Mextil
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 |
|---|---|---|
| mextil 500 mg tablet | ৳ 45.17 | ৳ 180.67 |
Description
Overview of the medicine
Mextil 500 mg Tablet contains Metformin Hydrochloride, an oral antidiabetic medication used to manage type 2 diabetes mellitus. It helps to lower blood glucose levels.
Uses & Indications
Dosage
Adults
Initial dose: 500 mg once or twice daily with meals. May be increased gradually to a maximum of 2550 mg/day in divided doses. Typical maintenance dose: 850 mg twice daily or 500 mg three times daily.
Elderly
Start with lower doses and titrate carefully, monitoring renal function regularly. Maximize dose gradually based on efficacy and tolerability.
Renal_impairment
Contraindicated if eGFR < 30 mL/min/1.73m². Dose adjustment required for eGFR 30-60 mL/min/1.73m². Consult prescribing information.
How to Take
Take Mextil 500 mg Tablet orally with food, usually with your morning and/or evening meal, to reduce gastrointestinal side effects.
Mechanism of Action
Metformin primarily acts by decreasing hepatic glucose production, decreasing intestinal absorption of glucose, and improving insulin sensitivity by increasing peripheral glucose uptake and utilization.
Pharmacokinetics
Onset
The full therapeutic effect typically takes several days to achieve. Blood glucose lowering effects are observed within a few hours.
Excretion
Excreted unchanged in the urine. Renal clearance is approximately 3.5 times higher than creatinine clearance, indicating tubular secretion.
Half life
The plasma elimination half-life is approximately 6.2 hours.
Absorption
Relatively slow and incomplete absorption from the gastrointestinal tract. Absolute bioavailability is approximately 50-60%. Food decreases the extent and slightly delays the absorption of metformin.
Metabolism
Metformin is not metabolized by the liver in humans and is not excreted via the biliary tract.
Side Effects
Contraindications
- Severe renal impairment (eGFR < 30 mL/min/1.73m²)
- Acute or chronic metabolic acidosis, including diabetic ketoacidosis
- Hypersensitivity to metformin or any component of the formulation
- Dehydration, acute heart failure, severe infection, recent myocardial infarction
Drug Interactions
Cimetidine
Increases plasma metformin concentrations.
Furosemide
Alters metformin pharmacokinetics.
Nifedipine
Increases plasma metformin concentrations.
Carbonic Anhydrase Inhibitors (e.g., topiramate, acetazolamide)
May increase the risk of lactic acidosis.
Storage
Store in a cool, dry place below 30°C. Protect from light and moisture. Keep out of reach of children.
Overdose
Overdose of metformin can lead to lactic acidosis, which is a medical emergency. Symptoms include malaise, myalgia, respiratory distress, somnolence, and abdominal distress. Treatment involves supportive measures and prompt hemodialysis to remove accumulated metformin and lactate.
Pregnancy & Lactation
Pregnancy: Limited data suggest metformin can be used during pregnancy for gestational diabetes or type 2 diabetes if insulin is not feasible. Consult your doctor. Lactation: Metformin is excreted into human breast milk in small amounts. Weigh the benefits of breastfeeding against the potential risks to the infant. Consult your doctor.
Side Effects
Contraindications
- Severe renal impairment (eGFR < 30 mL/min/1.73m²)
- Acute or chronic metabolic acidosis, including diabetic ketoacidosis
- Hypersensitivity to metformin or any component of the formulation
- Dehydration, acute heart failure, severe infection, recent myocardial infarction
Drug Interactions
Cimetidine
Increases plasma metformin concentrations.
Furosemide
Alters metformin pharmacokinetics.
Nifedipine
Increases plasma metformin concentrations.
Carbonic Anhydrase Inhibitors (e.g., topiramate, acetazolamide)
May increase the risk of lactic acidosis.
Storage
Store in a cool, dry place below 30°C. Protect from light and moisture. Keep out of reach of children.
Overdose
Overdose of metformin can lead to lactic acidosis, which is a medical emergency. Symptoms include malaise, myalgia, respiratory distress, somnolence, and abdominal distress. Treatment involves supportive measures and prompt hemodialysis to remove accumulated metformin and lactate.
Pregnancy & Lactation
Pregnancy: Limited data suggest metformin can be used during pregnancy for gestational diabetes or type 2 diabetes if insulin is not feasible. Consult your doctor. Lactation: Metformin is excreted into human breast milk in small amounts. Weigh the benefits of breastfeeding against the potential risks to the infant. Consult your doctor.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Usually 2-3 years from the date of manufacture.
Availability
Available in pharmacies and hospitals
Approval Status
DGDA approved
Patent Status
Off-patent
WHO Essential Medicine
YesClinical Trials
Metformin has been extensively studied in numerous clinical trials demonstrating its efficacy and safety in managing type 2 diabetes and reducing cardiovascular events in patients with diabetes.
Lab Monitoring
- Renal function (eGFR) should be assessed before initiating metformin and at least annually thereafter.
- HbA1c levels should be monitored every 3-6 months.
- Vitamin B12 levels should be monitored periodically, especially in patients on long-term therapy or with risk factors for deficiency.
Doctor Notes
- Emphasize the importance of regular renal function monitoring (eGFR) before and during metformin therapy.
- Counsel patients on symptoms of lactic acidosis and the need for immediate medical attention.
- Advise patients about the risk of vitamin B12 deficiency with prolonged use and consider periodic monitoring.
Patient Guidelines
- Take Mextil 500 mg with food to reduce stomach upset.
- Regularly monitor your blood glucose levels as advised by your doctor.
- Be aware of the symptoms of lactic acidosis (e.g., unusual muscle pain, difficulty breathing, unusual stomach discomfort, dizziness, feeling cold) and seek immediate medical attention if they occur.
- Inform your doctor about all other medications, supplements, and herbal products you are taking.
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 schedule. Do not double the dose to catch up.
Driving Precautions
Mextil 500 mg Tablet generally does not cause hypoglycemia when used alone, so it is unlikely to affect your ability to drive or operate machinery. However, if used in combination with other antidiabetic agents (e.g., sulfonylureas, insulin), it may increase the risk of hypoglycemia, which could impair driving ability. Be cautious.
Lifestyle Advice
- Follow a healthy diet plan recommended by your doctor or a dietitian.
- Engage in regular physical activity as part of your diabetes management plan.
- Maintain a healthy weight.
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