Concise Prescribing Info
Metformin HCl
Adjunct to diet & exercise to improve glycemic control in type 2 DM. Monotherapy or in combination w/ other antidiabetic agents or w/ insulin.
Dosage/Direction for Use
Glumet tab Adult ≥17 yr Initially 500 mg bid. May be increased in increments of 500 mg wkly. Max: 2,000 mg/day in divided doses. Childn 10-16 yr 500 mg bid. May be increased by 500 mg wkly. Max: 2,000 mg daily in divided doses. Doses >2,000 mg should be given in 3 divided doses. Concomitant use w/ insulin Initially 500 mg once daily. May be increased by 500 mg after approx 1 wk & by 500 mg every wk thereafter until adequate glycemic control is achieved. Max: 2,500 mg daily. Glumet 850-mg tab Adult Initially 500 or 850 mg bid or tid. Max: 3 g daily in 3 divided doses. Adolescent & childn >10 yr Initially 500 or 850 mg once daily. Max: 2 g daily in 2 or 3 divided doses. Glumet-XR tab Adult ≥17 yr Initially 500 mg once daily. Dose may be increased in increments of 500 mg wkly up to max 2,000 mg once daily.
Should be taken with food. Glumet-XR Swallow whole, do not chew/crush.
Hypersensitivity. Unstable &/or type 1 (insulin-dependent) DM. History of lactic acidosis. Acute or chronic metabolic acidosis, including diabetic ketoacidosis, w/ or w/o coma. Severe renal impairment (eGFR <30 mL/min/1.73 m2). Dehydration due to persistent or severe diarrhea, recurrent vomiting; severe infection, stress, trauma & other severe conditions where it is unlikely to control hyperglycemia; diagnostic exam (eg, IV urography, angiography) that involve use of iodinated contrast agents/media. Cardiac or resp failure, recent MI, shock. Acute or chronic alcoholism. Severe liver disease. Pregnancy & lactation.
Special Precautions
Lactic acidosis. Patients w/ CHF receiving digoxin & furosemide. Monitor renal function. Discontinue use at the time of, or prior to, an iodinated contrast imaging procedure; when hypoxic states occur; temporarily discontinue in patients undergoing surgery w/ restricted food or fluid intake & periods of stress eg, fever, trauma, infection. Hepatic impairment. Avoid excessive alcohol intake. Evaluate hematologic parameters prior to initiation of therapy & at least annually. Debilitated or malnourished patients, & those w/ adrenal or pituitary insufficiency or alcohol intoxication. May affect ability to drive & use machines. Elderly. Glumet-XR Matrix core of Glumet-XR is usually broken up in GIT, but advise patients that occasionally the biologically inert compd of the tab may remain intact & be passed in stool as a soft, hydrated mass that may resemble to the original tab. Childn.
Adverse Reactions
Nausea, vomiting, diarrhea, abdominal pain & loss of appetite/anorexia. Decrease in serum vit B12, megaloblastic anemia (rare); hyperglycemia, hypoglycemia, lactic acidosis, decreased wt; agitation, dizziness, headache, lightheadedness; chest discomfort, palpitations; flushing, HTN; dyspnea, flu syndrome, pneumonitis w/ vasculitis, rhinitis, upper resp infection; abdominal discomfort (eg, bloating, abdominal cramps) & distention, abnormal stools/loose stools, anorexia, constipation, dry mouth, dyspepsia/heartburn, epigastric discomfort, flatulence, gastric disorder & ulcer, GI disorder, indigestion, taste disturbance specifically metallic taste in the mouth; abnormal liver function tests, autoimmune hepatitis, cholestasis, hepatic injury, hepatitis; erythema, nail disorder, pruritus, rash, skin lesion, urticaria; asthenia, chills, musculoskeletal pain, myalgia; UTI; fatigue, increased sweating.
Drug Interactions
May increase in peak plasma & whole blood conc, & whole blood AUC w/ cationic drugs eg, amiloride, digoxin, morphine, procainamide, quinidine, quinine, ranitidine, triamterene, trimethoprim & vancomycin; furosemide. Reduced urinary excretion & increased plasma conc w/ cimetidine. Hypoglycemia may occur w/ other antidiabetic agents eg, sulfonylureas, meglitinides, glitazones, or insulin. May exacerbate DM & result in increased requirements of oral antidiabetic agents w/ thiazide diuretics. Increased absorption, Cmax & AUC, & excretion in urine w/ nifedipine. May impair glucose tolerance & mask true frequency or severity of hypoglycemia w/ β-adrenergic blocking agents (eg, propranolol, nadolol). May reduce fasting blood glucose conc w/ ACE inhibitors (eg, captopril, enalapril). Increased risk of hypoglycemia & lactic acidosis w/ alcohol. Increased ovulatory response w/ clomifene. May affect pharmacokinetic properties of coumarin anticoagulants. May lead to renal failure w/ iodinated contrast media. May cause hyperglycemia & exacerbate loss of glycemic control include other diuretics, corticosteroids, phenothiazines, thyroid products, estrogens, OCs, phenytoin, nicotinic acid, sympathomimetics, Ca channel blocking drugs & INH.
MIMS Class
ATC Classification
A10BA02 - metformin ; Belongs to the class of biguanides. Used in the treatment of diabetes.
Glumet tab 850 mg
100's (P1,037/box)
Glumet-XR XR tab 500 mg
100's (P1,030/pack)
Glumet tab 1 g
100's (P1,143/box)
Glumet tab 500 mg
100's (P865/pack)
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