The main ingredient of this product is metformin hydrochloride.
Chemical name: 1,1-dimethylbiguanidine hydrochloride.
Chemical structural formula:
Chemical structural formula:
Molecular formula: C4H11N5 · HCl
Molecular weight: 165.63
This product is a film coated tablet, which appears white after removing the coating.
This product is first used for type 2 diabetes with simple diet control and physical exercise ineffective in controlling blood sugar.
For adults, this product can be used for monotherapy or in combination with sulfonylurea drugs or insulin.
For children and adolescents aged 10 and above, this product can be used for monotherapy or in combination with insulin therapy.
Usage and dosage
In order to reduce the occurrence of gastrointestinal complications and to use the minimum dose of medication to control the patient's blood sugar, it should be taken from a small dose and gradually increased.
At the beginning of treatment and during the adjustment of dose (see the recommended medication plan), the measurement of fasting blood glucose can be used to determine the treatment response of the product and determine the minimum effective dose of the patient. Afterwards, glycated hemoglobin should be measured every three months. Whether used alone or in combination, the goal of treatment is to use the lowest effective dose to reduce the fasting blood glucose and glycosylated hemoglobin levels to normal or near normal levels.
Recommended medication plan
Adults with normal renal function (eGFR ≥ 90mL/min/1.73m2)
Single drug therapy and combination therapy with sulfonylurea drugs
The starting dose of this product (metformin hydrochloride tablets) is usually 500 milligrams twice a day, while the starting dose of this product (metformin hydrochloride tablets) is usually 500 milligrams twice a day; Take with meals. Can be gradually increased by 500 milligrams per week to 2000 milligrams per day, taken in batches. The maximum recommended dose for adults is 2500 milligrams per day. For patients who need further control of blood sugar, the dosage can be increased to 2500 milligrams per day. When the daily dose exceeds 2000 milligrams, it is best to take the medication in batches with three meals for better tolerance.
After 10 to 15 days, the dosage should be adjusted based on blood sugar levels. Slowly increasing the dose can improve gastrointestinal tolerance.
Combined use with sulfonylurea drugs
If patients who have not responded after taking the maximum recommended dose of this product for several weeks should consider gradually adding sulfonylurea oral hypoglycemic drugs while maintaining the maximum dose treatment, unless the patient already has primary or secondary failure to sulfonylurea drugs. Currently, there are only clinical and pharmacokinetic data on the interaction between metformin and glibenclae (glibenclae).
Combining this product with sulfonylurea drugs can achieve satisfactory blood sugar control by adjusting the dosage of both drugs. The risk of hypoglycemia caused by sulfonylurea drugs continues to exist or even increases when treated with this product, and appropriate prevention should be taken.
If the patient cannot satisfactorily control their blood sugar after 1 to 3 months of treatment with the maximum dose of this product combined with the maximum dose of oral sulfonylurea drugs, consideration should be given to changing the treatment method, including the combination of this product with insulin therapy or insulin therapy alone.
Combined use with insulin
The dosage of insulin can be maintained when starting to use this product. The initial dose of this product should be 500 milligrams per day for patients undergoing insulin treatment. If the patient's response is not sufficient, increase by 500 milligrams after 1 week, and then increase by 500 milligrams per week until satisfactory blood sugar control is achieved. The recommended maximum daily dose is 2500 milligrams. When the fasting blood glucose of patients who use this product in combination with insulin drops to 120mg/dL
When following, it is recommended to reduce insulin dosage by 10% to 25%. Individualized adjustments or medical advice should be continued based on the response to reduced blood sugar.
Dose adjustment in patients with impaired renal function
eGFR≥60mL/min/1.73m 2 No dose adjustment required, eGFR45-59mL/min/1.73m 2 Reduction, eGFR<45mL/min/1.73m 2 Disabled.
The usual starting dose of metformin hydrochloride is 500 milligrams, taken once a day with or after meals. After 10 to 15 days, the dosage should be adjusted based on blood sugar levels. Slowly increasing the dose can improve gastrointestinal tolerance. The maximum recommended dose of metformin hydrochloride is 2000 milligrams per day, taken in 2 or 3 doses.
[Adverse reactions]According to foreign literature reports:
At the initial stage of treatment, the most common adverse reactions are nausea, vomiting, diarrhea, abdominal pain, and loss of appetite, which most patients can usually alleviate on their own.
The following adverse reactions may occur when taking metformin.
The frequency of adverse reactions is defined as follows: very common (≥ 10%), common (1%~10%, including 1%), occasional (0.1%~1%, including 0.1%), rare (0.01%~0.1%, including 0.01%), very rare (<0.01%).
In each frequency group, adverse reactions are arranged in descending order of severity.
Metabolic and nutritional disorders:
? Lactic acid poisoning (see Precautions)
? Long term use of metformin may reduce the absorption of vitamin Bz ?. If the patient experiences megaloblastic anemia, this reason should be considered.
? Taste disorders
? Gastrointestinal abnormalities such as nausea, vomiting, diarrhea, abdominal pain, and loss of appetite. Most of these adverse reactions occur at the beginning of treatment, and most patients can usually alleviate them on their own. Slowly increasing the dose can improve gastrointestinal tolerance.
Abnormal liver and gallbladder function:
? Reports of individual cases with abnormal liver function or hepatitis that have returned to normal after discontinuing metformin use.
Skin and subcutaneous tissue abnormalities:
? Skin reactions, such as erythema, itching, urticaria
Other possible adverse reactions include: bloating, fatigue, indigestion, abdominal discomfort and headache, abnormal bowel movements, constipation, bloating, hypoglycemia, muscle pain, dizziness, dizziness, abnormal nails, rash, increased sweating, chest discomfort, chills, flu symptoms, hot flashes, palpitations, weight loss, etc.
In published data, post market data, and a one-year clinical controlled study conducted in a limited number of children aged 10-16, adverse events and their severity were similar to those in adults.
? Severe renal failure (eGFR<45mL/min/1.73m2);
? Acute conditions that may affect renal function, such as dehydration, severe infection, shock;
? Diseases that can cause tissue hypoxia (especially exacerbation of acute or onic diseases), such as decompensated heart failure, respiratory failure, recent myocardial infarction, and shock;
? Severe infections and injuries, major surgical procedures, clinical symptoms such as hypotension and hypoxia;
? Known allergies to metformin hydrochloride and any components in this product;
? Any acute metabolic acidosis, including lactic acidosis, diabetes ketoacidosis;
? The prodromal stage of Diabetic coma;
? Liver dysfunction, acute alcoholism, alcoholism;
? Individuals with uncorrected vitamin B12 and folic acid deficiencies.