They first started talking about the substance "Metformin" in 1922, its main and other alleged actions were described in 1929, and began to gain its popularity only after 1950. It was from this moment that scientists began to show increased interest in metformin as a hypoglycemic agent that does not affect the heart and blood vessels.
After careful studies and comparisons with other drugs in this group, it began to be actively prescribed in Canada in the 70s for type 2 diabetes, and in America it was allowed only in 1994, when it was approved by the FDA.
According to its chemical structure, metformin is the main representative of the biguanide series. It is a first-line drug for the treatment of type 2 diabetes and is considered the most popular hypoglycemic agent in many countries of the world. Unlike other groups of oral medications, it is better at keeping weight in place or promoting weight loss. Metformin is also sometimes used for weight loss (treatment of obesity) in people without diabetes, although it was not originally intended for this.
Its weight loss effect is due to several mechanisms:
- the level of “bad” cholesterol decreases;
- the absorption of simple sugars in the gastrointestinal tract decreases;
- glycogen formation is inhibited;
- Glucose processing is accelerated.
Composition and release form
All existing metformin is available in conventional film-coated or sustained-release tablets, which reduces the frequency of dosing. The composition includes metformin hydrochloride at a dosage of 500, 750, 850 or 1000 mg.
Pharmacological properties
The drug is a biguanide drug. Its uniqueness is that it does not increase the synthesis of its own insulin. In addition, it does not affect glucose levels in healthy people. Metformin is able to increase the sensitivity of special receptors to insulin, inhibit the absorption of glucose in the gastrointestinal tract and lower its level in the blood by inhibiting conversion in the liver.
Additionally, metformin has a positive effect on fat metabolism: it reduces cholesterol, low-density lipoproteins and triglycerides, and at the same time increases the content of high-density lipoproteins. During the course of treatment, body weight either remains unchanged (which is also a positive result) or slowly decreases.
The highest concentration of the substance is achieved approximately 2.5 hours after application. The half-life is approximately 7 hours. If kidney function is impaired, the risk of its accumulation in the body increases, which is fraught with complications.
Indications and contraindications
Metformin is prescribed for type 2 diabetes in obese patients when dietary adjustments and exercise have not brought the expected results. Can be used as the only drug against diabetes in children over 10 years of age and adults, or as an adjuvant to insulin. Adults can also combine it with other hypoglycemic tablets.
The drug has a lot of contraindications:
- Allergy to the active substance or any of the components.
- You should not take it during a strict diet if you consume less than 1000 kcal per day.
- Pregnancy.
- Severe heart failure, acute myocardial infarction, breathing problems against this background.
- Impaired kidney function. This also includes water balance disorders, shock, and severe infectious diseases that can lead to kidney failure.
- Large-scale surgical interventions and injuries.
- Diabetic ketoacidosis, precoma and coma.
- Liver dysfunction, alcoholism, acute poisoning from strong drinks.
- Accumulation of lactic acid in skeletal muscles, skin and brain, which is called lactic acidosis.
Metformin should not be taken by elderly people who have heavy physical activity - this is due to the possible occurrence of lactic acidosis. Women who are breastfeeding should also be careful and take the drug only in consultation with their doctor, but most often lactation is completed so as not to harm the baby.
How to take Metformin
It often causes adverse events from the gastrointestinal tract; to improve tolerability, it is recommended to increase doses slowly and split them up.
Dosage regimen for adults as the only drug for treatment or in combination with other sugar-lowering tablets:
- The drug is taken during or after meals. Usually the initial dose is 500-850 mg per day, divided into several doses. Its increase is directly related to the level of glucose in the blood.
- Maintenance dosage is 1500-2000 mg per day, divided into 2-3 doses to improve the gastrointestinal tract's response to the drug.
- The maximum daily dosage should not exceed 3000 mg.
Combination with insulin:
- The initial dosage of metformin is also 500-850 mg 2-3 times a day, the amount of insulin is selected individually based on blood sugar levels.
For children over 10 years of age, metformin is prescribed 500-850 mg once a day after meals. Dose adjustment is possible after 2 weeks of use of the drug. The maximum dosage should not exceed 2000 mg per day, it is divided into 2-3 doses.
Elderly people should monitor their kidney function at least 3 times a year during treatment with the drug. If everything is normal, the dosage and frequency of use of metformin are the same as for middle-aged people.
There is a prolonged form of tablets that you can take once a day. Dosages are selected and increased individually; in this case, the drug is usually used after dinner.
Metformin during pregnancy and lactation
There have been no full-scale studies on embryos. Limited observations indicate that no malformations have been identified in unborn children while the pregnant woman was taking the drug. But the official instructions insist that the expectant mother must notify the attending physician about her situation, and then he will consider switching her to insulin medications, if necessary.
It has been proven that the substance is excreted in breast milk, but side effects have not yet been observed in children. Despite this, it should not be taken during lactation; it is advisable to complete it so as not to cause unforeseen complications in the baby.
Side effects and overdose
Most often, while taking the drug, the digestive system suffers: loose stools, nausea, vomiting appear, the taste of food changes and appetite may deteriorate. Usually these symptoms are reversible - they appear at the very beginning of treatment and disappear as spontaneously as they appeared.
Other possible complications:
- Leather: itching, rashes, red spots.
- Metabolism: Lactic acidosis occurs extremely rarely. With long-term use of the medicine, the absorption of B 12 is sometimes impaired.
- Liver: violation of laboratory parameters, hepatitis. The changes are reversible and disappear after cancellation.
In cases where side effects do not interfere with overall health, the drug is continued without changes. If effects occur that are not described in the official instructions, you must inform your doctor about them and follow his further instructions.
An overdose of metformin occurs only when the dose taken is several times higher than the daily dose. It usually manifests itself as lactic acidosis - the central nervous system is depressed, respiratory, cardiovascular and excretory system disorders occur. In this case, immediate hospitalization is required!
special instructions
Surgical interventions. Metformin should be discontinued two days before planned surgical operations and prescribed no earlier than two days after them if renal function is preserved.
Lactic acidosis. It is a very serious complication, and there are factors that indicate the risk of its occurrence. These include:
- severe renal failure;
- conditions when it is not possible to control blood glucose levels with medication;
- presence of a large number of ketone bodies in the body;
- hunger strike;
- serious problems with liver activity;
- chronic alcoholism.
While taking metformin, you should avoid drinking alcohol. and preparations that may contain ethanol (tinctures, solutions, etc.)
If you suspect the development of lactic acidosis, you should immediately stop taking the drug and seek medical help. In most cases, emergency hospitalization is required.
Kidney activity. Elderly people who additionally take antihypertensive, diuretic and non-steroidal anti-inflammatory drugs and have kidney problems should be especially wary.
Other medications that may cause undesirable effects when taken simultaneously:
- danazol;
- chlorpromazine;
- β2-adrenergic agonists in the form of injections;
- nifedipine;
- digoxin;
- ranitidine;
- vancomycin.
You should notify your doctor in advance about their use.
Children from 10 years old. The diagnosis must be established before metformin is prescribed. Studies have shown that it does not affect puberty and growth. But control over these parameters should still be serious, especially at the age of 10-12 years.
Official research results
One important clinical trial, the UK Prospective Diabetes Study (UKPDS), was conducted on people with type 2 diabetes who were overweight and taking metformin. Results:
- mortality from type 2 diabetes is reduced by 42%;
- the risk of vascular complications is reduced - 32%;
- the risk of myocardial infarction is reduced by 39%, stroke – 41%;
- overall mortality decreases by 36%.
A later study, the Diabetes Prevention Program, was conducted on the original French drug, Glucophage. Afterwards the following conclusion was made:
- a slowdown or prevention of the development of diabetes in people with impaired carbohydrate metabolism by 31% was noted.
Review of drugs for weight loss and treatment of type 2 diabetes
The most common and best in quality are: Glucophage (the original French medicine), Metformin produced by Gedeon Richter and Siofor. The difference between them is not very big, the active substance is the same, only the auxiliary components that affect the release and absorption of the drug itself in the body can be different.
Popular drugs with the active ingredient "metformin", the cost depends on the dosage.
Metformin is a drug that is widely used in pharmacology today; it was first described at the beginning of the twentieth century in the USA; at first it was used to treat influenza and was believed to also have antibacterial and analgesic effects. Only in the 70s of the last century Metformin was isolated as a drug that could be used to treat diabetes.
Diabetes mellitus is a chronic endocrine disease that has become very common in the world among people of all ages. This disease leads to decreased performance and increased mortality. This led to the beginning of the creation of more and more new drugs to treat this disease. Today, dozens of groups of drugs have been created that are widely used. Moreover, one of the first - biguadins, of which Metformin is a representative, is still considered optimal for the treatment of uncomplicated type 2 diabetes.
Instructions for use of Metformin, description of the drug, price and reviews are described in detail below.
Main components: active substance - Metformin, additional substances - corn starch, crospovidone, talc.
Release form
Tablets for example orally, dose - 850, 500 and 100 mg in blisters of 120 and 30 tablets.
Mechanism of action
Metformin or dimethylbiguanide is part of the group of oral antidiabetic drugs, biguadins.
How does Metformin reduce blood glucose levels? It is worth noting that this expression is not entirely correct; the glucose level does not change in any way, but rather is redistributed and is not synthesized. This occurs as a result of several mechanisms. Firstly, Metformin inhibits the formation of glucose in the body. Quite the contrary, it stimulates its decay. This happens because Metformin blocks the formation of energy and oxygen in the cells that synthesize glucose, due to which the breakdown of glucose begins without the participation of oxygen. Glucose enters the cells from the extracellular space, and the cells receive the required amount of glucose, and the excess part is simply destroyed.
Also, Metformin, the instructions for use describes this in detail, stimulates the consumption of glycogen reserves in the liver without reducing blood glucose levels. It turns out that Metformin simply helps redistribute glucose to where it is needed, blocks the mechanisms for the formation of excess glucose and does not lead to changes in glucose levels in the body.
During diabetes, the amount of fatty acids increases and body weight increases. Metformin blocks the formation of free fatty acids. Obesity can also appear due to constantly high insulin levels; due to the action of Metformin, insulin levels decrease. This mechanism is very important for the prevention of complications on the blood vessels of the body.
Metformin increases the sensitivity of body cells to insulin, which helps the organs and tissues that suffer from a lack of glucose during diabetes to absorb glucose. When using the drug for more than a year, the patient feels a decrease in appetite and weight.
Metformin thins the blood; reduces the level of bad fats; inhibits the thickening of vascular walls. This indicates the importance of Metformin in the prevention of vascular complications of diabetes mellitus. Thus, Metformin delays the onset of diabetic angiopathy. So you can judge the risk level of a diabetic for a heart attack or stroke in the future by calculating the SCORE index; if cholesterol levels drop, the risk also decreases.
Metformin, the instructions for use indicate, has a positive effect on slowing the evolution of diabetes mellitus, acting on all pathological aspects of the disease.
After taking the drug, its maximum content in the blood is observed after 2-2.5 hours.
The correct intake of Metformin is only before meals, because otherwise it will be less well absorbed from the intestine and will not reach the concentration at which a therapeutic effect will occur.
It is worth recalling that it makes sense to take antidiabetic drugs only if the patient continues to adhere to the diet prescribed by the endocrinologist and does not practice a passive lifestyle, plays sports, or does exercises.
Indications for use
Metformin is a multi-tasking drug; in addition to diabetes, its effect on many other diseases has been discovered in recent years.
Indications for use:
- Type 2 diabetes mellitus, alone or in combination with other oral antidiabetic drugs from other groups or with insulin;
- Type 2 diabetes mellitus and obesity. In cases where it is impossible to control diabetes with non-drug treatment (exercise and diet).
Experimental Application
Recently, Metformin has been increasingly used in the experimental treatment of polycystic ovary syndrome, non-alcoholic fatty liver disease, early puberty and other diseases associated with insulin resistance, such as acromegaly, hypercortisolism.
There are no exact data and scientific conclusions on the effect of Metformin on the above diseases, however, some doctors claim that after prescribing Metformin, glucose and insulin levels decrease, but this is not enough to include the drug in the official protocol for treating the disease.
Metformin for polycystic ovarian syndrome (PCOS) for the treatment of ovulation stimulation remains unofficial, as many studies of its effect on reproductive function have produced various inaccurate results. Some doctors, using Metformin for polycystic ovary syndrome and secondary diabetes, notice an increase in the incidence of pregnancy in patients taking Metformin, as opposed to those who do not take it. However, clomiphene is classically used to stimulate ovulation.
Innovation
MD Anderson Cancer Center conducted a large study that showed the effect of Metformin in preventing pancreatic cancer. The study findings demonstrated that there was a 62% reduction in the risk of developing pancreatic cancer in study participants who took Metformin compared to a group of patients who did not take it. This led to the initiation of new research and the development of a program for the prevention of pancreatic cancer.
Metformin for weight loss
Today it has become popular among overweight and obese people without diabetes to take Metformin as a means of losing weight. There is a certain course of treatment with Metformin in order to burn excess weight. Endocrinologists do not advise their patients without diabetes mellitus and decreased sensitivity of cells to insulin to take Metformin. The instructions for use write about this. But often patients do this without consulting a doctor. This is a very dangerous practice.
Failure to follow the required low-glucose diet, or ignorance of the required dose of the drug, can lead to many side effects, firstly. Secondly, it has been proven that Metformin does not affect blood glucose levels in healthy people, which means that only the mechanism of reducing fatty acid levels will work in this case.
Metformin is contraindicated for weight loss, especially without a doctor's prescription.
A doctor can prescribe it only in case of prediabetes or insulin resistance. But even in this case, diet and exercise are much more effective than drug treatment, which is Metformin. The instructions for use do not describe the use of the drug for weight loss.
Contraindications
Metformin is taken only with a prescription written by the attending physician after a thorough examination and laboratory tests that will confirm that there are no restrictions on taking the medication.
Contraindications include:
- hypersensitivity to any substance contained in the drug;
- contraindicated for children under 15 years of age;
- diabetic precoma and diabetic ketoacidosis, lactic acidosis;
- vomiting or diarrhea with signs of dehydration;
- acute patient conditions in which an unexpected reaction to the drug may occur (DIC syndrome, inspiratory distress syndrome, sepsis);
- peritonitis, septicemia, sepsis, toxic shock;
- diseases that lead to hypoxia: a history of myocardial infarction, chronic bronchitis with COPD or emphysema, bronchial asthma with a long chronic progressive course;
- extensive injuries, traumatic shock;
- increased body temperature;
- administration of a contrast agent with iodine;
- pregnancy and lactation;
- acute ethanol poisoning or chronic alcoholism.
All these problems are contraindications for which Metformin should not be used.
Instructions for use, establishing the required dose
The drug is taken orally and washed down with water. If the tablet is 850 mg, you may have difficulty swallowing, then you can divide the tablet into two parts. If side effects are observed after taking, to alleviate them, you can divide the daily dose into 2-3 doses.
The minimum daily dose is 1 gram, the maximum dose per day is 3 grams. Two to three weeks after the drug is prescribed, the dose may be increased. Full activity of the drug and its effect are observed after 10-15 days.
If you need to start taking Metformin instead of another antidiabetic drug, you should stop taking the first drug, and only then initiate Metformin according to the dose.
The dose of insulin should be reduced if it is prescribed together with Metformin. Both drugs potentiate each other's hypoglycemic properties.
Side effects
Side effects of Metformin are quite rare; most often, taking the drug is easy for the patient. The most common side effects are:
- nausea;
- vomit;
- heartburn;
- bloating and abdominal pain;
- loss of appetite,
- feeling of a metallic taste in the mouth.
Typically, these symptoms begin with the first doses of the drug and quickly disappear, even if you do not change the dose of Metformin.
Very rarely, people with hypersensitivity to the composition of the drug may experience an allergic reaction in the form of erythema on the skin. In this case, it is worth considering the option of discontinuing the drug and replacing it with another. Anaphylactic shock or angioedema was not observed when using Metformin.
Very rarely, Metformin, the instructions for use write about this, can lead to the development of lactic acidosis. Therefore, the patient should regularly consult a doctor for monitoring.
Megaloblastic anemia or vitamin B12 deficiency can occur in a narrow circle of patients who take Metformin for a long period of time and in patients with severe chronic severe diseases of the gastrointestinal tract and after total resection of the gastric tract. Symptoms of megaloblastic anemia: yellowness of the skin and mucous membranes, general weakness, dry and flaky skin, hair loss, feeling of wobbly legs.
In patients with hypothyroidism, a decrease in typeotropic hormone is possible. In rare cases, a decrease in testosterone secretion in men may occur. Clinically, the last two side effects have not been proven.
Symptoms and dangers of overdose
An overdose of Metformin is extremely rare. In the literature you can find a description of only one case when taking the drug at a dose of 75g. At the same time, the glucose level did not change, but lactic acidosis developed - a very dangerous condition in which the lactate level in the blood becomes above 5 mmol/l. The first signs may be:
- dizziness;
- headache up to the onset of migraine;
- increased body temperature;
- interruptions in breathing;
- nausea;
- vomit;
- diarrhea;
- stomach ache;
- spasms in the muscles of the limbs.
Severe cases may result in coma and the need to be connected to a ventilator.
In case of such symptoms, it is necessary to immediately hospitalize the patient and carry out all the necessary tests that will show the level of lactate, pyruvate and their ratio in the blood.
To quickly remove Metformin from the body, it is rational to use hemodialysis.
Metformin during pregnancy and lactation
During pregnancy, Metformin is strictly contraindicated. It can and should be taken before pregnancy by women with type 2 diabetes and obesity to increase the risk of conception and weight loss, but once pregnancy occurs, the drug should be discontinued. Many doctors still prescribe Metformin during the first trimester, but this is fraught with complications for the fetus.
Subsequently, children whose mothers took Metformin during pregnancy will be at risk of developing obesity and diabetes. Therefore, it has been proven that a woman should take Metformin during pregnancy only if absolutely necessary and it is impossible to replace it with another drug.
For pregnancy planning, Metformin has earned the title of “indispensable” among women with diabetes, excess weight and polycystic ovary syndrome. Obese women are more likely to suffer from infertility. Metformin helps the body distribute glucose and reduces the level of fatty acids, thereby stabilizing hormonal levels and restoring the normal menstrual cycle.
If you are breastfeeding, you should also stop taking Metformin.
Metformin for children
In the twenty-first century, type 2 diabetes has become increasingly common in children and adolescents. Moreover, the disease affects children of different nationalities and social groups. Children around the world are susceptible to obesity and decreased tissue sensitivity to insulin. Recently, many programs have been developed for non-pharmacological treatment of children with insulin-resistant diabetes, which include a balanced diet and physical activity. However, more and more people have to resort to drug treatment. A passive lifestyle and unhealthy diet, rich in sugar and fats, led to a sharp rejuvenation of the disease.
Metformin was initially contraindicated in children under 15 years of age. After a recent study by American doctors, in which children and adolescents aged 10-16 years took Metformin for 16 weeks, a significant decrease in the level of free fatty acids in the blood, a decrease in the level of low and very low density lipoproteins, triglycerides, and weight loss. Among the side effects, neither hypoglycemia nor lactic acidosis was observed; rare events such as nausea or diarrhea did not affect the results of the study.
The benefits of using Metformin in childhood have been proven, starting from the age of 10, without serious complications, but with good results and in the future, complete control of diabetes and reducing the dose of the drug to a minimum with the possibility of its cancellation.
Interaction with other drugs
The use of Metformin as monotherapy does not lead to hypoglycemia, but it must be carefully combined with sulfonylureas and insulin.
Some substances can reduce the hypoglycemic effect of Metformin and cancel treatment: steroid hormones, thyroid hormones, glycogen, adrenaline and other stimulants of sympathetic nervous system receptors, female sex hormones (estrogen and progesterone), nicotinic acid derivatives, thiazide derivatives diuretics.
The use of Metformin with alcohol is strictly contraindicated, because ethanol can lead to lactic acidosis in combination with Metformin. Following the same logic, all drugs containing ethanol are not allowed together with Metformin. Lactic acidosis can also be triggered by taking iodine-containing contrast agents with Metformin. Some diagnostic procedures cannot be done without the administration of contrast with iodine; in this case, it is necessary to discontinue Metformin for 48 hours before and after the procedure.
Patients taking chlorpromazine will require an increased dose of Metformin. This occurs because chlorpromazine, in large doses, blocks the formation of insulin.
Lactic acidosis may occur when Metformin is combined with cimetidine.
Metformin and vitamin B12
Vitamin B12 or cyanocobalamin is a substance necessary for hematopoiesis and the functioning of the nervous system; thanks to it, protein is synthesized in the body.
It is assumed that with prolonged use of Metformin, the drug interferes with the absorption of this vitamin in the ileum, which leads to a gradual decrease in its level in the blood. In the fifth year of admission, B12 levels decrease by 5%; in the 13th year - by 9.3%.
It is worth noting that a deficiency of 9% does not lead to hypovitaminosis and the development of hemolytic anemia, but increases the risk of development in the future.
B12 deficiency leads to hemolytic anemia, which means that red blood cells become fragile and are destroyed directly in the bloodstream. This leads to the development of anemia and jaundice. The skin and mucous membranes become yellowish in color, the patient complains of weakness, dry mouth, numbness in the legs and arms, dizziness, loss of appetite, and loss of coordination.
To determine your vitamin B12 level, you need to do a complete blood test to look at the shape and size of your red blood cells. With B12 deficiency hemolytic anemia, red blood cells will be larger than normal and with a nucleus, anemia will be observed, and unbound bilirubin will be increased in a biochemical blood test.
It is worth making up for the lack of vitamin B12 when taking Metformin. The doctor may prescribe dietary supplements and vitamin complexes.
It’s a funny and logical coincidence, but treatment for B12 deficiency is, of course, also carried out by administering the vitamin, only intravenously.
special instructions
If you are taking Metformin continuously, do not forget to periodically check your kidney function. Like any drug, it undergoes its biotransformation and is excreted through the kidneys in the urine, so twice a year it is necessary to check the condition of the urinary system. The doctor will prescribe a general urine test, a biochemical blood test with a study of creatinine levels, and an ultrasound examination of the kidneys (renal ultrasound).
Should be prescribed with caution to people over 60 years of age.
People whose professions require greater mental concentration need not worry; no changes in the central nervous system are observed when taking Metformin. However, it is necessary to limit extreme physical activity; this may be a risk for the development of lactic acidosis.
Large-scale surgical interventions, as well as 2-3 degree burns, require the abolition of all antidiabetic drugs and the use of only insulin.
You must carefully study the instructions to make sure you have chosen the correct dose.
Terms of sale
Metformin can only be purchased as prescribed by the attending endocrinologist; without a prescription, a family doctor prescribing the drug without proper research can lead to side effects.
Storage conditions
Metformin must be stored in a dry place, protected from light, at a temperature of 15-25 degrees. If stored properly, the shelf life is approximately 3 years.
Should be kept out of the reach of children. Contraindicated for use after the expiration date.
This is a third-generation biguanide class hypoglycemic drug. The antidiabetic agent inhibits the process of gluconeogenesis and the transport of electrons in the respiratory chains of metachondria. Glycolysis is stimulated, cells begin to better absorb glucose, and its absorption by the intestinal walls decreases. The medicine does not cause a sharp decrease in blood sugar levels, since it does not stimulate insulin secretion. The drug has many analogues, produced by different manufacturing companies in Russia, Israel, Poland and Hungary.
Indications for use
Metformin is prescribed for the following pathologies:
- metabolic syndrome;
- athletes;
- cleropolycystic ovarian disease;
- obesity due to insulin resistance;
- impaired glucose tolerance;
- non-insulin-dependent diabetes mellitus.
Metformin has a wide spectrum of action and is approved for use in children over 10 years of age for the treatment of obesity and non-insulin-dependent diabetes.
Contraindications to therapy:
- pregnancy period, breastfeeding;
- surgical operations, mechanical injuries;
- previous lactic acidosis;
- renal failure;
- low-calorie diet therapy;
- liver pathologies;
- children under 10 years old.
The most dangerous side effect of taking Metformin is lactic acidosis, but this is extremely rare. Complications can be provoked by concomitant kidney diseases, chronic alcoholism, ketoacidosis, infectious diseases, and heart failure.
Side effects such as nausea, diarrhea and bloating may appear at the beginning of treatment, but they disappear within 2 weeks.
Add Metformin-Teva to your first aid kit
What kind of medicine is Metformin Teva, what is the release form and the price of the drug? This effective hypoglycemic agent is available in tablet form for oral administration in dosages of 500, 850 and 1000 mg. The drug is manufactured by an Israeli pharmaceutical company.
The attached instructions for use of Metformin Teva 1000, 850 or 500 mg indicate how to take the tablets correctly, what contraindications and side effects exist, prices for the medicine may vary in different pharmacies, the average cost of the drug is:
- Metformin Teva 1000 mg – 160–280 rubles;
- Metformin MV Teva prolonged action 500 mg – 263 rubles;
- Metformin Teva 500 mg – 77 rubles;
- Metformin Teva prolonged action dosage 750 mg – 150 rub.
Metformin MV Teva are capsules with a modified release of active components, which ensures an increase in the duration of its action. They are not prescribed to patients over 65 years of age or people performing intense physical activity due to the high likelihood of complications with lactic acidosis. Concomitant use of Metformin MB Teva with insulin therapy, treatment with sulfonylurea derivatives, ACE inhibitors and MAO inhibitors enhances the hypoglycemic effect. Therefore, therapy should be carried out under strict control of glycemic levels.
Hormonal drugs, thiazide diuretics, nicotinic acid derivatives may reduce the effectiveness of Metformin Teva.
Is Metformin-Canon good for diabetics?
The Russian pharmaceutical manufacturing company Canonpharma Production produces its products according to international quality standards. The hypoglycemic drug Metformin Canon is produced in dosages of 500, 850 and 1000 mg of active substance per tablet according to the attached instructions for use.
The medicine is available in the form of tablets-capsules for oral administration according to a prescription from an endocrinologist. Metformin Canon lowers the concentration of glucose in whole blood by suppressing gluconeogenesis by liver cells, slowing down the absorption of sugar by the intestines and accelerating its utilization by cells of peripheral tissues by improving the absorption of insulin. The drug does not cause hypoglycemia, improves fat metabolism, lowering the content of triglycerides and bad cholesterol. This helps reduce excess body weight.
Clinical picture
According to Decree No. 56742, every diabetic can receive a unique remedy at a special price!
Doctor of Medical Sciences, Head of the Institute of Diabetology Tatyana Yakovleva
I have been studying the problem of DIABETES for many years. It's scary when so many people die and even more become disabled due to diabetes.
I hasten to report good news - the Endocrinological Research Center of the Russian Academy of Medical Sciences managed to develop a medicine that completely cures diabetes mellitus. At the moment, the effectiveness of this drug is approaching 100%.
Another good news: the Ministry of Health has achieved approval, according to which the entire cost of the drug is compensated. In Russia and the CIS countries, diabetics before On July 6th they can receive the remedy - FOR FREE!
The drug is used both for monotherapy and for complex treatment with insulin injections in adults and children over 10 years of age.
The dosage of Metformin Canon should be selected by the attending physician taking into account indicators of renal tissue function, the severity of the disease, and the level of glycemia. Usually start with a minimum dose designed for a single dose. Correction is carried out based on the test results obtained during therapy.
Metformin Canon may have side effects such as a specific taste, nausea, lack of appetite, and abdominal pain. Hepatitis, allergic reactions, hypovitaminosis, and lactic acidosis rarely develop. The likelihood of undesirable consequences increases when drinking alcohol, refusing to eat, or liver failure. Metformin Conon in combination with certain medications can provoke lactic acidosis, so before starting treatment you must warn your doctor about the pills you are taking.
How much does the drug Metformin Canon 500, 850, 1000 mg cost?
- Metformin Canon 500 mg – price 130 rubles;
- Metformin Canon 850 mg – price 89 rubles;
- Metformin Canon dosage 1000 mg – price 107 rub.
Metformin Zentiva
Metformin Zentiva belongs to the group of biguanides. The manufacturer of the drug is the Slovak company Saneka Pharmaceutical. The tablets have a hypoglycemic effect, reduce the absorption of glucose in the digestive tract, and increase the absorption of insulin by muscle tissue. Metformin Zentiva is prescribed to mature patients and children over 10 with diagnosed type 2 diabetes mellitus or impaired glucose tolerance, if a low-carbohydrate diet and exercise have not produced results. The dosage is indicated in the instructions for use of the drug, but is adjusted taking into account the individual characteristics of each patient.
The drug helps reduce excess weight, reduces appetite, and normalizes carbohydrate and lipid metabolism.
Cost of Metformin Zentiva:
- Metformin Zentiva 850 mg – 160 rubles;
- Tablets with a dosage of 1000 mg – 175–200 rubles;
- Tablets with a dosage of 500 mg – 118–128 rubles.
We treat diabetes with Metformin-Richter tablets
Another analogue and synonym of an antidiabetic drug is Metformin Richter; these tablets are available in dosages of 500 and 850 mg. The drug is prescribed to patients with type 2 diabetes mellitus who are overweight, elderly and if there is no ketoacidosis.
According to the instructions for use of the capsule, Metformin Richter in a dosage of 500, 850 mg is absorbed relatively slowly and excreted from the body by the kidneys, therefore it is prescribed with caution if the urinary system is disrupted. The drug lowers blood sugar, improves the absorption of the hormone insulin by peripheral tissues, and accelerates the utilization of glucose.
What do Metformin Richter tablets help with, how do they differ from the main drug? Metformin Richter is a hypoglycemic agent that is prescribed to replace the main drug. The difference lies in the pharmaceutical manufacturing companies. The tablets are produced by the Russian and Hungarian company Gedeon Richter.
Cost of hypoglycemic agent:
- Metformin Richter dosage 500 mg, Russia – 180 rubles;
- Metformin Richter 850 mg, Russia – 237 rubles;
- Metformin Richter dosage 500 mg, Hungary – 180 rubles;
- Metformin Richter 850 mg, Hungary – 235 rub.
Review Reviews
Which manufacturer of Metformin Richter is better, what is the difference between the drugs? Russian medicines are not inferior in quality and effectiveness to foreign companies. The composition of the active ingredients is identical, and the cost is lower.
Patient reviews of the drug Metformin Canon 500, 850 and 1000 mg and other RLS analogues are divided, some patients experience improvements, others experience side effects, the prices for the medicine are reasonable, but most often complex therapy is required, the instructions for use do not clearly describe the dosage and treatment regimens.
Metformin MV Teva 850, 1000 mg and other analogues can cause lactic acidosis, this is a dangerous complication that is characterized by the accumulation of lactic acid in muscle tissue.
This condition can lead the patient to coma and death or severe disability.
Only the attending physician should prescribe Metformin Richter, Metformin Teva and other INN substitutes, taking into account the level of glycemia, the presence of complications, and concomitant diseases.
International nameMetformin
Hypoglycemic agent for oral administration of the biguanide groupDosage form
Tablets, film-coated tabletspharmachologic effect
Biguanide, hypoglycemic agent for oral administration. In patients with diabetes mellitus, it reduces the concentration of glucose in the blood by inhibiting gluconeogenesis in the liver, reducing the absorption of glucose from the gastrointestinal tract and increasing its utilization in tissues; Reduces the concentration in the blood serum of TG, cholesterol and LDL (determined on an empty stomach) and does not change the concentration of lipoproteins of other densities. Stabilizes or reduces body weight.
In the absence of insulin in the blood, the therapeutic effect does not appear. Does not cause hypoglycemic reactions. Improves the fibrinolytic properties of blood by suppressing tissue-type profibrinolysin activator inhibitor (plasminogen).
Indications
Diabetes mellitus type 2 in adults (including those with ineffectiveness of the sulfonylurea group), especially in cases accompanied by obesity.Contraindications
Hypersensitivity, hyperglycemic coma, ketoacidosis, chronic renal failure, liver disease, heart failure, acute myocardial infarction, respiratory failure, dehydration, infectious diseases, major operations and injuries, alcoholism, hypocaloric diet (less than 1000 kcal/day), lactic acidosis (incl. history), pregnancy, lactation. The drug is not prescribed 2 days before surgical operations, radioisotope, x-ray studies with the introduction of contrast drugs and within 2 days after them. With caution. Age over 60 years, performing heavy physical work (increased risk of developing lactic acidosis).Side effects
From the digestive system: nausea, vomiting, “metallic” taste in the mouth, decreased appetite, dyspepsia, flatulence, abdominal pain.
From the metabolic side: in some cases - lactic acidosis (weakness, myalgia, respiratory disorders, drowsiness, abdominal pain, hypothermia, decreased blood pressure, reflex bradyarrhythmia), with long-term treatment - hypovitaminosis B12 (malabsorption).
From the hematopoietic organs: in some cases - megaloblastic anemia.
Allergic reactions: skin rash.
In cases of side effects, the dose should be reduced or temporarily discontinued.
Application and dosage
Orally, during or immediately after meals, for patients not receiving insulin - 1 g (2 tablets) 2 times a day in the first 3 days or 500 mg 3 times a day, subsequently from days 4 to 14 - 1 g 3 times a day; after 15 days, the dosage can be reduced taking into account the glucose levels in the blood and urine. Maintenance daily dose – 1-2 g.
Retard tablets (850 mg) are taken 1 morning and evening. The maximum daily dose is 3 g.
With simultaneous use of insulin at a dose of less than 40 units/day, the metformin dosage regimen is the same, but the insulin dose can be gradually reduced (by 4-8 units/day every other day). With an insulin dose of more than 40 units/day, the use of metformin and a reduction in the insulin dose requires great caution and is carried out in a hospital.
special instructions
During treatment, monitoring of renal function is necessary; determination of lactate in plasma should be carried out at least 2 times a year, as well as when myalgia appears. If lactic acidosis develops, treatment should be discontinued.
When combined with sulfonylurea derivatives, careful monitoring of blood glucose concentrations is necessary.
Interaction
Reduces Cmax and T1/2 of furosemide by 31 and 42.3%, respectively.
Incompatible with ethanol (lactic acidosis).
Use with caution in combination with indirect anticoagulants and cimetidine.
Sulfonylurea derivatives, insulin, acarbose, MAO inhibitors, oxytetracycline, ACE inhibitors, clofibrate, cyclophosphamide and salicylates enhance the effect.
When used simultaneously with corticosteroids, hormonal contraceptives for oral administration, epinephrine, glucagon, thyroid hormones, phenothiazine derivatives, thiazide diuretics, nicotinic acid derivatives, the hypoglycemic effect of metformin may be reduced.
Furosemide increases Cmax by 22%.
Nifedipine increases absorption, Cmax, and slows excretion.
Cationic drugs (amiloride, digoxin, morphine, procainamide, quinidine, quinine, ranitidine, triamterene and vancomycin), secreted in the tubules, compete for tubular transport systems and with long-term therapy can increase Cmax by 60%.