Formetin, pills 500mg, 30pcs

Composition

1 tablet contains:

Active ingredient-metformin hydrochloride 0.5 g or 0.85 g or 1 g

excipients:

medium-molecular povidone (polyvinylpyrolidone),

croscarmellose sodium,

magnesium stearate for the pharmaceutical industry.

Pharmacological action

Hypoglycemic agent for oral use of the biguanide group

KodATH:  A 10 VA 02

Pharmacological properties

Pharmacodynamics .

Metformin inhibits gluconeogenesis in the liver, reduces glucose absorption from the intestine, increases peripheral glucose utilization, and increases the sensitivity of tissues to insulin.

At the same time, it does not affect the secretion of insulin by beta cells of the pancreas, and does not cause hypoglycemic reactions. Reduces the level of triglycerides and low-density lipoproteins in the blood. Stabilizes or reduces body weight. It has a fibrinolytic effect by suppressing the tissue-type plasminogen activator inhibitor.

Pharmacokinetics.

After oral use, metformin is slowly absorbed from the gastrointestinal tract. Bioavailability after taking a standard dose is 50-60%. The maximum concentration in blood plasma is reached 2.5 hours after oral use.

Practically does not bind to plasma proteins. It accumulates in the salivary glands, muscles, liver and kidneys. It is excreted unchanged by the kidneys. The elimination half-life is 1.5-4.5 hours. With impaired renal function, accumulation of the drug is possible.

Indications

Type 2 diabetes mellitus when diet therapy is ineffective (especially in obese patients).

Contraindications

• diabetic ketoacidosis, diabetic precoma, coma;
• severe renal dysfunction;
• cardiac and respiratory failure, acute phase of myocardial infarction, acute cerebrovascular accident, dehydration, alcoholism, and other conditions that can contribute to the development of lactic acidosis;
• pregnancy and lactation;
• hypersensitivity to the drug;
• major surgery or trauma, when shown the conduct of insulin therapy;
• serious infectious diseases;
• the hepatic impairment;
• acute alcohol poisoning;
• lactic acidosis (including history);
• application for at least 2 days before and for 2 days after the radioisotope or radiological examinations with the use of iodinated contrast agents;
• adherence to a reduced-calorie diet (less than 1000 cal/day). It is not recommended to use the drug in people over 60 years of age who perform heavy physical work, due to the increased risk of developing lactic acidosis.

Side effects

From the digestive system:  nausea, vomiting, “metallic” taste in the mouth, lack of appetite, diarrhea, flatulence, abdominal pain.

From the side of metabolism:  in rare cases, lactic acidosis (requires discontinuation of treatment); with prolonged treatment-hypovitaminosis In 12 (malabsorption).

From the side of hematopoietic organs:  in some cases – megaloblastic anemia.

From the endocrine system:  hypoglycemia (when used in inadequate doses).

Allergic reactions:  skin rash.

Interaction

When used concomitantly with sulfonylureas, acarbose, insulin, nonsteroidal anti-inflammatory drugs, monoamine oxidase inhibitors, oxytetracycline, angiotensin-converting enzyme inhibitors, clofibrate derivatives, cyclophosphamide, (3-adrenoblockers, it is possible to increase the hypoglycemic effect of metformin.

When used concomitantly with glucocorticosteroids, oral contraceptives, epinephrine, sympathomimetics, glucagon, thyroid hormones, thiazide and loop diuretics, phenothiazine derivatives, nicotinic acid derivatives, the hypoglycemic effect of metformin may decrease. Cimetidine slows down the elimination of metformin, which increases the risk of lactic acidosis.

Metformin may weaken the effect of anticoagulants (coumarin derivatives). Lactic acidosis may occur when alcohol is consumed at the same time. Nifedipine increases absorption, maximum concentration, slows down the elimination of metformin.

Cationic drugs (amiloride, digoxin, morphine, procainamide, quinidine, quinine, ranitidine, triamterene, vancomycin) secreted in the tubules compete for tubular transport systems and can increase the maximum concentration of the drug by 60% with prolonged therapy.

How to take, course of use and dosage

The dose of the drug is set by the doctor individually, depending on the level of glucose in the blood.

Take without chewing during or after a meal, with a sufficient amount of water. The initial dose is 0.5 g 1-2 times a day or 0.85 g 1 time a day, gradually (1 time a week) the dose is increased to 2-3 g per day. The maximum daily dose is 3 g.

In elderly patients, the daily dose should not exceed 1 g. Due to the increased risk of lactic acidosis, with severe metabolic disorders, the dose of the drug should be reduced.

Overdose

Metformin overdose may lead to fatal lactic acidosis. The cause of lactic acidosis may also be the accumulation of the drug due to impaired renal function.

Early symptoms of lactic acidosis include general weakness, nausea, vomiting, diarrhea, decreased body temperature, abdominal pain, muscle pain, decreased blood pressure, reflex bradyarrhythmia, and later rapid breathing, dizziness, impaired consciousness, and coma may occur.

Treatment: If signs of lactic acidosis appear, treatment with metformin should be stopped immediately, the patient should be urgently hospitalized and the diagnosis should be confirmed by determining the lactate concentration.

The most effective measure for removing lactate and metformin from the body is hemodialysis. Symptomatic treatment is also performed.

Special instructions

During treatment, it is necessary to monitor kidney function. At least 2 times a year, as well as when myalgia occurs, the plasma lactate content should be determined.

It is possible to use Formetin in combination with sulfonylurea derivatives. In this case, especially careful monitoring of blood glucose levels is necessary.

Influence on the ability to drive vehicles and work with mechanisms:

When used in monotherapy, Formetin does not affect the ability to drive vehicles and work with mechanisms.

When Formetin is combined with other hypoglycemic agents (sulfonylurea derivatives, insulin, etc. ), hypoglycemic conditions may develop, in which the ability to drive vehicles and engage in other potentially dangerous activities that require increased attention and rapid psychomotor reactions deteriorates.

Form of production

white tablets are round flat-cylindrical with a chamfer and a risk (with a dosage of 0.5 g) and white tablets are oval biconvex with a risk on one side (with a dosage of 0.85 g and 1.0 g).

Storage conditions

Store in a dry place, protected from light, at a temperature not exceeding 25 °C

Shelf life

2 years

Active ingredient

Metformin

Conditions of release from pharmacies

By prescription

Dosage form

Tablets

Description

For adults as directed by your doctor

Indications

Type 2 Diabetes