Xelmet
Generic Name
Metformin Hydrochloride Extended Release
Manufacturer
Multiple manufacturers (e.g., ACI Limited in Bangladesh)
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| xelmet 500 mg tablet | ৳ 6.00 | ৳ 60.00 |
| xelmet 850 mg tablet | ৳ 6.50 | ৳ 65.00 |
Description
Overview of the medicine
Xelmet contains Metformin Hydrochloride, an oral antidiabetic drug used to manage type 2 diabetes mellitus, particularly in overweight individuals. It works by decreasing glucose production by the liver and improving insulin sensitivity.
Uses & Indications
Dosage
Adults
Typically, initial dose is 500 mg extended-release tablet once daily with the evening meal. Dose may be gradually increased weekly by 500 mg, up to a maximum of 2000 mg once daily.
Elderly
Careful dose titration is recommended due to potential for decreased renal function. Renal function should be monitored regularly.
Renal_impairment
Contraindicated in severe renal impairment (eGFR < 30 mL/min/1.73m²). Dose adjustment required for moderate impairment (eGFR 30-45 mL/min/1.73m²).
How to Take
Take orally with food, usually with the evening meal, to minimize gastrointestinal side effects. Swallow tablets whole; do not crush, cut, or chew.
Mechanism of Action
Metformin decreases hepatic glucose production, decreases intestinal absorption of glucose, and improves insulin sensitivity by increasing peripheral glucose uptake and utilization.
Pharmacokinetics
Onset
Gradual, full therapeutic effect may take several days to weeks.
Excretion
Excreted unchanged in the urine, primarily via renal tubular secretion.
Half life
Plasma half-life is approximately 8.7 hours for the extended-release formulation.
Absorption
Extended-release formulation provides sustained absorption over a longer period (e.g., 7-8 hours). Bioavailability is approximately 50-60%.
Metabolism
Metformin is not metabolized in the liver.
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.
Drug Interactions
Alcohol
Increases risk of lactic acidosis.
Iodinated Contrast Agents
Temporary discontinuation of metformin is recommended before or at the time of the procedure, and for 48 hours after, due to increased risk of lactic acidosis.
Cationic Drugs (e.g., amiloride, cimetidine, digoxin)
May compete with metformin for renal tubular secretion, potentially increasing metformin plasma concentrations.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Metformin overdose can lead to lactic acidosis, which is a medical emergency and must be treated in a hospital. Symptoms include severe drowsiness, nausea, vomiting, stomach pain, fast or shallow breathing, and unusual muscle pain. Treatment is supportive, including hemodialysis to remove metformin from the blood.
Pregnancy & Lactation
Pregnancy Category B. While limited data suggest it may be used, insulin is generally preferred for blood glucose control during pregnancy. Consult your doctor. Metformin is excreted into breast milk; however, amounts are generally too low to be harmful to a breastfed infant.
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.
Drug Interactions
Alcohol
Increases risk of lactic acidosis.
Iodinated Contrast Agents
Temporary discontinuation of metformin is recommended before or at the time of the procedure, and for 48 hours after, due to increased risk of lactic acidosis.
Cationic Drugs (e.g., amiloride, cimetidine, digoxin)
May compete with metformin for renal tubular secretion, potentially increasing metformin plasma concentrations.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Metformin overdose can lead to lactic acidosis, which is a medical emergency and must be treated in a hospital. Symptoms include severe drowsiness, nausea, vomiting, stomach pain, fast or shallow breathing, and unusual muscle pain. Treatment is supportive, including hemodialysis to remove metformin from the blood.
Pregnancy & Lactation
Pregnancy Category B. While limited data suggest it may be used, insulin is generally preferred for blood glucose control during pregnancy. Consult your doctor. Metformin is excreted into breast milk; however, amounts are generally too low to be harmful to a breastfed infant.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
24 to 36 months from the date of manufacture, depending on storage conditions.
Availability
Available in pharmacies and hospitals nationwide
Approval Status
Approved by major regulatory bodies (e.g., FDA, DGDA)
Patent Status
Off-patent
WHO Essential Medicine
YesClinical Trials
Extensive clinical trials have demonstrated the efficacy and safety of metformin in managing type 2 diabetes. Studies have also explored its benefits in cardiovascular outcomes and weight management.
Lab Monitoring
- Renal function (eGFR) should be assessed before initiating metformin and at least annually thereafter.
- Hematologic parameters and vitamin B12 levels should be monitored periodically, especially in patients on long-term therapy or with risk factors for B12 deficiency.
Doctor Notes
- Emphasize the risk of lactic acidosis, especially in patients with impaired renal function or those undergoing radiological procedures with iodinated contrast agents.
- Advise patients on lifestyle modifications (diet, exercise) as foundational therapy for type 2 diabetes.
Patient Guidelines
- Take Xelmet exactly as prescribed by your doctor.
- Do not stop taking Xelmet without consulting your doctor.
- Inform your doctor about all other medications, supplements, and herbal products you are taking.
- Report any signs of lactic acidosis immediately to your doctor.
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 resume your regular dosing schedule. Do not double the dose to catch up.
Driving Precautions
Xelmet alone does not typically cause hypoglycemia, so it is unlikely to affect your 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 healthy diet, rich in fiber and low in refined sugars. Regular physical activity is crucial for managing type 2 diabetes. Aim for a healthy body weight.
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