4fa23ef36edd8b34b69ad55dac5e0e02

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4fa23ef36edd8b34b69ad55dac5e0e02

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Composition
1 tab.

850 mg of metformin hydrochloride

Excipients: Microcrystalline cellulose 25.5 mg Croscarmellose sodium 51 mg Purified water 17 mg Povidone 68 mg Magnesium stearate 8.5 mg.
pharmachologic effect
Oral hypoglycemic agent from the group of biguanides (dimetilbiguanid). The mechanism of action of metformin is related to its ability to inhibit gluconeogenesis, as well as free fatty acids and fat oxidation. Metformin does not affect the amount of insulin in the blood, but changes its pharmacodynamics by reducing the ratio of bound to free insulin and improve insulin ratio to proinsulin. An important element in the mechanism of action of metformin is the stimulation of glucose uptake by muscle cells.

Metformin increases blood circulation in the liver and accelerates the process of converting glucose into glycogen. It reduces the level of triglycerides, LDL, VLDL. Metformin improves fibrinolytic properties of blood due to the suppression of tissue plasminogen activator inhibitor type.
Pharmacokinetics
Metformin is absorbed from the gastrointestinal tract. Cmax plasma is about 2 hours after ingestion. After 6 hours, the absorption from the gastrointestinal tract and ends gradually decreasing the concentration of metformin in the plasma.

Almost does not bind to plasma proteins. It accumulates in the salivary glands, liver and kidneys.

T1 / 2 -. 1.5-4.5 hours excreted by the kidneys.

When renal function is possible accumulation of metformin.
Side effects
From the digestive system: possible (usually at the beginning of treatment), nausea, vomiting, diarrhea.

From the Endocrine: hypoglycemia (especially when used in inadequate doses).

From a metabolism: in some cases — lactic acidosis (requires discontinuation of treatment).

From hemopoiesis system: on occasion — megaloblastic anemia.
sale Properties
prescription
Special conditions
Do not use in acute infections, exacerbation of chronic infectious and inflammatory diseases, trauma, acute surgical diseases, the danger of dehydration.

Do not use before surgery and for 2 days after the elections.

Not recommended for use with metformin in patients over 60 years of age and persons performing heavy physical work, which is associated with an increased risk of lactic acidosis.

In the period of treatment should monitor kidney function; determination of lactate in plasma should be at least 2 times per year, as well as the appearance of myalgia.

Perhaps the use of metformin in combination with sulfonylureas. In this case, you need a particularly careful control of blood glucose levels.

Apply metformin in combination therapy with insulin is recommended in the hospital setting.
testimony
Diabetes mellitus type 1 (insulin-dependent) — c to reduce insulin needs and prevent weight gain (as an adjunct to insulin therapy).

Diabetes mellitus type 2 (insulin-dependent) in the case of poor diet (especially for obesity).
Contraindications
Expressed human liver and kidney, cardiac and respiratory failure, acute phase of myocardial infarction, chronic alcoholism, diabetic coma, ketoacidosis, lactic acidosis (including history), diabetic foot syndrome, pregnancy, lactation, hypersensitivity to metformin
Drug interactions
While the use of sulfonylureas, acarbose, insulin, salicylates, MAO inhibitors, oxytetracycline, ACE inhibitors, with clofibrate, cyclophosphamide may increase the hypoglycemic effect of metformin.

While the use of corticosteroids, hormonal contraceptives for ingestion, adrenaline, glucagon, thyroid hormones, phenothiazine derivatives, thiazide diuretics, nicotinic acid may reduce the hypoglycemic action of metformin.

Simultaneous administration of cimetidine may increase the risk of lactic acidosis.
Dosage
Patients receiving no insulin, the first 3 days — 500 mg 3 times / day or 1 g of 2 times / day during or after meals. On the 4th day 14 day — 1 g 3 times / day. After the 15th day the dose is adjusted according to the level of glucose in the blood and urine. The maintenance dose is 100-200 mg / day. With simultaneous application of insulin at a dose of less than 40 IU / day dosing regimen of metformin is the same as with the insulin dose can be gradually reduced (by 4-8 IU / day every other day). If the patient receives more than 40 U / day, the use of metformin and insulin dose reduction requires great care and held in hospital