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Before you buy, read the description of the drug.

Glucophage

Description of the dosage form Glucophage

Glucophage ® 500 and 850 mg: white, round, biconvex tablets, film-coated. On cross-section - a homogeneous white mass. Glucophage ® 1000 mg: white, oval, biconvex tablets, film-coated, with risks for both sides and engraved "1000" on one side. On cross-section - a homogeneous white mass.

Feature Glucophage

Hypoglycemic agent of the biguanide group for oral administration. Pharmacological action Pharmacological action - hypoglycemic.

Pharmacokinetics Glucophage

After oral administration, metformin adequately absorbed from the gastrointestinal tract. The absolute bioavailability of 50-60%. Cmax (approximately 2 mg / L or 15 umol) in plasma is reached in 2.5 h. In the simultaneous ingestion of metformin absorption is reduced and delayed. Metformin rapidly distributed into tissues, almost bound to plasma proteins. Undergoes metabolism to a very slight extent and excreted by the kidneys. Clearance in healthy subjects is 440 ml / min (4 times greater than creatinine clearance), which indicates the presence of active tubular secretion. T1 / 2 of approximately 6.5 h. In renal insufficiency, T1 / 2 increases, there is a risk of cumulation of the drug. Pharmacodynamics Glucophage ® reduces hyperglycemia without causing hypoglycemia. Unlike sulfonylureas, does not stimulate insulin secretion and has no hypoglycemic effect in healthy individuals. Increases the sensitivity of peripheral receptors to insulin and glucose utilization by cells. Inhibits hepatic gluconeogenesis. Delays absorption of carbohydrates in the intestines. In addition, has a beneficial effect on lipid metabolism: reduces total cholesterol, LDL and triglycerides.

Prescribed drug Glucophage ®

Type 2 diabetes in adults after failure of diet (especially in patients who are obese); in combination with insulin - diabetes mellitus type 2, especially in severe obesity accompanied by secondary insulin resistance; Type 2 diabetes in children 10 years of age - both in monotherapy and in combination with insulin.

Contra Glucophage

Hypersensitivity to metformin or any of the excipients; diabetic ketoacidosis, precoma and coma; renal dysfunction (Cl creatinine <60 ml / min); acute illness occurring at risk of developing renal dysfunction: dehydration (diarrhea, vomiting), fever, severe infectious disease, a condition of hypoxia (shock, sepsis, renal disease, bronchopulmonary disease); symptomatic manifestations of acute and chronic diseases that may lead to tissue hypoxia (cardiac or respiratory failure, acute myocardial infarction, etc.); major surgery and trauma (when shown an insulin); abnormal liver function; chronic alcoholism, acute alcohol poisoning; lactic acidosis (including history); period of at least 2 days before and after the radioisotope or radiology with the introduction of iodine-containing contrast agent; compliance with a hypocaloric diet (less than 1000 kcal / day); pregnancy; breastfeeding; It is not recommended to use the drug in patients over 60 years to do hard physical work, which is associated with an increased risk of developing lactic acidosis. Application of pregnancy and breastfeeding When planning a pregnancy, as well as in the case of pregnancy in patients receiving metformin, the drug should be withdrawn and assigned to insulin therapy. Must tell the doctor about pregnancy occurs while taking Glucophagea ®. Maternal and Neonatal installed surveillance. Since data on the penetration into breast milk is not, then the drug is contraindicated during breastfeeding. If necessary, use Glucophagea ® during breastfeeding breastfeeding should be discontinued. Side effects of the drug Glucophage ® Adverse effects of the drug is considered as follows: Very common - ≥ 1 / 10, often - ≥ 1 / 100 <1 / 10, rarely - ≥ 1 / 1000 <1 / 100, rare - ≥ 1 / 10 000 <1 / 1000, very rare - <1 / 10 000, unknown - can not be assessed with available data.

Side effects of Glucophage are presented in decreasing order of importance.

Nervous System: Frequent - breach of taste. Gastrointestinal organs: very common - nausea, vomiting, diarrhea, abdominal pain, loss of appetite. Most often they occur in the initial period of treatment and in most cases spontaneously resolve. To prevent the symptoms are advised to take metformin 2 or 3 times a day during or after meals. The slow increase in dose may improve gastrointestinal tolerability. There are few reports of violation of liver function tests or hepatitis after discontinuation of metformin adverse effects completely disappear. Skin: very rarely - Skin reactions such as erythema, pruritus, rash. Metabolic disorders: very rare - lactic acidosis (see "Special Instructions"). Patients receiving long-term treatment with metformin, there was a decrease absorption of vitamin B12 is accompanied by reduction of its concentration in blood serum. These effects are rapidly reversed, with the abolition of metformin and usually not clinically significant (<0.01%). Reduced levels of vitamin B12 should be taken into account in patients with megaloblastic anemia. Hepatobiliary disorders: there are few reports of violation of liver function tests or hepatitis after discontinuation of metformin adverse effects completely disappear. Published data, postmarketing data, and controlled clinical studies in limited populations of children in the age group 10-16 years show that the side effects of the nature and severity are similar to those in adult patients.

Interaction Glucophage

Deprecated combination

Not recommended for concomitant use of danazol because of its hyperglycemic action. If necessary, danazol treatment and after discontinuation of the latter requires a dosage adjustment Glucophagea ® under the control of blood glucose levels. Drinking alcohol increases the risk of lactic acidosis during acute alcoholic intoxication, especially during starvation and low calorie diet, as well as liver failure. During the administration of the drug should avoid alcohol and drugs containing ethanol.

Combination of Glucophage, requiring special care

Chlorpromazine at a reception in large doses (100 mg / day) improves glycemia by reducing insulin release. In the treatment with neuroleptics and after discontinuation of the latter required a dosage adjustment Glucophagea ® under the control of blood glucose levels. Corticosteroids in systemic and local application lower glucose tolerance, increased glycemia, sometimes causing ketosis. In the treatment of GCS and after discontinuation of the last required dose correction Glucophagea ® under the control of blood glucose levels. At the same time taking loop diuretics can lead to the development of lactic acidosis due to possible functional renal insufficiency. Should not be prescribed Glucophage ®, if Cl creatinine below 60 ml / min.

An overdose of Glucophage

Symptoms: when using metformin at a dose of 85 g of hypoglycemia was not observed. However, in this case, there was the development of lactic acidosis. Early symptoms of lactic acidosis include nausea, vomiting, diarrhea, fever, abdominal pain, muscle pain, in the future there may be a shortness of breath, dizziness, impaired consciousness and the development of coma. Treatment: If the signs of lactic acidosis, treatment with Glucophage ® should be stopped immediately, the patient to hospital and to determine the concentration of lactate, to clarify the diagnosis. The most effective interventions for the excretion of lactate and metformin is hemodialysis. Spend as symptomatic treatment.

Administration and Dosage Glucophage

Inside. Dose is set by the doctor individually depending on the level of glucose in the blood. Adults - monotherapy and combination therapy in combination with other oral hypoglycemic agents The usual starting dose is 500 mg 2-3 times daily during or after a meal. Perhaps further gradual increase in the dose depending on the level of glucose in the blood. Maintenance dose is usually 1500-2000 mg / day. To reduce the side effects on the gastrointestinal tract daily dose should be divided into 2-3 doses. The maximum dose is 3000 mg / day, divided into 3 doses. The slow increase in dose may improve gastrointestinal tolerability. Patients taking metformin at doses of 2000-3000 mg / day may be transferred to the reception Glucophagea ® 1000 mg. The maximum recommended dose is 3000 mg / day, divided into 3 doses. In the case of planning for the transition from taking other hypoglycemic agent to stop taking another tool and begin taking the drug Glucophage ® at a dose indicated above. Adults - a combination with insulin To achieve better control of blood glucose and insulin, metformin can be used as combination therapy. The usual initial dose of the drug Glucophage ® 500 and 850 mg of 1 table. 2-3 times a day, Glucophage ® 1000 mg - 1 tab. 1 time per day, while the insulin is selected on the basis of measurement of blood glucose. Children and Teens Children from 10 years of age Glucophage ® can be used as monotherapy and in combination with insulin. The usual starting dose is 500 mg 2-3 times daily during or after a meal. After 10-15 days, the dose should be adjusted based on the results of measurement of blood glucose. The maximum daily dose is 2000 mg, divided into 2-3 doses. Elderly patients Due to a possible reduction in kidney function dose of metformin should be selected by regular monitoring of indicators of kidney function (serum creatinine level of at least 2-4 times per year). Cautions If during treatment the patient appeared vomiting, abdominal pain, muscle aches, general weakness and severe malaise, you must stop taking the drug immediately and consult a doctor. These symptoms may be a sign of incipient lactic acidosis. For 48 h before and within 48 hours after the X-ray study (urography, intravenous angiography) should stop taking Glucophagea ®. Because metformin excreted by the kidneys, before starting treatment and regularly thereafter, to determine the level of creatinine in serum. Particular caution should be exercised in cases where renal function may be impaired, such as in the initial period of antihypertensive therapy or diuretic therapy, and initial treatment NSAIDs. The patient should inform the doctor about the appearance of bronchopulmonary infection or infectious diseases of the urogenital organs. During the treatment should refrain from drinking alcohol. Effects on ability to drive and operate with mechanisms

 

Shelf life of the drug Glucophage ® 5 years