Metfil
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 |
|---|---|---|
| metfil 400 mg tablet | ৳ 1.00 | N/A |
Description
Overview of the medicine
Metfil is an oral antidiabetic drug used to manage blood sugar levels in people with type 2 diabetes mellitus, especially in those who are overweight or obese and where diet and exercise alone have not been sufficient. It is also used in the treatment of polycystic ovary syndrome (PCOS).
Uses & Indications
Dosage
Adults
Initial dose 500 mg twice daily or 850 mg once daily with meals. May be gradually increased to a maximum of 2550 mg daily in divided doses.
Elderly
Lower initial doses are recommended due to potential for decreased renal function; monitor renal function closely.
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 meals to reduce gastrointestinal side effects. Swallow tablets whole; do not crush or chew extended-release forms.
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.
Pharmacokinetics
Onset
Within hours for blood glucose reduction.
Excretion
Primarily excreted unchanged in the urine by the kidneys.
Half life
Approximately 4-6 hours (plasma elimination half-life).
Absorption
Oral bioavailability is 50-60%. Food delays and slightly decreases the extent of absorption.
Metabolism
Not metabolized in the liver; excreted unchanged.
Side Effects
Contraindications
- Severe renal impairment (eGFR < 30 mL/min/1.73 m²)
- Metabolic acidosis (including diabetic ketoacidosis)
- Hypersensitivity to metformin
- Acute or chronic metabolic acidosis (e.g., lactic acidosis)
Drug Interactions
Alcohol
Increases risk of lactic acidosis.
Cimetidine
Increases metformin plasma concentration.
Iodinated contrast agents
Risk of lactic acidosis increases; discontinue metformin before or at the time of procedure.
Carbonic anhydrase inhibitors (e.g., topiramate)
May increase risk of lactic acidosis.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include lactic acidosis. Management involves supportive measures, hemodialysis for severe lactic acidosis, and correction of fluid and electrolyte imbalances.
Pregnancy & Lactation
Pregnancy Category B. Generally considered safe during pregnancy when benefits outweigh risks, but insulin is often preferred. Small amounts excreted in breast milk; generally considered compatible with breastfeeding with caution.
Side Effects
Contraindications
- Severe renal impairment (eGFR < 30 mL/min/1.73 m²)
- Metabolic acidosis (including diabetic ketoacidosis)
- Hypersensitivity to metformin
- Acute or chronic metabolic acidosis (e.g., lactic acidosis)
Drug Interactions
Alcohol
Increases risk of lactic acidosis.
Cimetidine
Increases metformin plasma concentration.
Iodinated contrast agents
Risk of lactic acidosis increases; discontinue metformin before or at the time of procedure.
Carbonic anhydrase inhibitors (e.g., topiramate)
May increase risk of lactic acidosis.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include lactic acidosis. Management involves supportive measures, hemodialysis for severe lactic acidosis, and correction of fluid and electrolyte imbalances.
Pregnancy & Lactation
Pregnancy Category B. Generally considered safe during pregnancy when benefits outweigh risks, but insulin is often preferred. Small amounts excreted in breast milk; generally considered compatible with breastfeeding with caution.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 24-36 months from manufacturing date
Availability
Pharmacies, hospitals, clinics
Approval Status
Approved by regulatory bodies (e.g., FDA, DGDA)
Patent Status
Generic available, original patent expired
WHO Essential Medicine
YesClinical Trials
Extensively studied in numerous clinical trials demonstrating efficacy in glycemic control and cardiovascular benefits in some populations.
Lab Monitoring
- Renal function (eGFR) periodically, especially before initiation and annually thereafter
- Vitamin B12 levels periodically for long-term users
- Blood glucose levels (fasting and postprandial)
- HbA1c
Doctor Notes
- Emphasize renal function monitoring for all patients, especially elderly and those with comorbidities.
- Educate patients on symptoms of lactic acidosis and importance of reporting immediately.
- Consider vitamin B12 supplementation for long-term users.
Patient Guidelines
- Take Metfil with meals to minimize stomach upset.
- Inform your doctor about all medications you are taking.
- Report any signs of lactic acidosis (e.g., unusual muscle pain, difficulty breathing, unusual stomach discomfort) immediately.
- Do not stop taking Metfil without consulting your doctor.
Missed Dose Advice
If a dose is missed, take it as soon as you remember, unless it is almost time for your next dose. Do not double the dose to catch up.
Driving Precautions
Metformin generally does not cause hypoglycemia when used alone, so it usually does not impair ability to drive or operate machinery. However, if used in combination with other antidiabetic agents that can cause hypoglycemia, caution is advised.
Lifestyle Advice
- Maintain a balanced diet.
- Engage in regular physical activity.
- Monitor blood sugar levels regularly.
- Limit alcohol intake.
Alternative Medicines in Bangladesh
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Global Brand Names
International brand names for this medicine. Click a brand to search for detailed information.
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