Metformin
Class:hypoglycaemic
Mechanism of action
Decreases hepatic
glucose production,decreasing intestinal absorption of glucose and improves
insulin sensitivity(increases peripheral glucose uptake and utilization).
Pharmacokinetics
Onset of
effect:within days,maximum effect upto 2 weeks.protein binding:92-99
percent.Elimination:renal;tubular secretion is major route.
Indications
Management of non
insulin dependent diabetes mellitus(type 2) as monotherapy when hyperglycemia
cannot be managed on diet alone.may be used concomitantly with a sulfonylurea
when diet and metformin or sulfonylurea alone do not result in adequate
glycemic control.
Contraindications
Hypersensitivity to
metformin or any component;renal disease or renal dysfunction,which may also
result from conditions such as cardiovascular collapse,acute myocardial
infarction,septicemia;acute or chronic metabolic acidosis with or without
coma(including diabetic ketoacidosis);should be temporarily withheld.
Precautions
Administration of
oral antidiabetic drugs has been reported to be associated with increased
cardiovascular mortality as compared to treatment with diet alone or diet plus
insulin.The kidney substantially excretes metformin-the risk of accumulation
and lactic acidosis increases with the degree of impairment of renal function.patients
with renal function below the limit of normal for their age should not receive
metformin.In elderly patients,renal function should be monitored regularly.
Side effects
Anorexia,nausea,vomiting,diarrhea,epigastric
fullness,
constipation,heartburn,rash,urticaria,photosensitivity,decreased vitmin B12 levels,blood dyscrasias,aplastic
anemia,hemolytic anemia,bone marrow
suppression,thrombocytopenia,agranulocytosis.
Pregnancy
Pregnancy risk factor
B.
Dosage
Initial:500 mg twice
daily(give with the morning and evening meals).dosage increases should be made
in increments of 1 tablet every week,given in divided doses,upto a maximum of
2500 mg/day.
Brands
