Metfo-XR
Generic Name
Metformin Hydrochloride Extended-Release Tablet
Manufacturer
Generic Pharmaceutical Company
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| metfo xr 1000 mg tablet | ৳ 10.00 | ৳ 50.00 |
Description
Overview of the medicine
Metformin XR is an oral antidiabetic drug used to manage type 2 diabetes mellitus, especially in overweight patients, when diet and exercise alone do not provide adequate glycemic control. It helps lower blood glucose levels by decreasing glucose production in the liver, decreasing intestinal absorption of glucose, and improving insulin sensitivity. Its extended-release formulation allows for once-daily dosing, improving patient compliance and reducing gastrointestinal side effects compared to immediate-release formulations.
Uses & Indications
Dosage
Adults
The usual starting dose for Metformin XR 1000 mg is one tablet (1000 mg) once daily with the evening meal. The dose may be gradually increased, if necessary, by 500 mg increments weekly, up to a maximum of 2000 mg once daily. Some patients may benefit from a maximum dose of 2500 mg daily, divided into two doses (e.g., 1000 mg and 1500 mg).
Elderly
Dosage should be individualized based on renal function, which should be assessed regularly. A lower starting dose and careful monitoring are recommended due to the potential for decreased renal function in the elderly.
Renal_impairment
Metformin is contraindicated in patients with an estimated glomerular filtration rate (eGFR) below 30 mL/min/1.73m². Dosage adjustments are necessary for patients with eGFR between 30 and 45 mL/min/1.73m², and initiation is not recommended in this range. For eGFR 45-60 mL/min/1.73m², maximum daily dose should not exceed 2000 mg.
How to Take
Metformin XR tablets should be taken orally, once daily with the evening meal. Tablets must be swallowed whole and should not be crushed, chewed, or broken, as this can affect their extended-release properties and potentially lead to an overdose. Food intake may reduce the risk of gastrointestinal side effects.
Mechanism of Action
Metformin works primarily by reducing hepatic glucose production (gluconeogenesis), decreasing intestinal absorption of glucose, and improving insulin sensitivity by increasing peripheral glucose uptake and utilization. It does not stimulate insulin secretion, so it rarely causes hypoglycemia when used as monotherapy. It also has beneficial effects on lipid profiles.
Pharmacokinetics
Onset
Glycemic control improvement is typically observed within a few days, with full therapeutic effect achieved within 1-2 weeks.
Excretion
Excreted unchanged primarily in the urine. Renal clearance is approximately 3.5 times higher than creatinine clearance, indicating active tubular secretion.
Half life
The plasma elimination half-life is approximately 6.2 hours.
Absorption
Slowly and incompletely absorbed from the gastrointestinal tract. Peak plasma concentrations (Cmax) are reached after approximately 7 hours (range 4 to 8 hours) with extended-release formulations. Bioavailability is approximately 50-60%.
Metabolism
Metformin is not metabolized in humans.
Side Effects
Contraindications
- •Severe renal impairment (eGFR < 30 mL/min/1.73m²).
- •Acute or chronic metabolic acidosis, including diabetic ketoacidosis, with or without coma.
- •Known hypersensitivity to metformin hydrochloride or any component of the formulation.
- •Acute or chronic conditions that may cause tissue hypoxia (e.g., cardiac or respiratory failure, recent myocardial infarction, shock).
- •Severe hepatic impairment.
- •Acute alcohol intoxication.
Drug Interactions
Alcohol
Potentiates the effect of metformin on lactate metabolism and increases the risk of lactic acidosis. Avoid excessive alcohol intake.
Iodinated Contrast Agents
Temporarily discontinue metformin at the time of or prior to an iodinated contrast imaging procedure in patients with risk factors for acute kidney injury. Metformin should be withheld for 48 hours after the procedure and reinstituted only after renal function has been re-evaluated and found to be normal.
Diuretics (Thiazide and Loop)
Thiazide and loop diuretics can increase blood glucose levels, potentially leading to a loss of glycemic control. Close monitoring is advised.
Carbonic Anhydrase Inhibitors (e.g., topiramate, zonisamide)
May increase the risk of lactic acidosis by increasing systemic acidosis. Consider more frequent monitoring of renal function and blood glucose.
Cationic drugs (e.g., amiloride, cimetidine, digoxin, procainamide, quinidine, ranitidine, triamterene, trimethoprim, vancomycin)
May increase metformin plasma concentrations by competing for renal tubular secretion. Close monitoring of blood glucose and metformin dose adjustment may be necessary.
Storage
Store below 30°C (86°F) in a dry place, away from direct light and moisture. Keep the tablets in their original packaging to protect from moisture. Keep out of reach of children.
Overdose
Metformin overdose, especially in the presence of predisposing factors, can lead to lactic acidosis, a medical emergency requiring immediate treatment. Symptoms of lactic acidosis include malaise, myalgia, respiratory distress, somnolence, and abdominal pain. Management involves supportive care and prompt hemodialysis to correct acidosis and efficiently remove metformin from the body.
Pregnancy & Lactation
Pregnancy: Limited data suggest that metformin is generally considered relatively safe for use in pregnancy when diet and exercise are insufficient for gestational diabetes or type 2 diabetes. However, insulin is often the preferred agent for glycemic control in pregnancy. Consult a doctor for personalized advice. Lactation: Metformin is excreted into breast milk in small amounts. Generally considered compatible with breastfeeding, but monitor the breastfed infant for any adverse effects such as hypoglycemia or gastrointestinal issues. Consult a doctor before breastfeeding while on this medication.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 24 to 36 months from the manufacturing date, when stored under recommended conditions.
Availability
Pharmacies, Hospitals
Approval Status
Approved
Patent Status
Off-patent
WHO Essential Medicine
YesAlternative Medicines in Bangladesh
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Global Brand Names
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