Metformin-Richter tablets 500 mg 60 pcs. in Moscow
Lactic acidosis
Lactic acidosis is a rare but serious (high mortality rate if not treated promptly) complication that may occur due to accumulation of metformin. Cases of lactic acidosis when taking metformin occurred mainly in patients with diabetes mellitus with severe renal failure.
Other associated risk factors, such as decompensated diabetes mellitus, ketosis, prolonged fasting, alcoholism, liver failure and any condition associated with severe hypoxia, should be considered, which may help reduce the incidence of lactic acidosis.
The risk of developing lactic acidosis should be taken into account when nonspecific signs appear, such as muscle cramps accompanied by dyspeptic disorders, abdominal pain and severe asthenia. Lactic acidosis is characterized by acidotic shortness of breath, abdominal pain and hypothermia followed by coma. Diagnostic laboratory parameters are a decrease in blood pH (less than 7.25), lactate content in the blood plasma over 5 mmol/l, increased anion gap and lactate/pyruvate ratio. If lactic acidosis is suspected, stop taking the drug and consult a doctor immediately.
Surgical operations
The use of metformin should be discontinued 48 hours before elective surgery and can be continued no earlier than 48 hours after, provided that renal function has been found to be normal during the examination.
Kidney function
Since metformin is excreted by the kidneys, before starting treatment and regularly thereafter, it is necessary to determine CC: at least once a year in patients with normal renal function, and 2-4 times a year in elderly patients, as well as in patients with CC at the lower limit norms.
Particular caution should be exercised in case of possible impairment of renal function in elderly patients, with simultaneous use of antihypertensive drugs, diuretics or non-steroidal anti-inflammatory drugs.
Children and teenagers
The diagnosis of type 2 diabetes mellitus must be confirmed before starting treatment with metformin.
In clinical studies lasting 1 year, metformin was shown to have no effect on growth and puberty. However, due to the lack of long-term data, careful monitoring of the subsequent effects of metformin on these parameters in children, especially during puberty, is recommended. The most careful monitoring is necessary in children aged 10-12 years. Other precautions:
- Patients are advised to continue to follow a diet with even carbohydrate intake throughout the day. Overweight patients are advised to continue to follow a low-calorie diet (but not less than 1000 kcal/day).
- It is recommended that routine laboratory tests be performed regularly to monitor diabetes mellitus.
- Metformin does not cause hypoglycemia when used alone, but caution is recommended when used in combination with insulin or other hypoglycemic agents (for example, sulfonylureas or repaglinide).
Impact on the ability to drive vehicles and machinery:
Monotherapy with Metformin does not cause hypoglycemia, and therefore does not affect the ability to drive vehicles and machines.
However, patients should be warned about the risk of hypoglycemia when using metformin in combination with other hypoglycemic drugs (sulfonylurea derivatives, repaglinide, insulin), which impairs the ability to drive vehicles and engage in other potentially hazardous activities that require increased attention and rapid psychomotor speed. reactions.
Buy Metformin-Richter film-coated tablets 500 mg No. 60 in pharmacies
Instructions for use
Metformin-Richter tab p.o 500mg No. 60
Dosage forms
tablets 500 mg Synonyms Bagomet Vero-Metformin Gliminfor Gliformin Glucophage Glucophage Long Diaformin OD Metfogamma 1000
Metformin
Siofor 1000
Formetin Group Antidiabetic agents - biguanides International nonproprietary name Metformin Composition Active substance - metformin hydrochloride. Manufacturers Gedeon Richter (Hungary) Pharmacological action Hypoglycemic. Reduces the concentration of glucose in the blood and the level of glycosylated hemoglobin, increases glucose tolerance. Reduces intestinal absorption of glucose, its production in the liver, potentiates sensitivity to insulin in peripheral tissues. Does not alter insulin secretion by beta cells of the pancreatic islets. Normalizes the lipid profile of blood plasma in patients with non-insulin-dependent diabetes mellitus: it reduces the content of triglycerides, cholesterol and LDL and does not change the levels of lipoproteins of other densities. Stabilizes or reduces body weight. Rapidly absorbed from the gastrointestinal tract. The maximum concentration is reached after approximately 2 hours. Absorption from the gastrointestinal tract ends after 6 hours and the concentration in the blood begins to gradually decrease. Can accumulate in the salivary glands, liver and kidneys. It is excreted unchanged by the kidneys. The half-life is 6.2 hours (plasma) and 17.6 hours (blood), because accumulates in erythrocytes. Side effects At the beginning of the course of treatment - anorexia, diarrhea, nausea, vomiting, flatulence, abdominal pain (reduced when taken with meals); metallic taste; megaloblastic anemia; lactic acidosis (respiratory disturbances, weakness, drowsiness, hypotension, reflex bradyarrhythmia, abdominal pain, myalgia, hypothermia), hypoglycemia; rashes and dermatitis. Indications for use Diabetes mellitus type 2 with ineffective correction of hyperglycemia by diet therapy, incl. in combination with sulfonylureas; type 1 diabetes mellitus as an adjunct to insulin therapy. Contraindications Hypersensitivity, kidney disease or renal failure, severe liver disorders, cardiac and respiratory failure, acute phase of myocardial infarction, infectious diseases, major operations and injuries, chronic alcoholism, acute or chronic metabolic acidosis, including diabetic ketoacidosis with or without coma, conducting research using radioactive isotopes of iodine, pregnancy, breastfeeding. Restrictions on use: Children and the elderly (over 65 years of age). Directions for use and dosage : Orally, during or immediately after meals. Monotherapy and combination therapy with other oral hypoglycemic agents. The initial dose is 500-1000 mg 1 time per day in the evening. After 7-15 days, if there are no adverse effects from the gastrointestinal tract, 500-1000 mg is prescribed 2 times a day in the morning and evening. A further gradual increase in the dose is possible depending on the concentration of glucose in the blood. Overdose Symptoms: lactic acidosis. Treatment: hemodialysis, symptomatic therapy. Interaction Phenothiazines, corticosteroids, thyroid hormones, estrogens, oral contraceptives, phenytoin, nicotinic acid, sympathomimetics, calcium antagonists, isoniazid, thiazide and other diuretics weaken the effect. Insulin, sulfonylurea derivatives, acarbose, NSAIDs, MAO inhibitors, oxytetracycline, ACE inhibitors, clofibrate derivatives, cyclophosphamide, beta-blockers enhance the effect. Furosemide increases the maximum concentration. Nifedipine increases absorption, maximum concentration, and prolongs elimination. Amiloride, digoxin, morphine, procainamide, quinidine, quinine, ranitidine, triamterene and vancomycin during long-term therapy can increase the maximum concentration by 60%. Incompatible with alcohol. Special instructions It is necessary to constantly monitor renal function, glomerular filtration, and blood glucose levels. Vitamin B12 levels should be determined once a year. When transferring a patient to metformin, it is prescribed immediately after discontinuation of the previous drug, with the exception of replacing chlorpropamide. It should not be used before surgical operations and within 2 days after them, as well as within 2 days before and after diagnostic studies. Should not be prescribed to people performing heavy physical work. Storage conditions List B. In a dry place, protected from light.
