Description of the drug
For the treatment of diabetes mellitus, oral hypoglycemic medications are used. One of the most effective representatives of this pharmacological group is Metformin. The standard instructions for the use of Metformin indicate that the drug normalizes blood glucose levels and is used to eliminate the symptoms of polycystic ovaries. The use of Metformin rarely leads to the manifestation of negative reactions from internal organs or systems. It has a quick, mild therapeutic effect. Many people prefer to use this drug for weight loss. Judging by the reviews of metformin-online.com, the medicine helps to lose weight without affecting the general condition of the body. How to take Metformin for weight loss, you should find out from your doctor. Before use, it is necessary to determine the presence or absence of an allergy to the components. You can buy Metformin in our pharmacy. Prescription drug is dispensed. The price of Metformin depends on the manufacturer, the number of tablets and the dosage of the active ingredient.
Release form, composition
Metformin is marketed in tablet form. The tablets have a rounded shape and are covered with a special film membrane, which dissolves, penetrating the intestines. Tablets are packaged in blisters of 120 or 30 pieces. In our pharmacy, Metformin is presented in all dosages. Metformin is based on metformin hydrochloride. One may contain 500 or 850 mg of the main active substance. Also, manufacturers use a number of additional components. The list of excipients consists of: • corn starch; • povidone K90; • talc; • magnesium stearate; • crospovidone. The following substances were used for the production of the film coating: talc, titanium dioxide, macrogol 6000, eudragit L 100-55, methacrylic acid.
Metformin belongs to biguanides. Its mechanism of action is to inhibit the process of gluconeogenesis in the liver. The use of Metformin entails a decrease in the absorption of glucose from the gastrointestinal tract, increasing the susceptibility of tissues to insulin. Under the influence of tablets, a decrease in blood levels of triglycerides and lipoproteins with low density is observed, peripheral glucose utilization is enhanced. The rate of lipoproteins, which are characterized by high density, increases by about 30%. The drug reduces the craving for food, due to which the extra pounds gradually disappear. It has fibrinolytic properties. The drug exhibits an inhibitory effect directed at tissue-type plasminogen activator inhibitors. Biotransforms glucose into glycogen, accelerates blood flow in liver tissues, and helps to reduce the degree of fat oxidation. The drug has an inhibitory effect on the production of free radicals and changes the pharmacodynamics of insulin. The mechanism of influence of the drug lowers the concentration of glucose after eating and normalizes the base level. Thanks to the drug, hyperinsulinemia is stopped, which is the reason for the development of complications in the cardiovascular system and weight gain in diabetes. With glucose values within normal limits, this drug does not lead to their change. Metformin has a slowing effect on the proliferation of smooth muscle sections of the vascular walls. Prevents the progression of diabetic angiopathy. Effective after 2.5-3 hours, when the maximum level of concentration of the main component is fixed in plasma. The bioavailability level reaches 50-60%. A small amount of the active substance comes into contact with plasma proteins. The accumulation of the active component of the drug is carried out in the kidneys / liver, salivary glands, and muscles. It is excreted from the body for about 6-6.5 hours with urine in its original form, since the substance is not metabolized. If the patient’s organ performance is impaired, there is a risk of cumulation of the drug.
Before taking Metformin tablets, you should understand what they help from. Treatment with Metformin should be carried out with the permission of a qualified specialist and in the presence of certain conditions. The main indications for the use of Metformin: 1. Type I and II diabetes mellitus. 2. Obesity, which occurs in connection with an increased concentration of glucose. 3. Polycystic ovary syndrome (polycystic syndrome). To lose weight, it is not enough just to take Metformin, you must adhere to proper nutrition, fill the diet with healthy foods and connect physical activity. Running, swimming, morning exercises are suitable. In the absence of doctor’s recommendations and indications, Metformin is better not to use, so as not to provoke a worsening of the condition. Metformin can be used as a single drug or as part of polytherapy with antidiabetic drugs and insulin. It is noted that with a separate dose, it is much less likely to cause negative reactions. The drug does not have painkillers, so Metformin is not prescribed for pain. The drug has a positive effect on the menstrual cycle. With irregular periods, Metformin contributes to their normalization. Over the past few years, scientists have been checking whether the drug can be used to diagnose non-alcoholic fatty liver disease or premature puberty. To date, these indications are experimental, and there is not enough information regarding its effectiveness, despite the fact that many studies have been conducted.
Metformin tablets are intended for oral administration. They must be swallowed whole, washed down with clean water. Experts recommend taking Metformin before or after meals, since meals have no particular effect on the effectiveness of the drug. The therapeutic regimen is developed by the doctor individually, based on the level of glucose in the blood. The standard instructions indicate the average initial dose – 1-2 tablets (500-1000 mg) per day. If necessary, after 10-14 days of treatment, the doctor can adjust the dosage of Metformin. An increase in dosage occurs after checking the level of glucose in the blood. The maximum allowable amount of medication in 24 hours is 6 tablets (3000 mg). Patients after 65 years of age are not recommended to take more than two tablets per day. With age, the process of removing the drug from the body slows down, so the risk of an overdose increases. To maintain normal levels of glucose, 1,500-2,000 mg are prescribed three to four times a day. For a more convenient intake, the daily amount of the drug can be divided into several equal doses. Thus, it will be possible to avoid the manifestation of negative reactions from the organs of the gastrointestinal tract. With polytherapy, which in addition to Metformin, insulin enters in the first days, the amount of the drug does not decrease. After 2-3 days, the dosage of insulin should be reduced. If before Metformin the patient was taking another hypoglycemic drug, first you need to stop taking this drug, and then start a new course. Doctors do not recommend combining medications. In Moscow, Metformin can be ordered in our pharmacy.
In general, Metformin is well tolerated by patients. However, with an incorrectly selected scheme or increased susceptibility to components, negative reactions from internal systems can occur. The most common side effects of Metformin: • deviations in the digestive system: loss of appetite, vomiting, nausea, pain in the abdomen, flatulence, a taste of metal in the oral cavity; • metabolic process: very rarely observed lactic acidosis. In such cases, the use of Metformin tablets should be discontinued. When using the medicine for a long time, the absorption of vitamin B12 may be impaired, which may lead to deviations of hematopoiesis or megaloblastic anemia; • endocrine system: hypoglycemia; • circulatory system: anemia. If you are allergic to Metformin, rashes appear on the skin that may be accompanied by itching. If the patient is found to be intolerant of the components of the medication, the doctor can choose no less effective analogues of Metformin. To date, a large number of drugs are available that can be used to replace Metformin.
Metformin is a potent drug. Before using it, you must familiarize yourself with the contraindications. The list of conditions in which it is forbidden to take this drug includes: 1. Hypersensitivity to the components. 2. Gangrene. 3. Renal failure / renal dysfunction. 4. Diabetic precoma. 5. Coma. 6. Dehydration against vomiting and diarrhea. 7. Acute myocardial infarction, respiratory and heart failure. 8. Liver failure. 9. Children’s age. Children Metformin is prescribed only from the age of 15. 10. Lactic acidosis. 11. Fever. 12. Alcohol addiction. 13. Pathologies that are accompanied by tissue hypoxia. 14. Adrenal dysfunction. 15. Acute ethanol poisoning. 16. Intraarterial / intravenous administration of iodine-containing drugs. 17. Surgical interventions or extensive injuries. 18. A diet in which a person consumes no more than 1000 calories in 24 hours. If you are allergic to the components of the drug, you must choose a substitute for Metformin, which is based on other components. Analogs are selected not only by composition, but also by the principle of action. Since some of them may not have a sufficiently high degree of effectiveness, you must consult a doctor to select a substitute. An improperly selected drug can aggravate the situation and provoke the development of complications. Doctors also do not recommend taking Metformin during breastfeeding, as there is no information regarding its ability to pass into breast milk. In order not to harm the fragile body of the child, for the duration of therapy, experts recommend transferring the baby to artificial feeding.
Metformin is not prescribed during pregnancy. To date, there is not enough information regarding its impact on the fetal development process and the risk of pregnancy complications. If it is necessary to undergo treatment, you can choose Metformin analogues that are safer for the fetus. To do this, consult a doctor. He will choose the most optimal option, taking into account the diagnosis and the general condition of the patient. If conception occurred during the treatment course with Metformin, discontinue use and switch to insulin.
Use in old age
Specialists with increased caution prescribe Metformin to patients after 65 years of age who are engaged in performing heavy physical activities, since the risk of manifestation of lactic acidosis increases. The treatment of elderly patients should be carried out under the supervision of a qualified specialist. The maximum allowable amount of the drug per day is 1000 mg.
Reception of Metformin has a number of features. Before starting treatment, you must familiarize yourself with special instructions. Throughout the entire therapeutic course, kidney function should be monitored. Doctors recommend twice a year and at the first manifestations of signs to determine the level of lactate in the plasma. Also required procedures include checking the concentration of creatinine in plasma. It is carried out once every six months. It is especially important to check indicators in old age. If the creatinine level in men reaches 135 μmol / L and higher (in women -? 110 μmol / L), treatment with Metformin is prohibited. The simultaneous use of Metformin tablets and sulfonylurea derivatives is allowed. With complex therapy, it is necessary to systematically check the blood sugar level. If it became necessary to undergo intravenous angiography or urography, it is necessary to interrupt the course of treatment 2 days before and within two days after the procedure. If symptoms of an infection of the urethra are infectious or bronchopulmonary infections, the attending physician should be informed as soon as possible. Metformin in combination with other medicines can affect the ability to drive vehicles. It is also advisable to refrain from activities that require increased concentration of attention. Metformin as a single drug does not affect the ability to work with various mechanisms and drive vehicles. Specialists warn of the incompatibility of Metformin with alcohol. This combination increases the risk of lactic acidosis. In order not to harm the body and not cause complications, it is necessary to refrain from alcoholic beverages and medications, which are based on ethanol, during treatment. Among women, it is believed that Metformin helps to lose weight. In various forums you can find reviews about Metformin, which confirm that with its help you can quickly lose extra pounds without doing sports and not following diets. However, the main objective of the medication is not weight loss, but the normalization of the concentration of glucose in the blood. With normal glucose readings, it is not recommended to use the drug in order to reduce weight. This can be a health hazard. You must first consult with a qualified professional.
Excessive single use of Metformin or the use of a medication for a long period of time can provoke an overdose. When a large amount of a substance enters the body, the risk of developing lactic acidosis increases. This condition can develop with the cumulation of a drug with renal dysfunction. In the initial stages, the patent feels nauseous and there are bouts of vomiting. Body temperature may decrease, pain appears in the muscles and abdomen. Gradually, the condition worsens: dizziness occurs, breathing quickens, and consciousness is disturbed. In medical practice, cases have been recorded when the patient fell into a coma. Severe poisoning can cause death. If the first signs of an overdose of Metformin appear, interrupt treatment and take the patient to a medical facility to determine the level of lactate concentration. The most effective treatment for overdose is hemodialysis. This procedure helps to eliminate the substance from the body. If necessary, the doctor can choose additional therapeutic measures.
Doctors pay increased attention to the compatibility of Metformin with other medications. With simultaneous administration, they can enhance or completely neutralize the therapeutic effect of each other. Therefore, doctors allow taking other medications only 2-2.5 hours after taking the tablets. If the patient is taking any medications, he needs to inform the doctor at the first consultation so that he can draw up an effective and safe treatment regimen. Increased caution requires the combined use of Metformin with chlorpromazine (at a dosage of? 100 mg in 24 hours). The risk of developing glycemia increases, the rate of release of insulin decreases. In order not to provoke the hyperglycemic effect of Danazol, if necessary, simultaneous treatment should be adjusted, the dosage of both medicines should be adjusted. It is also necessary to control the level of glycemia. In combination with Metformin and Cimetidine, its excretion from the body slows down. Drugs that increase the level of Metformin in plasma: 1. Ranitidine. 2. Vancomycin. 3. Morphine. 4. Quinidine. 5. Nifedipine. 6. Quinine. 7. Triamteren. 8. Procainamide. 9. Amyloride. When combining these medications, the concentration of the antidiabetic drug rises by about 60%. In this regard, such combinations are strictly prohibited. Cholestyramine and Guar have a slowing effect on the absorption of metformin, which leads to a decrease in the degree of effectiveness of the drug. According to the instructions for use of Metformin, the drug can enhance the therapeutic effect of internal anticoagulants. The hypoglycemic effect is potentiated by: monoamine oxidase inhibitors, α2-adrenergic antagonists, clofibrate derivatives, non-steroidal anti-inflammatory drugs, cyclophosphamide derivatives, angiotensin-converting factor inhibitors. In combination with medicines that contain iodine, patients may develop renal failure.
Terms and conditions of storage
The shelf life of the drug is 2 years from the date of issue. The date is indicated on the package. At the end of the shelf life, it is strictly forbidden to take pills. So that the medicine does not deteriorate ahead of time, storage conditions must be observed. The instructions for use of Metformin indicate that the medication should be stored out of the reach of small children, dry, protected from direct sunlight, at an air temperature of 15 to 25 ° C.