Xelmet
Generic Name
Metformin Hydrochloride
Manufacturer
Incepta Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| xelmet 850 mg tablet | ৳ 6.50 | ৳ 65.00 |
Description
Overview of the medicine
Xelmet 850 mg Tablet contains Metformin Hydrochloride, an oral antidiabetic medicine used to lower blood glucose levels in people with type 2 diabetes. It is typically used in conjunction with diet and exercise.
Uses & Indications
Dosage
Adults
Initial dose is typically 500 mg once or twice daily, taken with meals. Gradually increase to 850 mg once daily or 500 mg twice daily. Maximum dose is usually 2550 mg per day in divided doses.
Elderly
A lower initial dose 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/1.73 m²). Dose adjustment required for moderate impairment (eGFR 30-60 mL/min/1.73 m²).
How to Take
Take the tablet orally with meals to minimize gastrointestinal side effects. Swallow the tablet whole; do not crush, chew, or break it.
Mechanism of Action
Metformin works by reducing glucose production in the liver (gluconeogenesis), decreasing glucose absorption from the intestines, and improving insulin sensitivity by increasing peripheral glucose uptake and utilization.
Pharmacokinetics
Onset
Within hours of administration, peak plasma concentrations typically achieved in 2-3 hours.
Excretion
Excreted unchanged in the urine, primarily via renal tubular secretion.
Half life
Plasma elimination half-life is approximately 6.2 hours.
Absorption
Approximately 50-60% absorbed from the gastrointestinal tract under fasting conditions. Food decreases the extent and slightly delays absorption.
Metabolism
Not metabolized in the liver.
Side Effects
Contraindications
- Hypersensitivity to metformin or any component of the formulation.
- Severe renal impairment (eGFR < 30 mL/min/1.73 m²).
- Acute or chronic metabolic acidosis, including diabetic ketoacidosis, with or without coma.
- Acute or chronic disease that may cause tissue hypoxia (e.g., cardiac failure, respiratory failure, recent myocardial infarction, shock).
- Severe hepatic impairment.
- Alcohol intoxication.
Drug Interactions
Alcohol
Potentiates the effect of metformin on lactate metabolism and increases the risk of lactic acidosis, especially in cases of fasting or malnutrition.
Cimetidine
May increase metformin plasma concentrations, increasing risk of lactic acidosis.
Iodinated Contrast Agents
Temporarily discontinue metformin before or at the time of an iodinated contrast imaging procedure and for 48 hours afterward; reinitiate only after renal function has been re-evaluated and found to be normal.
Carbonic Anhydrase Inhibitors (e.g., Topiramate, Acetazolamide)
May increase the risk of lactic acidosis.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Overdose of metformin can lead to lactic acidosis, a medical emergency. Symptoms include malaise, myalgia, respiratory distress, increasing somnolence, and abdominal distress. Management involves hospital admission, immediate hemodialysis to remove metformin, and supportive care.
Pregnancy & Lactation
Pregnancy Category B. Consult your doctor before using this medicine if you are pregnant, planning to become pregnant, or breastfeeding. Metformin is excreted in breast milk; however, the amount is usually low. Discuss potential risks and benefits with your physician.
Side Effects
Contraindications
- Hypersensitivity to metformin or any component of the formulation.
- Severe renal impairment (eGFR < 30 mL/min/1.73 m²).
- Acute or chronic metabolic acidosis, including diabetic ketoacidosis, with or without coma.
- Acute or chronic disease that may cause tissue hypoxia (e.g., cardiac failure, respiratory failure, recent myocardial infarction, shock).
- Severe hepatic impairment.
- Alcohol intoxication.
Drug Interactions
Alcohol
Potentiates the effect of metformin on lactate metabolism and increases the risk of lactic acidosis, especially in cases of fasting or malnutrition.
Cimetidine
May increase metformin plasma concentrations, increasing risk of lactic acidosis.
Iodinated Contrast Agents
Temporarily discontinue metformin before or at the time of an iodinated contrast imaging procedure and for 48 hours afterward; reinitiate only after renal function has been re-evaluated and found to be normal.
Carbonic Anhydrase Inhibitors (e.g., Topiramate, Acetazolamide)
May increase the risk of lactic acidosis.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Overdose of metformin can lead to lactic acidosis, a medical emergency. Symptoms include malaise, myalgia, respiratory distress, increasing somnolence, and abdominal distress. Management involves hospital admission, immediate hemodialysis to remove metformin, and supportive care.
Pregnancy & Lactation
Pregnancy Category B. Consult your doctor before using this medicine if you are pregnant, planning to become pregnant, or breastfeeding. Metformin is excreted in breast milk; however, the amount is usually low. Discuss potential risks and benefits with your physician.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
2 to 3 years from the date of manufacture, consult package for exact date.
Availability
Available in pharmacies and hospitals
Approval Status
Approved by regulatory authorities worldwide for Type 2 Diabetes
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. Notable studies include the UKPDS.
Lab Monitoring
- Renal function (eGFR) should be assessed before initiating metformin and at least annually thereafter. More frequent monitoring may be needed in elderly patients and those at risk of renal impairment.
- Hematologic parameters and vitamin B12 levels should be measured periodically, especially in patients receiving long-term treatment.
Doctor Notes
- Emphasize the importance of renal function monitoring (eGFR) at baseline and annually.
- Educate patients on the symptoms of lactic acidosis and the need for immediate medical attention.
- Advise patients about the need for B12 supplementation if deficiency is detected, especially in long-term users.
- Ensure patients understand the role of diet and exercise alongside medication.
Patient Guidelines
- Take metformin with food as directed by your doctor.
- Do not stop taking metformin without consulting your doctor.
- Be aware of symptoms of lactic acidosis (e.g., unusual muscle pain, trouble breathing, unusual stomach discomfort, dizziness, feeling cold) and seek immediate medical attention if they occur.
- Maintain a balanced diet and regular exercise routine as advised by your healthcare provider.
Missed Dose Advice
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and resume your regular dosing schedule. Do not double the dose.
Driving Precautions
Metformin alone typically does not cause hypoglycemia, which could impair driving. However, if used in combination with other antidiabetic medications (e.g., sulfonylureas, insulin), the risk of hypoglycemia increases. Patients should be aware of their body's response to the medicine before driving or operating machinery.
Lifestyle Advice
- Adhere to a healthy diet plan to manage blood sugar levels.
- Engage in regular physical activity to improve insulin sensitivity and support weight management.
- Limit alcohol consumption to reduce the risk of lactic acidosis.
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