Wellmet
Generic Name
Metformin Hydrochloride
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
Loading images...
Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| wellmet 500 mg tablet | ৳ 4.00 | ৳ 40.00 |
Description
Overview of the medicine
Metformin is an oral antidiabetic medicine used to manage type 2 diabetes mellitus. It helps lower blood glucose levels by decreasing glucose production in the liver, decreasing glucose absorption from the intestine, and improving insulin sensitivity. It is often used in conjunction with diet and exercise.
Uses & Indications
Dosage
Adults
Initial dose is typically 500 mg once or twice daily with meals. May be titrated up to 2000-2500 mg/day in divided doses. Maximum dose is usually 2550 mg/day.
Elderly
Lower initial doses recommended due to potential decreased renal function. Renal function should be monitored regularly. Not recommended if eGFR < 30 mL/min/1.73m².
Renal_impairment
Dose adjustment required based on eGFR. Contraindicated if eGFR < 30 mL/min/1.73m². Not recommended to initiate if eGFR is 30-45 mL/min/1.73m².
How to Take
Take orally with meals to reduce gastrointestinal side effects. Swallow tablets whole with a glass of water. Do not crush, break, or chew extended-release tablets.
Mechanism of Action
Metformin primarily reduces hepatic glucose production by inhibiting gluconeogenesis and glycogenolysis. It also decreases intestinal absorption of glucose and improves insulin sensitivity by increasing peripheral glucose uptake and utilization. It does not stimulate insulin secretion and therefore does not cause hypoglycemia.
Pharmacokinetics
Onset
1-3 hours (for plasma glucose lowering effect)
Excretion
Primarily excreted renally as unchanged drug within 24 hours. Renal clearance is approximately 3.5 times higher than creatinine clearance.
Half life
Approximately 6.2 hours (plasma), 17.6 hours (blood)
Absorption
Absolute bioavailability is 50-60%. Food delays absorption and slightly decreases the extent of absorption.
Metabolism
Not metabolized in the liver or excreted via bile. Excreted unchanged in the urine.
Side Effects
Contraindications
- Severe renal impairment (eGFR < 30 mL/min/1.73m²).
- Acute or chronic metabolic acidosis (including diabetic ketoacidosis, with or without coma).
- Hypersensitivity to metformin or any component of the formulation.
- Acute heart failure, acute myocardial infarction, severe infection, or other conditions predisposing to lactic acidosis.
Drug Interactions
Alcohol
Potentiates the effect of metformin on lactate metabolism, increasing the risk of lactic acidosis. Avoid excessive alcohol intake.
Verapamil
May decrease metformin exposure.
Cimetidine
Increases metformin plasma concentration, potentially increasing the risk of lactic acidosis.
Nifedipine
May enhance metformin absorption and increase plasma concentrations.
Iodinated contrast agents
Temporarily impairs renal function, increasing the risk of lactic acidosis. Discontinue metformin before or at the time of the procedure and for 48 hours after.
Diuretics (thiazide, loop)
May exacerbate hyperglycemia and increase the risk of lactic acidosis by impairing renal function.
Storage
Store below 30°C in a dry place, protected from light and moisture. Keep out of reach and sight of children.
Overdose
Overdose, particularly in the presence of comorbid conditions, can lead to lactic acidosis. Symptoms include malaise, myalgia, respiratory distress, increased somnolence, and abdominal distress. Management involves supportive care and immediate hemodialysis to remove metformin.
Pregnancy & Lactation
Pregnancy: Category B. Limited data suggest it can be used during pregnancy under strict medical supervision when the benefits outweigh the risks. Lactation: Metformin is excreted into breast milk in small amounts. Generally considered compatible with breastfeeding, but consult a healthcare professional.
Side Effects
Contraindications
- Severe renal impairment (eGFR < 30 mL/min/1.73m²).
- Acute or chronic metabolic acidosis (including diabetic ketoacidosis, with or without coma).
- Hypersensitivity to metformin or any component of the formulation.
- Acute heart failure, acute myocardial infarction, severe infection, or other conditions predisposing to lactic acidosis.
Drug Interactions
Alcohol
Potentiates the effect of metformin on lactate metabolism, increasing the risk of lactic acidosis. Avoid excessive alcohol intake.
Verapamil
May decrease metformin exposure.
Cimetidine
Increases metformin plasma concentration, potentially increasing the risk of lactic acidosis.
Nifedipine
May enhance metformin absorption and increase plasma concentrations.
Iodinated contrast agents
Temporarily impairs renal function, increasing the risk of lactic acidosis. Discontinue metformin before or at the time of the procedure and for 48 hours after.
Diuretics (thiazide, loop)
May exacerbate hyperglycemia and increase the risk of lactic acidosis by impairing renal function.
Storage
Store below 30°C in a dry place, protected from light and moisture. Keep out of reach and sight of children.
Overdose
Overdose, particularly in the presence of comorbid conditions, can lead to lactic acidosis. Symptoms include malaise, myalgia, respiratory distress, increased somnolence, and abdominal distress. Management involves supportive care and immediate hemodialysis to remove metformin.
Pregnancy & Lactation
Pregnancy: Category B. Limited data suggest it can be used during pregnancy under strict medical supervision when the benefits outweigh the risks. Lactation: Metformin is excreted into breast milk in small amounts. Generally considered compatible with breastfeeding, but consult a healthcare professional.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years from the date of manufacture, specific details are printed on the packaging.
Availability
Pharmacies, Hospitals
Approval Status
Widely approved globally
Patent Status
Off-patent
WHO Essential Medicine
YesClinical Trials
Extensive clinical trials have established the efficacy and safety of metformin in the management of type 2 diabetes, showing significant reductions in HbA1c and fasting plasma glucose, as well as positive cardiovascular outcomes in some studies.
Lab Monitoring
- HbA1c levels regularly (e.g., every 3-6 months) to assess glycemic control.
- Renal function (eGFR) at baseline, annually, and more frequently in elderly or those at risk of renal impairment.
- Vitamin B12 levels periodically, especially in long-term users or those with risk factors for deficiency.
Doctor Notes
- Always assess renal function (eGFR) prior to initiation of metformin and at least annually thereafter. Discontinue if eGFR falls below 30 mL/min/1.73m².
- Educate patients thoroughly on the signs and symptoms of lactic acidosis and the importance of prompt medical attention if they occur.
- Consider periodic monitoring of vitamin B12 levels, especially in patients on long-term therapy or with pre-existing risk factors for B12 deficiency.
Patient Guidelines
- Take metformin with meals to reduce stomach upset.
- Do not stop taking the medicine without consulting your doctor, even if you feel well.
- Immediately report any signs of lactic acidosis such as unusual muscle pain, difficulty breathing, unusual stomach discomfort, dizziness, or lightheadedness.
- Inform your doctor or pharmacist about all other medications, supplements, and herbal products you are taking.
- Limit or avoid alcohol consumption while on this medication.
Missed Dose Advice
If a dose is missed, take it as soon as you remember, unless it's almost time for your next scheduled dose. In that case, skip the missed dose and resume your regular dosing schedule. Do not double the dose to catch up.
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 cautious and monitor for symptoms of low blood sugar.
Lifestyle Advice
- Maintain a healthy diet, low in sugar and unhealthy fats, as advised by your healthcare provider.
- Engage in regular physical activity to help manage blood glucose levels and promote overall health.
- Monitor your blood glucose levels regularly as instructed by your doctor.
- Stay well-hydrated, especially during exercise or in hot weather.
Alternative Medicines in Bangladesh
Similar medicines available in the market
Global Brand Names
International brand names for this medicine. Click a brand to search for detailed information.
Other Medicines in Wellmet Brand
Other medicines available under the same brand name
