Metfar
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 |
|---|---|---|
| metfar 850 mg tablet | ৳ 6.00 | ৳ 60.00 |
Description
Overview of the medicine
Metfar 850 mg Tablet contains Metformin Hydrochloride, an oral antidiabetic medicine used to control high blood sugar levels in people with type 2 diabetes mellitus, especially in those who are overweight and diet and exercise alone have not been enough. It is often used with other antidiabetic medications or insulin.
Uses & Indications
Dosage
Adults
Initial dose: 500 mg or 850 mg once daily with the main meal. Dose should be increased gradually. Maximum recommended dose is 2550 mg daily, given in 3 divided doses (e.g., 850 mg three times daily). For Metfar 850 mg, it is usually taken 1-2 times daily with meals.
Elderly
Elderly patients should start with a lower initial dose, and renal function should be closely monitored due to increased risk of lactic acidosis.
Renal_impairment
Metformin is contraindicated if eGFR <30 mL/min/1.73m². Dose adjustment required if eGFR is 30-60 mL/min/1.73m² (e.g., max 1000 mg/day). Regular monitoring of renal function is essential.
How to Take
Take Metfar 850 mg Tablet orally, with or just after meals. This helps reduce gastrointestinal side effects. Swallow the tablet whole with a glass of water; do not crush or chew it.
Mechanism of Action
Metformin works by reducing 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 cause hypoglycemia in monotherapy.
Pharmacokinetics
Onset
Initial effects on blood glucose are typically seen within a few days, with full therapeutic effects observed after several weeks of consistent use.
Excretion
Excreted primarily via the renal route as unchanged drug. Renal clearance is approximately 3.5 times higher than creatinine clearance.
Half life
The plasma elimination half-life is approximately 4-9 hours.
Absorption
Oral bioavailability is 50-60% when administered under fasting conditions. Peak plasma concentrations are reached within 2-3 hours.
Metabolism
Metformin is not metabolized by the liver; it is excreted unchanged.
Side Effects
Contraindications
- Hypersensitivity to metformin or any component of the formulation.
- Any type of acute metabolic acidosis (such as lactic acidosis, diabetic ketoacidosis).
- Severe renal failure (eGFR <30 mL/min/1.73m²).
- Acute conditions with potential for renal impairment (e.g., dehydration, severe infection, shock).
- Acute or chronic disease which may cause tissue hypoxia (e.g., cardiac failure, respiratory failure, recent myocardial infarction, shock).
- Hepatic insufficiency, acute alcohol intoxication, alcoholism.
Drug Interactions
Cimetidine
Increases metformin plasma concentration by decreasing its renal clearance. Consider dose reduction.
Iodinated contrast agents
Temporarily discontinue metformin before or at the time of the 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 imaging procedure, and restart metformin if renal function is stable.
Diuretics (especially loop diuretics)
May increase the risk of lactic acidosis by potentially impairing renal function.
Corticosteroids, Sympathomimetics, Thiazides
These drugs can increase blood glucose levels, potentially requiring an adjustment in metformin dosage.
Storage
Store in a cool, dry place below 30°C. Protect from direct sunlight and moisture. Keep out of reach of children.
Overdose
Overdose of metformin can lead to lactic acidosis, a serious medical emergency requiring immediate hospitalization. Symptoms include severe nausea, vomiting, diarrhea, abdominal pain, muscle pain, rapid shallow breathing, drowsiness, and low body temperature. Treatment is primarily symptomatic and supportive, with hemodialysis being highly effective in removing metformin from the blood.
Pregnancy & Lactation
Pregnancy Category B. Limited data suggest metformin may be used in pregnancy when clinically needed, but insulin is generally preferred. For lactation, metformin is excreted into breast milk in small amounts. Consult a doctor before use while breastfeeding. Potential risks versus benefits should be discussed.
Side Effects
Contraindications
- Hypersensitivity to metformin or any component of the formulation.
- Any type of acute metabolic acidosis (such as lactic acidosis, diabetic ketoacidosis).
- Severe renal failure (eGFR <30 mL/min/1.73m²).
- Acute conditions with potential for renal impairment (e.g., dehydration, severe infection, shock).
- Acute or chronic disease which may cause tissue hypoxia (e.g., cardiac failure, respiratory failure, recent myocardial infarction, shock).
- Hepatic insufficiency, acute alcohol intoxication, alcoholism.
Drug Interactions
Cimetidine
Increases metformin plasma concentration by decreasing its renal clearance. Consider dose reduction.
Iodinated contrast agents
Temporarily discontinue metformin before or at the time of the 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 imaging procedure, and restart metformin if renal function is stable.
Diuretics (especially loop diuretics)
May increase the risk of lactic acidosis by potentially impairing renal function.
Corticosteroids, Sympathomimetics, Thiazides
These drugs can increase blood glucose levels, potentially requiring an adjustment in metformin dosage.
Storage
Store in a cool, dry place below 30°C. Protect from direct sunlight and moisture. Keep out of reach of children.
Overdose
Overdose of metformin can lead to lactic acidosis, a serious medical emergency requiring immediate hospitalization. Symptoms include severe nausea, vomiting, diarrhea, abdominal pain, muscle pain, rapid shallow breathing, drowsiness, and low body temperature. Treatment is primarily symptomatic and supportive, with hemodialysis being highly effective in removing metformin from the blood.
Pregnancy & Lactation
Pregnancy Category B. Limited data suggest metformin may be used in pregnancy when clinically needed, but insulin is generally preferred. For lactation, metformin is excreted into breast milk in small amounts. Consult a doctor before use while breastfeeding. Potential risks versus benefits should be discussed.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years from the date of manufacture. Refer to the specific packaging for exact expiry date.
Availability
Pharmacies nationwide
Approval Status
Approved
Patent Status
Generic available
WHO Essential Medicine
YesClinical Trials
Key clinical trials such as the UK Prospective Diabetes Study (UKPDS) have demonstrated metformin's efficacy in reducing macrovascular and microvascular complications in type 2 diabetes. The Diabetes Prevention Program (DPP) showed that metformin can prevent or delay the onset of type 2 diabetes in high-risk individuals.
Lab Monitoring
- Renal function (eGFR) should be assessed before starting metformin and at least annually thereafter. More frequent monitoring may be needed in elderly patients or those at risk of renal impairment.
- Blood glucose and HbA1c levels should be monitored regularly to assess glycemic control.
- Vitamin B12 levels should be measured periodically in patients on long-term metformin therapy, especially if anemia or peripheral neuropathy is suspected.
Doctor Notes
- Always assess renal function (eGFR) prior to initiating and periodically during metformin therapy.
- Educate patients on the symptoms of lactic acidosis and the importance of prompt medical attention if suspected.
- Counsel patients on lifestyle modifications, including diet and exercise, as an integral part of diabetes management.
- Consider vitamin B12 supplementation or monitoring in patients on long-term metformin, especially if symptoms of deficiency arise.
Patient Guidelines
- Take Metfar with food to minimize stomach upset.
- Inform your doctor about all other medications you are taking, including over-the-counter drugs and herbal supplements.
- Be aware of the symptoms of lactic acidosis (e.g., unusual muscle pain, difficulty breathing, unusual tiredness) and seek immediate medical attention if they occur.
- Do not stop taking Metfar without consulting your doctor, even if you feel well.
Missed Dose Advice
If you miss a dose of Metfar 850 mg, take it as soon as you remember, unless it is almost time for your next dose. In that case, skip the missed dose and resume your regular dosing schedule. Do not take a double dose to make up for a missed one.
Driving Precautions
Metformin monotherapy typically does not cause hypoglycemia and therefore usually does not affect the ability to drive or operate machinery. However, if used in combination with other antidiabetic agents (e.g., sulfonylureas, insulin) that can cause hypoglycemia, patients should be aware of the risk and take precautions.
Lifestyle Advice
- Maintain a balanced diet that is low in sugar and saturated fats.
- Engage in regular physical activity as advised by your doctor to help manage blood sugar levels and weight.
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