meforex
Generic Name
Metformin Hydrochloride
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| meforex 850 mg tablet | ৳ 3.01 | ৳ 30.10 |
Description
Overview of the medicine
Meforex 850 mg tablet contains Metformin Hydrochloride, an oral antidiabetic medication used to control high blood sugar levels in people with type 2 diabetes mellitus. It is often used in combination with diet and exercise. It can be used alone or with other antidiabetic agents.
Uses & Indications
Dosage
Adults
Initial dose is usually 500 mg once or twice daily, or 850 mg once daily with meals. Dosage may be gradually increased to a maximum of 2550 mg daily, divided into 2-3 doses. Meforex 850 mg is often prescribed once or twice daily.
Elderly
Elderly patients should have their renal function assessed regularly. Dosage should be carefully titrated to avoid potential lactic acidosis.
Renal_impairment
eGFR 60-89 mL/min/1.73m²: No adjustment needed. eGFR 45-59 mL/min/1.73m²: Max 2000 mg/day. eGFR 30-44 mL/min/1.73m²: Max 1000 mg/day. eGFR <30 mL/min/1.73m²: Contraindicated.
How to Take
Take Meforex 850 mg tablet orally with meals to reduce gastrointestinal side effects. Swallow the tablet whole with a glass of water, do not crush or chew.
Mechanism of Action
Metformin works by decreasing glucose production by the liver, 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 typically cause hypoglycemia.
Pharmacokinetics
Onset
Within hours, but full therapeutic effect may take several days.
Excretion
Renal excretion. Approximately 90% of the absorbed drug is eliminated via the renal route within 24 hours.
Half life
Plasma elimination half-life is approximately 4-9 hours. In individuals with normal renal function, the half-life is approximately 6.2 hours.
Absorption
Slow and incomplete. Absolute bioavailability is approximately 50-60%. Food decreases the extent and slightly delays the absorption.
Metabolism
Not metabolized by the liver. Excreted unchanged in the urine.
Side Effects
Contraindications
- Severe renal impairment (eGFR <30 mL/min/1.73m²).
- Acute or chronic metabolic acidosis, including diabetic ketoacidosis, with or without coma.
- Severe dehydration, acute heart failure, hepatic impairment, acute myocardial infarction.
- Hypersensitivity to metformin or any component of the formulation.
- Any acute condition with the potential to alter renal function such as dehydration, severe infection, shock.
Drug Interactions
Alcohol
Potentiates the effect of metformin on lactate metabolism, increasing the risk of lactic acidosis.
Iodinated Contrast Agents
Temporarily discontinue metformin at the time of or prior to iodinated contrast imaging procedures and for at least 48 hours afterward in patients with an eGFR between 30 and 60 mL/min/1.73m²; in patients with a history of liver disease, alcoholism, or heart failure; or in patients who will be administered intra-arterial iodinated contrast agents. Re-evaluate eGFR after the procedure and restart metformin if renal function is stable.
Cimetidine, Amiloride, Triamterene, Vancomycin, Furosemide, Nifedipine
Can increase metformin plasma concentrations by competing for renal tubular secretion, potentially increasing 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 metformin can lead to lactic acidosis, which is a medical emergency. Symptoms include stomach pain, nausea, vomiting, severe tiredness, muscle pain, difficulty breathing, and slowed heartbeat. Treatment involves supportive measures, hemodialysis to remove metformin and correct acidosis. Immediately seek emergency medical attention.
Pregnancy & Lactation
Pregnancy Category B. While studies in animals have not shown harm, adequate and well-controlled studies in pregnant women are lacking. Metformin is generally considered safe for use during pregnancy if benefits outweigh risks, often with insulin being preferred. Consult a doctor. Metformin is excreted into breast milk; however, the amount is low and considered safe for most breastfed infants. Discuss with a healthcare provider.
Side Effects
Contraindications
- Severe renal impairment (eGFR <30 mL/min/1.73m²).
- Acute or chronic metabolic acidosis, including diabetic ketoacidosis, with or without coma.
- Severe dehydration, acute heart failure, hepatic impairment, acute myocardial infarction.
- Hypersensitivity to metformin or any component of the formulation.
- Any acute condition with the potential to alter renal function such as dehydration, severe infection, shock.
Drug Interactions
Alcohol
Potentiates the effect of metformin on lactate metabolism, increasing the risk of lactic acidosis.
Iodinated Contrast Agents
Temporarily discontinue metformin at the time of or prior to iodinated contrast imaging procedures and for at least 48 hours afterward in patients with an eGFR between 30 and 60 mL/min/1.73m²; in patients with a history of liver disease, alcoholism, or heart failure; or in patients who will be administered intra-arterial iodinated contrast agents. Re-evaluate eGFR after the procedure and restart metformin if renal function is stable.
Cimetidine, Amiloride, Triamterene, Vancomycin, Furosemide, Nifedipine
Can increase metformin plasma concentrations by competing for renal tubular secretion, potentially increasing 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 metformin can lead to lactic acidosis, which is a medical emergency. Symptoms include stomach pain, nausea, vomiting, severe tiredness, muscle pain, difficulty breathing, and slowed heartbeat. Treatment involves supportive measures, hemodialysis to remove metformin and correct acidosis. Immediately seek emergency medical attention.
Pregnancy & Lactation
Pregnancy Category B. While studies in animals have not shown harm, adequate and well-controlled studies in pregnant women are lacking. Metformin is generally considered safe for use during pregnancy if benefits outweigh risks, often with insulin being preferred. Consult a doctor. Metformin is excreted into breast milk; however, the amount is low and considered safe for most breastfed infants. Discuss with a healthcare provider.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
3 years from the date of manufacture (check specific batch for exact expiry)
Availability
Available in pharmacies nationwide
Approval Status
Approved (Bangladesh DGDA, International regulatory bodies)
Patent Status
Generic available, original patent expired
WHO Essential Medicine
YesClinical Trials
Metformin has been extensively studied in numerous clinical trials demonstrating its efficacy and safety in managing type 2 diabetes, often as a first-line therapy, and its benefits in cardiovascular outcomes and mortality reduction in certain populations.
Lab Monitoring
- Renal function (eGFR) should be assessed prior to initiation and at least annually. More frequent monitoring is recommended for elderly patients and those at increased risk of renal impairment. Vitamin B12 levels should be monitored periodically, especially in patients with neuropathy or anemia.
Doctor Notes
- Counsel patients on the importance of diet and exercise in conjunction with metformin therapy.
- Emphasize the rare but serious risk of lactic acidosis and symptoms to watch for.
- Monitor renal function before initiating metformin and at least annually thereafter.
- Consider vitamin B12 supplementation in patients on long-term metformin therapy, especially if symptoms of neuropathy or anemia develop.
- Review concomitant medications for potential drug interactions.
Patient Guidelines
- Take your medicine regularly as prescribed by your doctor.
- Follow a healthy diet plan and engage in regular physical activity.
- Monitor your blood sugar levels regularly as advised by your healthcare provider.
- Be aware of the symptoms of lactic acidosis and seek immediate medical help if they occur.
- Do not stop taking metformin without consulting your doctor.
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 take a double dose to make up for a missed one.
Driving Precautions
Meforex 850 mg does not directly affect the ability to drive or operate machinery. However, if used in combination with other antidiabetic agents (e.g., sulfonylureas, insulin), it may cause hypoglycemia, which could impair driving ability. Patients should be aware of the symptoms of hypoglycemia.
Lifestyle Advice
- Maintain a balanced diet low in refined sugars and saturated fats.
- Engage in at least 30 minutes of moderate-intensity exercise most days of the week.
- Avoid excessive alcohol consumption, as it can increase the risk of lactic acidosis.
- Stay well-hydrated.
- Manage stress effectively.
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