Metarin XR
Generic Name
Metformin Hydrochloride Extended-Release
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| metarin xr 500 mg tablet | ৳ 7.00 | ৳ 70.00 |
Description
Overview of the medicine
Metarin XR 500 mg Tablet contains Metformin Hydrochloride, an oral antidiabetic drug used to manage type 2 diabetes mellitus. It helps control high blood sugar levels in conjunction with diet and exercise.
Uses & Indications
Dosage
Adults
Initial dose is typically 500 mg once daily with the evening meal. Dose may be gradually increased by 500 mg weekly to a maximum of 2000 mg once daily. Max daily dose: 2500 mg (XR).
Elderly
Start with a lower dose; adjust based on renal function and glycemic control. Renal function should be monitored regularly.
Renal_impairment
Contraindicated in severe renal impairment (eGFR <30 mL/min). Dose adjustment is required for moderate impairment (eGFR 30-60 mL/min). Regular monitoring of renal function is essential.
How to Take
Take orally, once daily with the evening meal. Swallow the tablet whole; do not crush, chew, or break it.
Mechanism of Action
Metformin works by decreasing hepatic glucose production, 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
Gradual, therapeutic effects observed over several days to weeks.
Excretion
Primarily excreted unchanged in the urine (renal elimination).
Half life
Approximately 4-8 hours (plasma elimination half-life).
Absorption
Slowly and incompletely absorbed from the gastrointestinal tract. Peak plasma levels are reached in about 4-8 hours for extended-release formulations.
Metabolism
Not metabolized in the liver.
Side Effects
Contraindications
- Severe renal impairment (eGFR <30 mL/min)
- Metabolic acidosis (including diabetic ketoacidosis)
- Hypersensitivity to metformin
- Dehydration, acute heart failure, severe infection, or recent myocardial infarction (conditions that can lead to lactic acidosis)
Drug Interactions
Alcohol
Increases the risk of lactic acidosis.
Iodinated contrast agents
Temporarily discontinue metformin at the time of or prior to iodinated contrast imaging procedures.
Carbonic anhydrase inhibitors (e.g., topiramate, zonisamide)
May increase the risk of lactic acidosis.
Drugs that can cause hyperglycemia (e.g., corticosteroids, diuretics, estrogens, oral contraceptives)
May require adjustment of metformin dosage.
Cationic drugs (e.g., amiloride, digoxin, morphine, procainamide, quinidine, ranitidine, triamterene, trimethoprim, vancomycin)
May increase metformin concentration.
Storage
Store below 30°C in a dry place, away from direct light and moisture. Keep out of reach of children.
Overdose
Overdose of metformin can lead to lactic acidosis, a medical emergency that requires prompt treatment in a hospital. Hemodialysis is the most effective means of removing lactate and metformin from blood. Symptomatic and supportive treatment should be given.
Pregnancy & Lactation
Pregnancy Category B. Limited data suggest it may be used during pregnancy if clearly needed and the benefits outweigh the risks. Metformin is excreted into breast milk; caution is advised when administered to a nursing woman.
Side Effects
Contraindications
- Severe renal impairment (eGFR <30 mL/min)
- Metabolic acidosis (including diabetic ketoacidosis)
- Hypersensitivity to metformin
- Dehydration, acute heart failure, severe infection, or recent myocardial infarction (conditions that can lead to lactic acidosis)
Drug Interactions
Alcohol
Increases the risk of lactic acidosis.
Iodinated contrast agents
Temporarily discontinue metformin at the time of or prior to iodinated contrast imaging procedures.
Carbonic anhydrase inhibitors (e.g., topiramate, zonisamide)
May increase the risk of lactic acidosis.
Drugs that can cause hyperglycemia (e.g., corticosteroids, diuretics, estrogens, oral contraceptives)
May require adjustment of metformin dosage.
Cationic drugs (e.g., amiloride, digoxin, morphine, procainamide, quinidine, ranitidine, triamterene, trimethoprim, vancomycin)
May increase metformin concentration.
Storage
Store below 30°C in a dry place, away from direct light and moisture. Keep out of reach of children.
Overdose
Overdose of metformin can lead to lactic acidosis, a medical emergency that requires prompt treatment in a hospital. Hemodialysis is the most effective means of removing lactate and metformin from blood. Symptomatic and supportive treatment should be given.
Pregnancy & Lactation
Pregnancy Category B. Limited data suggest it may be used during pregnancy if clearly needed and the benefits outweigh the risks. Metformin is excreted into breast milk; caution is advised when administered to a nursing woman.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
2 to 3 years from manufacturing date.
Availability
Pharmacies, Hospitals
Approval Status
Approved (e.g., FDA, DGDA)
Patent Status
Off-patent
WHO Essential Medicine
YesClinical Trials
Extensive clinical trials have demonstrated the efficacy and safety of metformin in improving glycemic control and reducing macrovascular complications in patients with type 2 diabetes. Studies also support its extended-release formulation for once-daily dosing.
Lab Monitoring
- Renal function (eGFR) should be assessed before initiating metformin and at least annually thereafter. More frequent monitoring is advised for elderly patients and those with a history of renal impairment.
- Vitamin B12 levels should be monitored periodically in patients on long-term metformin therapy.
Doctor Notes
- Emphasize the importance of diet and exercise alongside Metarin XR therapy.
- Educate patients on the symptoms of lactic acidosis and the need for immediate medical attention.
- Monitor renal function and vitamin B12 levels regularly, especially in elderly patients or those at risk.
Patient Guidelines
- Take Metarin XR exactly as prescribed by your doctor.
- Follow a healthy diet and regular exercise program as recommended by your healthcare provider.
- Monitor your blood sugar levels regularly as advised.
- Report any unusual symptoms, especially severe gastrointestinal issues or signs of lactic acidosis, 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 scheduled dose. Do not take a double dose to make up for a missed one.
Driving Precautions
Metformin alone generally does not cause hypoglycemia and therefore usually does not affect the ability to drive or operate machinery. However, if Metarin XR is used in combination with other antidiabetic agents (e.g., sulfonylureas, insulin) that can cause hypoglycemia, patients should be aware of the symptoms of hypoglycemia and take precautions.
Lifestyle Advice
- Maintain a balanced diet with controlled carbohydrate intake.
- Engage in regular physical activity suitable for your health condition.
- Limit or avoid alcohol consumption.
- Stay well-hydrated, especially during hot weather or strenuous exercise.
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