Metsa
Generic Name
Metformin Hydrochloride
Manufacturer
Acme Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| metsa 850 mg tablet | ৳ 5.02 | ৳ 50.20 |
Description
Overview of the medicine
Metsa 850 mg tablet contains Metformin Hydrochloride, an oral antidiabetic medicine used to manage type 2 diabetes mellitus, especially in overweight patients. It helps lower blood glucose levels by reducing glucose production in the liver, decreasing glucose absorption from the intestines, and improving insulin sensitivity.
Uses & Indications
Dosage
Adults
Initially 500 mg or 850 mg once or twice daily with or after meals. Gradually increase to maximum 2550 mg daily in divided doses. 850 mg is often taken once or twice daily.
Elderly
Careful dose titration is recommended due to potential decreased renal function. Maximum dose should be lower.
Renal_impairment
Contraindicated if eGFR <30 mL/min/1.73 m². Dose adjustment needed for eGFR 30-60 mL/min/1.73 m².
How to Take
Swallow the tablet whole with a glass of water, with or after meals, to reduce gastrointestinal side effects. Do not crush or chew.
Mechanism of Action
Metformin primarily reduces hepatic glucose production by inhibiting gluconeogenesis and glycogenolysis. It also enhances insulin sensitivity in peripheral tissues, leading to increased glucose uptake and utilization. Additionally, it delays glucose absorption from the gastrointestinal tract.
Pharmacokinetics
Onset
Initial glucose lowering effect within hours, full effect takes several days to weeks.
Excretion
Primarily excreted renally (via urine) as unchanged drug.
Half life
Plasma elimination half-life is approximately 4-9 hours.
Absorption
Bioavailability is 50-60%. Food delays and slightly decreases absorption.
Metabolism
Not metabolized in the liver. Excreted unchanged.
Side Effects
Contraindications
- Renal impairment (eGFR <30 mL/min/1.73 m²)
- Metabolic acidosis (including diabetic ketoacidosis)
- Acute or chronic disease that may cause tissue hypoxia (e.g., cardiac or respiratory failure, recent myocardial infarction, shock)
- Severe hepatic impairment
- Alcohol intoxication
- Hypersensitivity to metformin or any excipients
Drug Interactions
Iodinated Contrast Agents
Temporarily discontinue metformin before or at the time of an iodinated contrast imaging procedure in patients with 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 procedure; restart metformin if renal function is stable.
Carbonic Anhydrase Inhibitors (e.g., Topiramate)
May increase risk of lactic acidosis.
Drugs that reduce metformin clearance (e.g., Cimetidine, Ranolazine, Dolutegravir)
May increase metformin plasma concentrations.
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, hypoglycemia (rare with monotherapy), and gastrointestinal discomfort. Treatment involves supportive measures, gastric lavage, and hemodialysis for severe lactic acidosis.
Pregnancy & Lactation
Pregnancy Category B. Limited data suggest it may be used if clinically needed for gestational diabetes or type 2 diabetes. Metformin is excreted into breast milk; however, the amount is usually low and not expected to cause harm to breastfed infants. Use with caution.
Side Effects
Contraindications
- Renal impairment (eGFR <30 mL/min/1.73 m²)
- Metabolic acidosis (including diabetic ketoacidosis)
- Acute or chronic disease that may cause tissue hypoxia (e.g., cardiac or respiratory failure, recent myocardial infarction, shock)
- Severe hepatic impairment
- Alcohol intoxication
- Hypersensitivity to metformin or any excipients
Drug Interactions
Iodinated Contrast Agents
Temporarily discontinue metformin before or at the time of an iodinated contrast imaging procedure in patients with 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 procedure; restart metformin if renal function is stable.
Carbonic Anhydrase Inhibitors (e.g., Topiramate)
May increase risk of lactic acidosis.
Drugs that reduce metformin clearance (e.g., Cimetidine, Ranolazine, Dolutegravir)
May increase metformin plasma concentrations.
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, hypoglycemia (rare with monotherapy), and gastrointestinal discomfort. Treatment involves supportive measures, gastric lavage, and hemodialysis for severe lactic acidosis.
Pregnancy & Lactation
Pregnancy Category B. Limited data suggest it may be used if clinically needed for gestational diabetes or type 2 diabetes. Metformin is excreted into breast milk; however, the amount is usually low and not expected to cause harm to breastfed infants. Use with caution.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
24 months
Availability
Pharmacies, Hospitals
Approval Status
FDA Approved
Patent Status
Generic available
WHO Essential Medicine
YesClinical Trials
Metformin has been extensively studied in numerous clinical trials, demonstrating its efficacy in reducing HbA1c, improving insulin sensitivity, and reducing cardiovascular events in type 2 diabetes patients, particularly in overweight individuals. Landmark studies include the UKPDS.
Lab Monitoring
- Renal function (eGFR) before initiation and at least annually (more frequently in elderly or at-risk patients)
- Vitamin B12 levels (periodically, especially with long-term use)
- Blood glucose levels (regularly)
- HbA1c levels (regularly)
Doctor Notes
- Advise patients on lifestyle modifications (diet, exercise) as cornerstone of diabetes management.
- Educate on symptoms of lactic acidosis and need for immediate medical attention.
- Ensure regular monitoring of renal function and B12 levels.
- Counsel on proper administration with meals to minimize GI side effects.
Patient Guidelines
- Take Metformin regularly as prescribed by your doctor.
- Inform your doctor if you experience severe gastrointestinal symptoms or any signs of lactic acidosis (e.g., unusual muscle pain, difficulty breathing, unusual tiredness).
- Maintain a balanced diet and regular exercise regimen.
- Avoid excessive alcohol consumption.
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
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, caution is advised.
Lifestyle Advice
- Adopt a healthy diet low in refined sugars and unhealthy fats.
- Engage in regular physical activity (e.g., walking, jogging, cycling) for at least 30 minutes most days of the week.
- Maintain a healthy weight.
- Quit smoking if applicable.
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