Generic Medicine Info
Should be taken with food.
Acute or chronic metabolic acidosis with or without coma, acute conditions which may alter renal function (e.g. dehydration, severe infection, shock), acute or chronic disease-causing hypoxia (e.g. unstable cardiac or respiratory failure, recent MI, shock), acute alcohol intoxication or alcoholism. Severe renal (eGFR<30 mL/min) impairment. Intravascular administration of iodinated contrast agents.
Special Precautions
Patients with risk factors for lactic acidosis, stable heart failure, dehydration, prerenal azotemia. Mild to moderate renal impairment. Hepatic impairment. Children and elderly. Pregnancy and lactation. Not indicated for use in patient with type 1 diabetes mellitus or with diabetic ketoacidosis. Monitoring Parameters Monitor glucose and ketones (urine and blood), fasting blood sugar, haemoglobin A1c at least twice yearly in stable glycaemic control; quarterly if not meeting therapy goals. Monitor renal function prior to initiation of therapy and annually thereafter; haematologic parameters at baseline and annually thereafter; vitamin B12 serum concentration every 2-3 years (prolonged use). Monitor for signs and symptoms of lactic acidosis.
Adverse Reactions
Significant: Vitamin B12 deficiency. Cardiac disorders: Chest discomfort, palpitations, dyspnoea. Gastrointestinal disorders: Nausea, vomiting, diarrhoea, abdominal pain, flatulence, heartburn/dyspepsia, abdominal distention, abnormal stools, constipation. General disorders and administration site conditions: Asthenia, flu-like symptoms, malaise. Hepatobiliary disorders: Cholestatic, hepatocellular, mixed hepatocellular liver injury. Musculoskeletal and connective tissue disorders: Myalgia, chills. Nervous system disorders: Taste disturbance, headache. Psychiatric disorders: Increased somnolence. Respiratory, thoracic and mediastinal disorders: Upper respiratory tract infection. Skin and subcutaneous tissue disorders: Nail disease, rash. Vascular disorders: Flushing.
Potentially Fatal: Lactic acidosis.
Drug Interactions
Increased risk of hypoglycaemia with insulin and insulin secretagogues (e.g. sulfonylurea). Increased risk of lactic acidosis with carbonic anhydrase inhibitors (e.g. acetazolamide, dichlorphenamide), NSAIDs, and antihypertensive agents (e.g. ACE inhibitors). Increased plasma concentration and reduced clearance with OCT2 inhibitors (e.g. cimetidine, dolutegravir, ranolazine, trimethoprim, vandetanib, isavuconazole).
CIMS Class
ATC Classification
A10BA02 - metformin ; Belongs to the class of biguanides. Used in the treatment of diabetes.
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