Metformin Stella 850mg tablets for diabetes (4 blisters x 15 tablets)

Dosage form Box of 4 blisters x 15 tablets
Specifications Metformin

Ingredient

Composition information	Content
Metformin	850mg

Uses

Indications

Metformin 850mg Stella is indicated in the following cases:

Treatment of diabetes does not depend on insulin (type II): Single therapy, when unable to treat blood glucose with a simple diet. sufficient. Biguanid.

ATC code: A10BA02

Metformin is a Biguanid -group anti -diabetic drug. Unlike sulfonylure, Metformin does not stimulate the release of insulin from the pancreatic beta cells. The drug has no effect of lowering blood glucose in humans without diabetes, in people with diabetes, metformin reduces hyperglycemia but does not cause a hypoglycemic catastrophe (except for fasting or coordinating synonyms).

metformin reduces glucose levels in plasma, when hungry and after meals, in patients with type II diabetes (regardless of insulin). The mechanism of the peripheral effect of Metformin is to increase the use of glucose in the cell, improve the link of insulin to the receptor and perhaps both the effect of the receptor, the synthesis of glucose synthesis in the liver and reducing the absorption of glucose in the intestine.

In addition to anti -diabetes effects, metformin has somewhat good effects on lipoprotein metabolism, often disorders in people with diabetes without insulin. Contrary to the sulfonylurea, the weight of the person treated with metformin tends to be stable or may decrease slightly.

pharmacokinetics

metformin hydrochloride is absorbed slowly and incomplete in the digestive tract. The absolute bioavailability of the 500mg single dose is reported from 50 - 60% and can be reduced when used with food. When absorbed, the drug is associated with negligible plasma proteins and is eliminated in a constant form in the urine. Selling waste time in plasma is reported between 2 and 6 hours after drinking. A small amount of metformin hydrochloride is distributed into breast milk.

Before taking Metformin Stella 850mg tablets for diabetes (4 blisters x 15 tablets)

How to use

metformin Stella 850mg is used by oral with meals or after eating.

Transferring from other anti -diabetes drugs to:

generally no transition period, unless moving from chlorpropamid to. When switching from chlorpropamid to the first 2 weeks, the existence of chlorpropamid lasts in the body, which can lead to the effect of the effect of the drug and can cause hypoglycemia.

Simultaneous treatment with Metformin and Sulfonylurea oral:

If the patient does not respond to treatment for 4 weeks at the maximum dose of metformin in a single therapy, it is necessary to gradually add a oral sulfonyluree while continuing to use Metformin at the maximum dose, whether it has previously had a primary or secondary failure with a sulfonylurea. When treated in combination with the maximum dose of both drugs, but patients do not respond for 1-3 months, they often have to stop treating with anti -diabetes drugs and start taking insulin.

Dosage

recommended dose: Starting dose for patients who are not using Metformin is 500mg, 1 time/day, oral use. If the patient does not have a harmful reaction to the gastrointestinal tract and need to increase the dose, an additional 500mg can be used after each treatment period from 1 to 2 weeks. The dose of Metformin should be considered for adjustment on each specific patient based on the effect and tolerance of the patient and not exceeding the maximum dose recommended as 2000mg/day.

Adults:

Start taking 1 capsule/time, drink 1 time (drink for breakfast). Increasing a dose of 1 tablet 1 day, 1 week 1 week, divided into several doses to the maximum of 3 capsules/day. The maintenance dose is usually used as 1 capsule 2 times/day (drink at breakfast and dinner). Some patients can use 1 capsule 3 times/day (at meals).

Children ≥ 10 years old and teenagers:

Single and combined with insulin: The normal starting dose is 1 tablet once a day. After 10 to 15 days, the dose should be adjusted based on blood glucose measurement. The highest dose proposed is 2g/day, divided into 2-3 doses.

Elderly:

The starting dose and maintenance dose need to be reserved, because there may be renal function impairment . Typically, elderly people should not treat to the maximum dose of metformin.

Recommendation of using drugs in patients with renal failure:

Review kidney function before the beginning of treatment with Metformin and periodic assessment. EGFR drops below 45ml/minute/1.73m2, risk assessment - benefits when continuing treatment.

Due to the risk of lactic acid infection rare but nearly 50% of death cases, Metformin must be avoided for people with clinical and testing liver disease.

Stop using Metformin when performing an image diagnostic test using contrast drug containing iodine:

On patients with EGFR in the range of 30 - 60ml/minute/1.73m2, in patients with a history of liver, alcoholism or heart failure, or on patients, they will use iodine -containing iodine contrast drugs through artery lines, stop metformin before or at the time of diagnostic testing tests using iodine -containing optical drugs containing iodine. Reassess the EGFR after a 48 -hour projection, reuse Metformin if the kidney function is stable.

Note: The above dose is for reference only. Specific dosage depends on the condition and level of progression of the disease. For a suitable dose, you need to consult a doctor or medical specialist.

What to do when overdose?

Metformin can be differentiated with the clearance coefficient of up to 170ml/minute; Hemolysis can have the effect of eliminating accumulated drugs in patients suspected of using overdose.

What to do when forgetting 1 dose? However, if the time to relax with the next dose is too short, skip the dose and continue the calendar of the drug. Do not use double dose to compensate for missed dose.

Side Effects

When using Metformin 850mg Stella , you may experience unwanted effects (ADR).

The most unwanted effects of Metformin are digestive. These effects are related to the dose, and often occur at the beginning of treatment, but often temporary.

Common (1/100 ≤ ADR

digestive: anorexia, nausea, vomiting, diarrhea, epigastric, constipation, heartburn.

Hematology: Blood dysplasia, aquatic anemia, hemolytic anemia, myeloma, thrombocytopenia, grain leukemia.

Can reduce the side effects of the drug by reducing the dose.

When experiencing side effects of the drug, it is necessary to stop using and notify the doctor or go to the nearest medical facility for timely treatment.

Warnings

Before using the drug you need to read the instructions carefully and refer to the information below.

Contraindicated

Patients who have a history of hypersensitivity to Metformin or any excipients of the drug. 1.5mg/dl in men, either larger or equal to 1.5mg/dl in women), or may be due to pathological conditions such as cardiovascular collapse, acute myocardial infarction and blood infections.

Patients with acute or chronic metabolic acidosis, including diabetes metonic acidosis. Acute metabolic compensation, for example cases of infections or canal.

Precautions when using

Lactic acidosis:

After -sales surveillance process has recorded lactic acidosis related to metformin, including death, heat reduction, hypotension, prolonged slow arrhythmia. The onset of lactic acidic acidosis related to Metformin is often not easy to detect, accompanied by typical symptoms such as discomfort, muscle pain, respiratory failure, drowsiness and abdominal pain. Lactic acidic acidosis related to metformin is characterized by increased lactate levels in the blood (> 5mmol/l), anion space (no evidence of keto urine or blood keto), increased lactate pyruvate ratio and plasma metformin level generally increasing ≥ 5μg/ml. With certain drugs (for example, carbon dioxide inhibitors such as Topiramat), aged 65 and older, performing screens using contrast drugs, surgery and performing other procedures, reducing inhaled oxygen (eg acute congestive heart failure), drinking lots of alcohol and liver failure. Details in the instruction sheet of drug use [see the use of the use, dosage, contraindication, warning and caution when taking the drug, interactions, cavalry of the drug]. Returning to the hemorrhage to quickly regulate acidosis and removing metformin fertilizer (metformin hydrochloride can be absorbed with 170ml/minute clearance under good hemodynamic conditions). Dialysis can reverse symptoms and recovery.

Renal failure: Lactic acidosis related to metformin during after -sales drug monitoring occurs mainly in patients with severe renal failure. The risk of cumulative metformin and lactic acidosis is related to metformin increases with the severity of renal failure because metformin is excreted mainly through the kidneys. Clinical recommendations based on the patient's kidney function include [see section of usage, dose]

Before the beginning of treatment with Metformin should estimate the level of glomerular filtration (EGFR) of the patient.

Contraindicated Metformin in patients with EGFR below 30ml/min/1.73m2 [See contraindications].

Do not recommend the beginning of treatment with Metformin in patients with EGFR in the range of 30 - 45ml/minute/1.73m2.

Collect data on EGFR at least once a year in all patients using Metformin, in patients who are likely to increase the risk of renal impairment (such as the elderly), the kidney function should be evaluated more often.

In patients who are using metformin and have EGFR drops below 45ml/min/1.73m2, assess risk - benefits of continuing the regimen.

Medicinal interaction: simultaneous use of metformin with some drugs may increase the risk of lactic acidosis related to metformin: Patients with impaired renal function leads to significant hemodynamic changes, affecting acid -base balance or increasing metformin accumulation [see section 11

Patients aged 65 and older: The risk of acidic lactic associated with metformin increases with the age of the patient because the elderly patients are likely to have liver failure, kidney failure, heart failure than younger patients. Need to evaluate kidney function more often for older patients.

Perform diagnostic tests using contrast drugs: Injecting contrast drugs into the inner circuit in patients who are being treated metformin can lead to impaired renal function and cause lactic acidosis. Stop using Metformin before or at the time of performing a scan using iodine -containing contrast drug in patients with EGFR in the range of 30 - 60ml/min/1.73m2, patients with a history of liver failure, alcoholism, heart failure or patients will use IOD contrast drugs in artery. Reassess EGFR 48 hours after screening and reuse Metformin if the kidney function is stable.

Surgical or other procedures: food storage and fluid during surgery or performing other procedures may increase the risk of decreased volume, drop blood pressure and kidney failure. Metformin should be temporarily stopped temporarily when the patient has a limited amount of food and deposits.

Inhalation oxygen reduction: The after -sales monitoring process has recorded a number of lactic acidosis related to Metformin occurring in acute congestive heart failure (especially when accompanied by reduced perfusion and oxygen reduction). Cardiovascular collapse (shock), acute myocardial infarction, blood infections and other diseases related to hypoxemia have an relationship with lactic acidosis and may also cause nitrogen nitrogen before the kidneys. When these events occur, stop Metformin. drinking alcohol: Alcohol has the potential to affect the effects of metformin on lactate metabolism and thereby increases the risk of lactic acidosis associated with metformin. Warning patients do not drink alcohol when using Metformin.

Hepatic failure: Patients with liver failure can progress to lactic acidosis related to metformin due to lactate excretion decrease, leading to increased lactate concentration in the blood. Therefore, avoid using Metformin in patients who have been diagnosed with liver disease through testing or clinical evidence.

Patients need to be recommended to regulate diet, because nutrition is treated as an important stage in the management of diabetes. Metformin treatment is only considered support, not to replace the regulation of a reasonable diet.

There has been a report on the use of oral medications to treat diabetes, increasing cardiovascular mortality, compared to a simple diet treatment or insulin combination with a diet.

The ability to drive and operate machinery

Use single metformin hydrochloride non -hypoglycemia and thus not affecting the condition of driving or operating machinery. However, patients need to be warned of the risk of hypoglycemia when using metformin hydrochloride combined with other diabetes medications (sulfonylurea, insulin, repaglinid).

Pregnancy

Survey the existence of Metformin Hydrochloride on the placenta shows a part of the drug through the placenta. When blood glucose concentration in mothers abnormally during pregnancy can combine with high risk of congenital abnormalities, most experts recommend that insulin should be used during pregnancy to best maintain blood glucose levels.

Breastfeeding period

metformin hydrochloride is excreted in breast milk. The stopping of breastfeeding or stopping the drug depends on the importance of the drug for the mother. If you stop using Metformin hydrochloride and a diet that does not control the level of blood glucose satisfactory, it should be conducted with insulin treatment.

Medicinal interaction

Interaction of drugs

Reduce effects: The drugs tend to cause hyperglycemia (for example, diuretics, corticosteroids, phenothiazine, thyroid preparations, estrogen, oral contraceptives, phenytoin, nicotinic acid, sympathetic neurological effects, calcium channel blockers, ISONIAZID) can lead to reduction in blood glucose control.

Increased effect: Furosemid increases the maximum concentration of Metformin in plasma and in the blood, without changing Metformin's kidney clearance coefficient in the study using a single dose.

Increased toxicity: Cationic drugs (e.g. amilorid, digoxin, morphine, process, quinidin, quinin, ranitidin, triamteren, trimethoprim, and vancomycin) are excreted by excretion through the renal tubules that can interact with Metformin by competing with ordinary renal transport systems in the kidney tubes. Cimetidine increases (60%) of the peak concentration of plasma and total blood, thus avoiding Metformin combination with cimetidine.

Tyeum of drugs

Due to no research on the correlation of the drug, not mixing this drug with other drugs.

Storage

Leave a cool place, avoid light, temperature below 30⁰C.

To be out of reach of children.

Other drugs

Disclaimer

Every effort has been made to ensure that the information provided by Drugslib.com is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Drugslib.com information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Drugslib.com does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Drugslib.com's drug information does not endorse drugs, diagnose patients or recommend therapy. Drugslib.com's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners.

The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Drugslib.com does not assume any responsibility for any aspect of healthcare administered with the aid of information Drugslib.com provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.