Diabetes is one of the problems of our society, the number of people suffering from it is increasing every day. The increase in the number of diabetes all over the world has caused the need for new and effective methods in managing this disease. Glucophage tablets are one of the most important drugs to control diabetes. Metformin is a valuable drug that plays a very important role in reducing blood sugar and managing diabetes. This drug is also known as a synthetic insulin, which is recommended for people with type 2 diabetes. The main mechanism of action of this drug is to increase the sensitivity of body cells to insulin, which reduces the amount of glucose in the blood.
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Pharmaceutical forms of glucophage
Pharmacies produce their products in pharmaceutical forms such as tablets, capsules, syrups, injectable solutions, serums, etc. Each of these forms is used in different cases and diseases. The doctor should prescribe the best forms of medicine according to the physical conditions of the patient, the age of the patient (adults, elderly and children) and the type of disease. Glucophage dosage forms include immediate-release tablets 500 mg, 850 mg and 1000 mg, long-acting tablets 500 mg (generic, Glometza), 750 mg and 1000 mg (generic, Glometza), oral solution on the market Supplied.
Uses of Glucophage tablets
Glucophage or metformin tablets are used with a proper diet and exercise program and possibly with other medications to control high blood sugar. Controlling high blood sugar can help prevent kidney damage, blindness, neurological problems, loss of limbs, and problems with sexual function. Proper diabetes control may also reduce the risk of heart attack or stroke. This medicine works by helping to restore your body’s proper response to the insulin you naturally produce. It also reduces the amount of sugar your liver makes and your stomach or intestines absorb.
Uses of metformin tablets in adults
- Type 2 diabetes
- Prevention of type 2 diabetes
- Polycystic ovary syndrome
- Myoclonus epilepsy
Taking metformin tablets in the elderly
Elderly patients are more likely to have reduced kidney function. This drug is contraindicated in patients with renal failure, carefully monitor kidney function in the elderly and use with caution as they age. It is contraindicated in patients over 80 years of age, unless normal kidney function is determined. The initial and maintenance dose of glucophage (metformin) in elderly patients should be conservative, as there is a possibility of decreased renal function in this population. Controlled clinical studies of metformin did not include sufficient numbers of elderly patients to determine whether they respond differently from younger patients.
Pharmacological effects and mechanism of action of metformin drug
decrease in hepatic glucose production; Decreases GI glucose uptake and increases target cell insulin sensitivity. Renal clearance of this drug is 450-540 ml/min (regular release) and finally it is excreted through urine (90%) by tubular secretion.
Dosage of metformin
Take Glucophage (metformin) tablets orally as directed by your doctor, usually 1 to 3 times a day with food. Drink plenty of fluids while taking this medication, unless your doctor tells you otherwise. Measure your dose carefully with a special device or spoon. Dosage is determined based on your medical condition, response to treatment, and other medications you may be taking. To reduce the risk of side effects (such as stomach upset), your doctor may instruct you to start this medication at a low dose and gradually increase your dose.
Dosage of metformin tablets (Glucophage) in adults
- Glucophage tablets are used as an adjunct to diet and exercise to improve blood sugar control in adults with type 2 diabetes.
- The dosage for the treatment of type 2 diabetes is 500 mg every 12 hours or 850 mg daily with meals.
- For type 2 diabetes with extended-release tablets, 500 mg daily with dinner is recommended.
- It can be used to control the determination of orphans in the treatment of polycystic ovary syndrome and myoclonus epilepsy in children with the doctor’s prescription.
- Finally, for the prevention of type 2 diabetes, 850 mg daily can be consumed as prescribed by the doctor.
Time to take Glucophage tablets
Before starting to take metformin, carefully read the drug information on the product packaging. If your doctor has prescribed this medicine for you, take the product as directed by your doctor to get the most benefit from it. If you are already taking another diabetes medication (such as chlorpropamide), follow your doctor’s instructions carefully for stopping or continuing the old medication and starting metformin. Monitor your blood sugar regularly, tell your doctor if your blood sugar reading is too high or too low.
Precautions
This product may contain inactive ingredients that can cause allergic reactions or other problems. Before using glucophage (metformin) tablets, inform your doctor of your medical history, such as severe respiratory problems (such as obstructive lung disease, severe asthma), blood problems (such as anemia, vitamin B12 deficiency), kidney disease, liver disease, etc. . If you are taking certain herbal or chemical medicines, you may need to stop taking them for a while. Older people may be at greater risk for side effects such as low blood sugar or lactic acidosis.
- Concomitant use of insulin and insulin-secreting agents (eg, sulfonylureas) may increase the risk of hypoglycemia. Therefore, to minimize the risk of hypoglycemia in combination with metformin, a lower dose of insulin or an insulin secretagogue may be required.
- Withholding food and fluids during surgery or other procedures may increase the risk of volume depletion, hypotension, and kidney failure. Treatment should be temporarily discontinued while patients have restricted food and fluid intake.
- There is an increased risk of severe hypoglycemia, especially in the elderly, frail or malnourished, adrenal or pituitary insufficiency, dehydration, hypoxic conditions, liver or kidney failure, stress from infection, fever, trauma, or surgery.
- Metformin treatment may need to be discontinued and insulin administered if exposed to stress (fever, trauma, infection) or experience diabetic ketoacidosis.
- Several cases of lactic acidosis associated with metformin have occurred postmarketing in the setting of acute congestive heart failure (especially when associated with hypoperfusion and hypoxemia).
- This drug may interfere with the use or absorption of vitamin B12 and calcium. With long-term treatment, monitor serum B12 concentrations periodically.
- It is not recommended for use in patients with type 1 diabetes who are dependent on insulin due to lack of efficacy.
- Avoid in patients with dehydration or prerenal azotemia.
- Definitive evidence of macrovascular risk reduction with metformin has not been established.
Contraindications to the use of glucophage
- Pregnancy and breastfeeding
- Diabetic ketoacidosis with or without coma
- Severe kidney disease
- Abnormal creatinine clearance due to shock, septicemia, or myocardial infarction
- Allergy to metformin
Glucophage side effects (metformin)
Nausea, vomiting, stomach upset, diarrhea, weakness or metallic taste in the mouth, etc. are some of the side effects of Glucophage tablets. If any of these effects persist or worsen, tell your doctor or pharmacist right away. Stomach symptoms that occur after the first few days of your treatment may be signs of lactic acidosis. Most people who use this drug do not experience serious side effects. Metformin does not usually cause hypoglycemia. Low blood sugar may occur if this drug is prescribed with other diabetes medications.
- diarrhea
- nausea and vomiting
- Low serum vitamin B-12
- stomach ache
- constipation
- Indigestion/heartburn
- Flatulence
- Dizziness and headache
- Upper respiratory tract infection
- taste disorder
- Cholestatic, hepatic, and mixed hepatic injury
Glucophage drug interactions
Drug interactions may change how your medications work or increase your risk of serious side effects. Patients, before visiting the doctor, prepare a list of chemical and herbal medicines you use and show them to him. Beta-blocker medications (such as metoprolol, propranolol, glaucoma eye drops such as timolol) may prevent the rapid heartbeat or palpitations you usually feel when you bleed. Other symptoms of low blood sugar, such as dizziness, hunger, or sweating, are not affected by these drugs. Many medications can affect your blood sugar and make it harder to control.
Taking glucophage (metformin) tablets during pregnancy and breastfeeding
Limited data in pregnant women are insufficient to determine the risk associated with metformin glucophage tablets for birth defects or miscarriage. Published studies on metformin use during pregnancy have not reported a clear association with birth defects or risk of miscarriage. Poorly controlled diabetes mellitus in pregnancy increases the risk of diabetic ketoacidosis, preeclampsia, spontaneous abortion, premature delivery, stillbirth, and birth complications. Also, diabetes mellitus with poor control will increase the risk of major birth defects, stillbirths and complications related to macrosomia.
Animal and human studies for glucophage tablets in pregnancy
- Published data from post-marketing studies have not reported a clear association with metformin and major birth defects, miscarriage, or adverse maternal or fetal outcomes when used during pregnancy. However, due to methodological limitations, including small sample sizes and inconsistent comparison groups, these studies cannot definitively prove the absence of risk associated with glucophage tablets.
- Metformin hydrochloride (Glucophage) did not adversely affect developmental outcomes when administered to pregnant rats and rabbits at doses up to 600 mg/kg/day. This represents an exposure of approximately 2 and 5 times the clinical dose of 2550 mg based on body surface area comparisons for rats and rabbits. Fetal concentration determination showed a partial placental barrier for metformin.
The effect of glucophage (metformin) in breastfeeding
Limited published studies report that glucophage is present in human milk. However, there is not enough information to determine the effects of this drug on nursing infants, and no studies are available on its effects on breast milk production. Therefore, the developmental and health benefits of breastfeeding should be considered along with the mother’s clinical need for treatment and any potential adverse effects on the nursing infant from the mother’s treatment or underlying disease.
Glucophage tablet storage conditions
Glucophage (Metformin) should be stored at room temperature away from light and moisture. Keep all chemical and herbal medicines out of the reach of children and animals. Dispose of this product properly when it has expired or is no longer needed. Avoid pouring all kinds of medicines into the toilet well, street and sewer.
The last word about Glucophage tablets
Despite the many benefits that glucophage (metformin) offers and we mentioned them in this article from Green Positive Online Pharmacy magazine, it should be noted that this drug requires medical supervision and advice. Possible side effects such as changes in blood glucose levels, digestive problems and effects on kidney function should be considered. Also, optimal use and taking the right amount of this drug is very important to reduce side effects.
In general, this drug is an effective and valuable drug in the management of diabetes, which can help people with this disease to have a better quality of life. Due to the importance of this issue, people should consult with their doctor about the most suitable strategies and drugs to manage their diabetes and be careful when taking drugs.
Site source: Medscape