Xelmet-XR
Generic Name
Metformin Hydrochloride (Extended Release)
Manufacturer
Renata Limited
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| xelmet xr 500 mg tablet | ৳ 7.00 | ৳ 49.00 |
Description
Overview of the medicine
Xelmet-XR 500 mg Tablet contains Metformin Hydrochloride in an extended-release formulation. It is an oral medicine used to treat type 2 diabetes mellitus, typically in conjunction with diet and exercise. It helps to control high blood sugar levels by reducing glucose production in the liver, decreasing glucose absorption from the intestines, and improving the body's sensitivity to insulin.
Uses & Indications
Dosage
Adults
Initial dose: 500 mg once daily with the evening meal. Dose may be increased gradually by 500 mg weekly up to a maximum of 2000 mg once daily. Some patients may require 2500 mg daily.
Elderly
Careful titration and monitoring of renal function are required. Start with a lower dose.
Renal_impairment
eGFR 45-59 mL/min/1.73m²: Max dose 1000 mg/day. eGFR 30-44 mL/min/1.73m²: Max dose 500 mg/day. eGFR <30 mL/min/1.73m²: Contraindicated.
How to Take
Take orally, once daily with the evening meal. Swallow the tablet whole; do not crush, chew, or break it. Taking with food helps to reduce gastrointestinal side effects.
Mechanism of Action
Metformin primarily reduces hepatic glucose production by inhibiting gluconeogenesis and glycogenolysis. It also improves insulin sensitivity in peripheral tissues, leading to increased glucose uptake and utilization. Additionally, it decreases glucose absorption from the gastrointestinal tract.
Pharmacokinetics
Onset
Gradual, typically within hours, but full therapeutic effect may take several days to weeks.
Excretion
Excreted unchanged in the urine, primarily through renal tubular secretion.
Half life
Plasma elimination half-life is approximately 4-9 hours. In the extended-release formulation, effective half-life is prolonged.
Absorption
Slow and incomplete absorption from the GI tract. Peak plasma concentrations are reached approximately 4-8 hours after administration of the extended-release formulation. Absolute bioavailability is approximately 50-60%.
Metabolism
Not metabolized in the liver.
Side Effects
Contraindications
- Severe renal impairment (eGFR <30 mL/min/1.73m²)
- Metabolic acidosis (including diabetic ketoacidosis), with or without coma
- Known hypersensitivity to metformin
- Severe tissue hypoperfusion (e.g., acute heart failure, septic shock)
Drug Interactions
Alcohol
Enhances the effect of metformin on lactate metabolism, increasing the risk of lactic acidosis.
Cationic drugs
Drugs eliminated by renal tubular secretion (e.g., cimetidine, amiloride, trimethoprim) may increase metformin concentrations.
Iodinated contrast media
Temporary discontinuation of metformin is advised prior to or at the time of an iodinated contrast imaging procedure due to increased 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. Symptoms include malaise, myalgia, respiratory distress, somnolence, and abdominal pain. Management involves supportive care and immediate hemodialysis to remove metformin and lactate.
Pregnancy & Lactation
Pregnancy Category B. Limited data suggest metformin can be used during pregnancy if clinically indicated, but insulin is generally preferred for blood glucose control. Small amounts are excreted in breast milk; generally considered compatible with breastfeeding, but consult a doctor.
Side Effects
Contraindications
- Severe renal impairment (eGFR <30 mL/min/1.73m²)
- Metabolic acidosis (including diabetic ketoacidosis), with or without coma
- Known hypersensitivity to metformin
- Severe tissue hypoperfusion (e.g., acute heart failure, septic shock)
Drug Interactions
Alcohol
Enhances the effect of metformin on lactate metabolism, increasing the risk of lactic acidosis.
Cationic drugs
Drugs eliminated by renal tubular secretion (e.g., cimetidine, amiloride, trimethoprim) may increase metformin concentrations.
Iodinated contrast media
Temporary discontinuation of metformin is advised prior to or at the time of an iodinated contrast imaging procedure due to increased 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. Symptoms include malaise, myalgia, respiratory distress, somnolence, and abdominal pain. Management involves supportive care and immediate hemodialysis to remove metformin and lactate.
Pregnancy & Lactation
Pregnancy Category B. Limited data suggest metformin can be used during pregnancy if clinically indicated, but insulin is generally preferred for blood glucose control. Small amounts are excreted in breast milk; generally considered compatible with breastfeeding, but consult a doctor.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
24 months
Availability
Pharmacies, hospitals, clinics
Approval Status
Approved (DGDA, FDA and other regulatory bodies)
Patent Status
Generic available
WHO Essential Medicine
YesClinical Trials
Numerous clinical trials have established the efficacy and safety of metformin in managing type 2 diabetes, with particular attention to its extended-release formulations for improved tolerability and compliance. Ongoing research explores its potential benefits in other metabolic conditions.
Lab Monitoring
- Renal function (eGFR) at least annually, more frequently in elderly or renally impaired patients
- HbA1c levels regularly to assess glycemic control
- Vitamin B12 levels periodically, especially in long-term users or those with risk factors for deficiency
Doctor Notes
- Assess renal function (eGFR) before initiating and periodically during metformin therapy.
- Counsel patients on the symptoms of lactic acidosis and emphasize avoiding excessive alcohol intake.
- Consider vitamin B12 supplementation for patients on long-term metformin therapy, especially if neurological symptoms or anemia develop.
Patient Guidelines
- Take Xelmet-XR with your evening meal to reduce stomach upset.
- Swallow the tablet whole; do not chew, crush, or break it.
- Inform your doctor if you have kidney problems or are going for any imaging tests with contrast.
- Monitor your blood sugar regularly as advised by your doctor.
- Adhere to diet and exercise recommendations.
Missed Dose Advice
If a dose is missed, 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-XR as monotherapy is unlikely to cause hypoglycemia, which could impair driving. However, if used in combination with other anti-diabetic agents (e.g., insulin, sulfonylureas) that can cause hypoglycemia, patients should be aware of the risk and take precautions.
Lifestyle Advice
- Maintain a balanced diet rich in fiber and low in refined sugars.
- Engage in regular physical activity (e.g., 30 minutes of moderate exercise most days of the week).
- Avoid smoking and limit alcohol consumption.
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