recommended during pregnancy unless clearly needed; insulin is typically preferred for glycemic control. Limited data suggest it is excreted in breast milk; caution should be exercised. Consult a doctor.
Side Effects
Contraindications
- Hypersensitivity to goodmet or any components 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.
- Acute conditions with potential for renal function impairment (e.g., dehydration, severe infection, shock).
- Hepatic impairment, acute alcohol intoxication.
Drug Interactions
Alcohol
Increases the risk of lactic acidosis.
Cimetidine
May increase goodmet plasma concentrations by reducing renal clearance.
Iodinated Contrast Media
Temporarily discontinue goodmet prior to or at the time of an iodinated contrast imaging procedure in patients with an eGFR between 30 and 60 mL/min/1.73 m², in patients 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 procedure; restart goodmet if renal function is stable.
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
Overdose of goodmet can lead to lactic acidosis, characterized by symptoms like malaise, myalgia, respiratory distress, somnolence, and abdominal distress. Management involves supportive care and prompt hospitalization. Hemodialysis is the most effective method to remove goodmet and lactate from the blood.
Pregnancy & Lactation
Goodmet is generally not recommended during pregnancy unless clearly needed; insulin is typically preferred for glycemic control. Limited data suggest it is excreted in breast milk; caution should be exercised. Consult a doctor.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
24 months from the date of manufacture.
Availability
Available in pharmacies and hospitals nationwide
Approval Status
Approved by regulatory bodies (e.g., FDA, DGDA)
Patent Status
Generic available, original patent expired
WHO Essential Medicine
YesClinical Trials
Ongoing studies are exploring the potential cardiovascular benefits of goodmet and its role in various metabolic conditions beyond type 2 diabetes.
Lab Monitoring
- Renal function (eGFR) should be assessed before initiating goodmet and at least annually thereafter. More frequent monitoring is advised in patients at increased risk for renal impairment.
- Hematologic parameters (e.g., hemoglobin/hematocrit) and Vitamin B12 levels should be monitored periodically, especially with long-term use.
Doctor Notes
- Assess renal function (eGFR) before initiating and periodically during therapy.
- Counsel patients on the risk of lactic acidosis and symptoms to watch for.
- Advise patients to temporarily discontinue goodmet before iodinated contrast imaging procedures and specific surgical procedures.
- Consider Vitamin B12 monitoring with long-term use.
Patient Guidelines
- Take goodmet exactly as prescribed by your doctor.
- Do not stop taking goodmet without consulting your doctor, even if you feel well.
- Maintain a balanced diet and regular exercise regimen as advised by your healthcare provider.
- Report any unusual symptoms, especially severe gastrointestinal upset or muscle pain, to your doctor immediately.
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 dosing schedule. Do not double the dose.
Driving Precautions
Goodmet alone does not typically cause hypoglycemia and therefore usually does not impair the ability to drive or operate machinery. However, if used in combination with other antidiabetic agents that can cause hypoglycemia (e.g., sulfonylureas, insulin), caution should be exercised.
Lifestyle Advice
- Follow a healthy, balanced diet low in sugar and saturated fats.
- Engage in regular physical activity (e.g., brisk walking for 30 minutes most days of the week).
- Limit alcohol intake.
- Maintain a healthy weight.
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