Metformin Pharmland tablets p/o 850mg №10×3

Name:
Metformin tab 850mg No. 30 Pharmland
Description:
Dose 850 mg: white or almost white tablets, oblong, film-coated, scored on both sides. The main active substance Metformin Form of release: film-coated tablets Dosage 500 mg Indications for use Non-insulin-dependent diabetes mellitus (type II) in case of failure of diet therapy (especially in obese patients): As monotherapy or combination therapy in conjunction with other oral hypoglycemic agents or in combination with insulin for the treatment of adults; As monotherapy or combination therapy with insulin for the treatment of children over 10 years of age. Dosage and administration Monotherapy or combination therapy in conjunction with other oral glypoglycemic agents. The usual starting dose is 500 mg or 850 mg (metformin, 500 mg tablets or 850 mg film-coated tablets) 2 to 3 times daily with or after meals. After 10-15 days of treatment, the dose must be adjusted in accordance with the results of measurements of glucose levels in the blood serum. Slowly increasing the dose helps to reduce side effects from the digestive tract. The maximum recommended dose is 3000 mg per day, divided into 3 divided doses. In the case of a transition to treatment with metformin, it is necessary to stop taking another antidiabetic agent. Combination Therapy with Insulin Metformin and insulin can be used as combination therapy to achieve better blood glucose control. Usually the initial dose is 500 mg or 850 mg of the drug 2-3 times a day, while the dose of insulin is selected according to the results of measuring blood glucose levels. Children Monotherapy or combination therapy in combination with insulin The drug is used in children over 10 years of age. Usually the initial dose is 500 mg or 850 mg of the drug 1 time per day during or after meals. After 10-15 days of treatment, the dose must be adjusted in accordance with the results of measurements of glucose levels in the blood serum. Slowly increasing the dose helps to reduce side effects from the digestive tract. The maximum recommended dose is 2000 mg divided into 2-3 doses. In elderly patients, deterioration of renal function is possible, therefore the dose of metformin should be selected on the basis of an assessment of renal function, which must be carried out regularly. Application during pregnancy and lactation When planning pregnancy, as well as in the event of pregnancy when using the drug, it must be canceled and insulin therapy should be prescribed. During therapy with metformin, in the event of pregnancy, the patient should inform the doctor. Mother and newborn are subject to observation, since there is no data on the penetration of metformin into breast milk. This drug is contraindicated during lactation. If necessary, the use of the drug during breastfeeding, feeding the baby with breast milk is stopped. Precautions Lactic acidosis is a rare but severe metabolic complication that may result from accumulation of metformin hydrochloride. Cases of lactic acidosis have been reported in patients with diabetes mellitus and severe renal failure. Risk factors for lactic acidosis: poorly controlled diabetes mellitus, ketosis, prolonged fasting, excessive alcohol consumption, liver failure, or any condition associated with hypoxia. Lactic acidosis is characterized by muscle cramps, acidotic dyspnea, abdominal pain and hypothermia, and coma may develop in the future. If lactic acidosis is suspected, it is necessary to stop using the drug and immediately hospitalize the patient. Renal failure. Since metformin is excreted by the kidneys, serum creatinine levels should be checked before and during drug treatment, especially in patients with impaired renal function and in elderly patients. Caution should be exercised in cases where renal function may be impaired, for example, at the beginning of treatment with antihypertensive drugs, diuretics and at the beginning of NSAID therapy. Iodine-containing radiopaque agents. When conducting radiological studies using radiopaque agents, it is necessary to stop using the drug 48 hours before the study and not resume earlier than 48 hours after the X-ray examination and assessment of kidney function. Surgical interventions. It is necessary to stop the use 48 hours before the planned surgical intervention, carried out under general, spinal or epidural anesthesia, and not resume earlier than 48 hours after the operation and evaluation of renal function. Children. According to the results of clinical studies, there was no effect of metformin on growth and puberty in children. However, there is no data on the effect of metformin on growth and puberty with long-term use, therefore, the drug should be used with caution in children during puberty, especially those aged 10 to 12 years. If during treatment the patient has vomiting, abdominal pain, muscle pain, general weakness and severe malaise, the drug should be stopped immediately. These symptoms may be signs of the onset of lactic acidosis. It is possible to develop a bronchopulmonary infection or an infectious disease of the genitourinary organs. The drug is incompatible with alcohol. Patients need to follow a diet and monitor laboratory parameters. When used together with insulin or sulfonylurea derivatives, an increase in the hypoglycemic effect is possible. Interaction with other drugs The action of metformin is enhanced by NSAIDs, MAO inhibitors, oxytetracycline, ACE inhibitors, clofibrate derivatives, cyclophosphamide, beta-blockers. With the combined use of metformin with sulfonylurea derivatives, insulin, acarbose and salicylates, potentiation of the hypoglycemic effect is possible. Compatible with sulfonylurea derivatives, insulin. Nifedipine increases absorption, Cmax, prolongs the excretion of metformin. The effect of metformin is weakened by phenothiazines, thyroid hormones, estrogens, oral contraceptives, phenytoin, nicotinic acid, calcium antagonists, isoniazid. Therefore, more frequent monitoring of blood glucose levels in patients receiving these drugs is necessary, especially at the beginning of treatment. If necessary, the dose of the drug is adjusted both during such treatment and after its termination. The simultaneous use of guar gum or cholestyramine disrupts the absorption of the drug and reduces its effect. With the simultaneous use of the drug metformin with danazol, a hyperglycemic effect may develop (this combination is not recommended). When the drug metformin and chlorpromazine are used together, it should be borne in mind that the neuroleptic, when used in high doses, reduces the release of insulin and increases blood glucose levels (this may require dose adjustment of metformin under the control of blood glucose levels). With simultaneous injections of beta-2-sympathomimetics, the hypoglycemic effect of metformin may be weakened (it is necessary to control blood glucose and, if necessary, prescribe insulin). The effect of metformin is weakened by thiazide and other diuretics. Furosemide increases the Cmax of metformin by 22%. Metformin reduces Cmax and t1/2 of furosemide by 31% and 42.3%, respectively. The simultaneous use of loop diuretics and metformin can lead to lactic acidosis due to the possible development of functional renal failure. With the joint appointment of GCS (for systemic and local use), they affect the effectiveness of metformin, reducing glucose tolerance and increasing the level of glucose in the blood plasma, in some cases causing ketosis (if necessary, the use of such a combination requires dose adjustment of metformin under the control of blood glucose levels) . Drugs (amiloride, digoxin, morphine, procainamide, quinidine, quinine, ranitidine, triamterene, and vancomycin) secreted in the tubules compete for tubular transport systems and, with long-term therapy, can increase Cmax by 60%. The use of iodine-containing radiopaque agents for radiological examination against the background of the use of metformin can lead to the development of lactic acidosis against the background of functional renal failure. Cimetidine slows down the excretion of metformin and increases the risk of developing lactic acidosis. Metformin weakens the effect of indirect anticoagulants (coumarin derivatives). Against the background of the use of the drug metformin, alcohol and ethanol-containing drugs should not be consumed, as this increases the risk of developing lactic acidosis, especially when fasting or following a low-calorie diet. Contraindications Hypersensitivity to metformin or to an excipient that is part of the drug; Diabetic ketoacidosis, diabetic coma, coma; Impaired kidney function (creatinine clearance less than 60 ml / min); Acute conditions that occur with a risk of developing impaired renal function: dehydration of the body; B) severe infectious diseases; shock; D) the clinical manifestation of acute and chronic diseases that can lead to the development of tissue hypoxia (heart or respiratory failure, acute myocardial infarction, shock, etc.); E) use in radioisotope or X-ray studies with intravascular administration of iodine-containing contrast agents; Liver failure; Acute alcohol intoxication, alcoholism; Fever, hypoxic conditions (sepsis, kidney infections, bronchopulmonary diseases). CompositionDose 850 mg: metformin hydrochloride – 850 mg, calcium hydrogen phosphate dihydrate, corn starch, lactose monohydrate, povidone K-30, gelatin, talc, magnesium stearate, croscarmellose sodium, titanium dioxide (E 171), hydroxypropyl methylcellulose (E 464), ethyl cellulose ( E 462), propylene glycol, polyethylene glycol. Overdose When using the drug at a dose of 85 g, the development of glycemia is not observed. However, in this case, the development of lactic acidosis is observed. Early symptoms of lactic acidosis are nausea, vomiting, diarrhea, fever, abdominal pain, muscle pain, and later rapid breathing, dizziness, impaired consciousness and coma may occur. Side effectThe indicated adverse reactions occurred with the following frequency: Very often (> 1/10); Often (> 1/100, <1/10); Uncommon (> 1/1000, <1/100); Rare (> 1/10,000, <1/1000); Very rare (<1/10000), including isolated reports. From the gastrointestinal tract: often, especially at the beginning of treatment - nausea, vomiting, "metallic" taste in the mouth, lack of appetite, flatulence, diarrhea, abdominal pain. Slowly increasing the dose reduces side effects from the gastrointestinal tract. Symptoms usually go away on their own. The appointment of antacids, atropine derivatives or antispasmodics weakens these symptoms. If dyspeptic symptoms persist, treatment should be discontinued. Metabolic disorders: very rarely with long-term treatment - lactic acidosis (treatment withdrawal is required). A decrease in the absorption of vitamin B12 is accompanied by a decrease in its level in the blood serum. Observed when prescribing metformin to patients with a history of megaloblastic anemia. From the nervous system: often - a violation of taste. On the part of the digestive system: individual reports - a decrease in liver function, drug-induced hepatitis, which are leveled when metformin is canceled. From the skin and subcutaneous tissue: very rarely - skin rash, itching, urticaria. In some conditions, taking these drugs increases the likelihood of developing lactic acidosis. The likelihood of developing lactic acidosis may increase in case of an overdose. Storage conditions In a place protected from light at a temperature not exceeding 25 ° C. Keep out of the reach of children. Buy Metformin Farmland tablets p/o 850mg No. 10x3