Metformin-Zentiva is a medication intended for the treatment of type 2 diabetes mellitus (DM 2). Producer - Sanofi India Ltd. / Zentiva. Belongs to the class of biguanides. In addition to the main purpose, it lowers cholesterol and extra pounds. The main active ingredient is metformin hydrochloride.
The tool helps to reduce the production of glucose by the liver, delays its absorption in the digestive tract, and inhibits the synthesis of fats. In the process of intake in the muscles, sensitivity to insulin increases. Metformin has a positive effect on lipid metabolism. Reduces cholesterol, LDL, triglycerides. The concentration of sugar in the blood is reduced by suppressing the formation of glucose. In the course of studies, stabilization or a moderate decrease in body weight was found.
Indications for use
The medication is prescribed in the following cases:
- treatment of type 2 diabetes as mono therapy,
- treatment of type 2 diabetes with insulin or other sugar-lowering drugs,
- reduction of complications from the cardiovascular system in individuals with type 2 diabetes,
- complex therapy in the treatment of obesity.
Instructions for use
The drug is prescribed for adults and children from 10 years old according to the following scheme:
- Monotherapy or combination with other tableted drugs
They begin therapy with minimal doses - 500 mg 2-3 times a day. After 1-2 weeks, if necessary, adjust the dosage. The maximum dose is 2000-3000 mg in 3 divided doses.
The medicine is consumed 500-850 mg 2-3 times a day. Correction of insulin injections.
- Persons with a mild degree of renal failure start taking 500 mg once a day. The maximum dosage is 1000 mg 2 times.
The drug is contraindicated in the following cases:
- hypersensitivity to the components of the drug,
- moderate / severe renal failure,
- heart failure,
- alcohol addiction,
- a recent heart attack,
- liver failure,
- pregnancy / lactation.
Metformin is well tolerated by patients, but in some cases the following negative effects are observed:
- decreased absorption of B12 (with prolonged use),
- gastrointestinal disorders
- taste violation
- skin reactions
- lactic acidosis.
Interaction with other drugs
The drug is not compatible with ethanol. Insulin, salicylic acid derivatives, MAO inhibitors, sulfonylureas, nootropics enhance the action of metformin. Oral contraceptives, hormones, diuretics, niacin, phenothiazines reduce the effect of the drug.
Terms and conditions of storage of the drug
Metformin Zentiva does not require special saving conditions. It is stored at a temperature of 25 degrees in the original package. Shelf life is 3 years.
The pharmacological market has many drugs based on metformin.
Most popular brand names:
- Bagomet, Argentina,
- Glycomet, India,
- Glucophage, France,
- Insufor, Turkey,
- Metformin Sandoz, Slovenia / Poland,
- Siofor, Germany.
Release form, composition
The tablets, film-coated white, are oblong, biconvex, with a risk for division on both sides.
|metformin hydrochloride||1000 mg|
PRING sodium carboxymethyl starch - 40 mg, povidone 40 - 80 mg, colloidal silicon dioxide - 14 mg, corn starch - 20 mg, magnesium stearate - 6 mg.
The composition of the film membrane: sephyphilm 752 white (hypromellose - 35-45%, microcrystalline cellulose - 27-37%, macrogol stearate - 6-10%, titanium dioxide - 18-22%) - 20 mg, macrogol 6000 - 0.23 mg.
10 pieces. - blisters (1) - packs of cardboard.
10 pieces. - blisters (3) - packs of cardboard.
10 pieces. - blisters (6) - packs of cardboard.
10 pieces. - blisters (9) - packs of cardboard.
Hypoglycemic drug for oral use. Metformin is a biguanide with a hypoglycemic effect, which determines a decrease in the basal (fasting) and postprandial (2 hours after the start of food intake) plasma glucose concentration. Unlike sulfonylurea derivatives, metformin does not stimulate insulin secretion by pancreatic beta cells and does not pose a risk of hypoglycemia.
Increases the sensitivity of peripheral receptors to insulin and the utilization of glucose by cells. Reduces liver glucose production by inhibiting gluconeogenesis and glycogenolysis. Delays intestinal absorption of glucose.
Metformin stimulates the synthesis of intracellular glycogen by acting on glycogen synthase. Increases the transport capacity of all types of membrane glucose transporters.
Metformin has a beneficial effect on lipid metabolism: it lowers total cholesterol, LDL and triglycerides.
While taking metformin, the patient's body weight either remains stable or decreases moderately.
In patients aged 10-16 years who were treated with metformin for 1 year, the glycemic control indicators were comparable with those in the adult population.
After oral administration, metformin is absorbed in the digestive tract. With max achieved 2.5 hours after ingestion. Bioavailability for dosages of 500 and 850 mg in healthy people is 50-60%. Absorption of metformin when ingested is saturated and incomplete. It is assumed that the pharmacokinetics of metformin absorption is non-linear. When metformin is used in recommended doses and according to the recommended regimen, C ss in plasma is achieved within 24-48 hours and usually is less than 1 μg / ml. C max metformin does not exceed 5 μg / ml, even when using the drug in maximum doses.
Eating reduces the degree and slows down the absorption of metformin. After ingestion of an 850 mg tablet, a decrease in C max of 40%, a decrease in AUC of 25% and an increase of 35 minutes in the time to reach C max are observed.
Metformin is rapidly distributed in tissues, practically does not bind to plasma proteins. Metformin penetrates red blood cells. C max in the blood is lower than C max in the blood plasma, and is achieved approximately simultaneously. Red blood cells, in all likelihood, are a secondary distribution depot. The average V d is in the range of 63-276 liters.
Metformin is excreted unchanged by the kidneys, is metabolized very slightly, metabolites have not been identified.
After taking the drug inside through the intestine, 20-30% of the non-absorbed substance is excreted. The renal clearance of metformin is more than 400 ml / min, which indicates the elimination of metformin by active glomerular filtration and tubular secretion. After oral administration, T 1/2 is about 6.5 hours.
In case of impaired renal function, cumulation of the drug is possible, which leads to an increase in the concentration of metformin in blood plasma.
Special patient groups
Patients with impaired renal function. The available data obtained in patients with moderate renal insufficiency are few and do not allow to reliably assess the systemic effects of metformin in this subgroup, as can be done in individuals with normal renal function.
Patients of childhood. After a single use of metformin at a dose of 500 mg in children, a pharmacokinetic profile was found that was similar to that observed in healthy adults. After repeated use of metformin at a dose of 500 mg 2 times / day for 7 days in children, C max and AUC 0-t are reduced
approximately 33% and 40%, respectively, compared with the values of these parameters in adult patients with diabetes who received metformin in a dosage of 500 mg 2 times a day for 14 days. Since the dose of the drug is selected individually depending on the level of glycemia, these data are of limited clinical value.
Dosage and administration
The drug is taken orally. Tablets should be taken whole during or immediately after a meal with a small amount of liquid.
The drug Metformin Zentiva should be taken daily, without interruption. If treatment is discontinued, the patient should inform the doctor.
Monotherapy and combination therapy in combination with other oral hypoglycemic agents
The initial dose, as a rule, is 500 mg or 850 mg 2-3 times / day after or during meals. A further gradual increase in dose is possible depending on the concentration of glucose in the blood.
After 10-15 days of use, the dose must be adjusted taking into account the results of measuring the concentration of glucose in blood plasma. Slow dose increases can help improve gastrointestinal tolerance.
The maintenance dose is usually 1500-2000 mg / day. To reduce side effects from the gastrointestinal tract, the daily dose should be divided into 2-3 doses. The maximum dose is 3000 mg / day, divided into 3 doses.
Patients taking metformin in doses of 2000-3000 mg / day can be transferred from taking metformin tablets at a dose of 500 mg to taking metformin tablets at a dose of 1000 mg. The maximum recommended dose is
3000 mg / day, divided into 3 doses.
In the case of planning the transition from taking another hypoglycemic agent: you must stop taking another drug and start taking Metformin Zentiva in the dose indicated above.
To achieve better blood glucose control, metformin and insulin can be used as a combination therapy. The initial dose of Metformin Zentiva, as a rule, is 500 mg or 850 mg 2-3 times / day, while the dose of insulin is selected on the basis of blood glucose concentrations.
Patients with impaired renal function
Metformin can be used in patients with moderate renal impairment (CC 45-59 ml / min, GFR 45-59 ml / min / 1.73 m 2 of the body surface) only in the absence of other conditions that may increase the risk of lactic acidosis, and under the following conditions of dose adjustment: the initial dose of Metformin Zentiva is 500 mg or 850 mg 1 time / day.
The maximum dose is 1000 mg / day, divided into 2 doses. Careful monitoring of renal function is required (every 3-6 months).
If QC 2 of the body surface, Metformin Zentiva should be discontinued immediately.
Due to possible impaired renal function, the dose of the drug Metformin Zentiva in elderly patients must be selected under regular monitoring of renal function indicators (determine the concentration of creatinine in blood serum at least 2-4 times a year).
Children and teens
In children aged 10 years and older, the drug Metformin Zentiva can be used both as monotherapy and in combination with insulin. The initial dose, as a rule, is 500 mg or 850 mg 1 time / day after or during meals. After 10-15 days, the dose must be adjusted based on indicators of glucose concentration in the blood. The maximum daily dose is 2000 mg, divided into 2-3 doses.
Symptoms: when applied at a dose of 85 g (42.5 times the maximum daily dose), the development of hypoglycemia was not observed. With an overdose of metformin, lactate acidosis may develop. Lactic acidosis is an emergency and requires inpatient treatment. The cause of the development of lactic acidosis can also be the cumulation of the drug due to impaired renal function.
The earliest symptoms of lactic acidosis are nausea, vomiting, diarrhea, lowering body temperature, abdominal pain, muscle pain, and thereafter, rapid breathing, dizziness, impaired consciousness and the development of coma can occur.
Against the background of an overdose of metformin, pancreatitis may occur.
Treatment: in case of signs of lactic acidosis, treatment with metformin should be stopped immediately, the patient should be urgently hospitalized, the concentration of lactic acid in the blood plasma should be determined and the diagnosis confirmed. The most effective procedure for removing lactic acid and metformin from the body is hemodialysis. Symptomatic treatment is also carried out.
Interaction with other l / s
Iodine-containing radiopaque agents
Intravascular administration of iodine-containing radiopaque agents can lead to the development of functional renal failure, thereby increasing the accumulation of metformin and the risk of lactic acidosis. In patients with GFR> 60 ml / min / 1.73 m2 of body surface area, metformin should be discontinued before or during the X-ray examination and not renewed within 48 hours after it is completed, provided normal kidney function is confirmed. In patients with impaired renal function of moderate severity (GFR 45-60 ml / min / 1.73 m 2), the use of metformin should be discontinued 48 hours before the administration of an iodine-containing contrast medium and resumed no earlier than 48 hours after the completion of the study and only after re-evaluation renal function in the absence of signs of its deterioration.
In acute alcohol intoxication, the risk of developing lactic acidosis increases, especially in the case of starvation or malnutrition, following a low-calorie diet or with liver failure. While taking the drug, alcohol and drugs containing ethanol should be avoided.
Combinations requiring caution
The simultaneous use of danazol is not recommended in order to avoid the hyperglycemic effect of the latter. If treatment with danazol is necessary and after stopping the latter, dose adjustment of metformin is required under the control of blood glucose concentration.
Chlorpromazine when taken in high doses (100 mg / day) increases the concentration of glucose in the blood, reducing the release of insulin. In the treatment of antipsychotics and after stopping their administration, dose adjustment of metformin is required under the control of blood glucose concentration.
GCS of systemic and local action reduce glucose tolerance, increase the concentration of glucose in the blood, sometimes causing ketosis. In the treatment of corticosteroids and after cessation of their intake, a dose adjustment of metformin is required under the control of the concentration of glucose in the blood.
Diuretics (especially loopbacks)
The simultaneous use of "loop" diuretics can lead to the development of lactic acidosis due to possible functional renal failure. Metformin should not be prescribed to patients if the CC is below 60 ml / min.
Beta 2 -adrenomimetics in the form of injections
Beta 2 -adrenergic agonists increase the concentration of glucose in the blood due to the stimulation of β 2 -adrenoreceptors. In this case, it is advisable to regularly monitor the concentration of glucose in the blood. If necessary, insulin is recommended.
With the simultaneous use of the above drugs, the dose of metformin can be adjusted during treatment or after its termination.
Antihypertensive drugs, with the exception of ACE inhibitors, can alter the concentration of glucose in the blood. If necessary, the dose of metformin should be adjusted.
Derivatives of sulfonylureas, insulin and acarbose
With simultaneous use with metformin, the development of hypoglycemia is possible.
With simultaneous use with metformin, the development of hypoglycemia is possible.
Increases absorption and increases C max of metformin.
Amiloride, digoxin, morphine, procainamide, quinidine, quinine, ranitidine, triamteren, trimethoprim and vancomycin, excreted by the renal tubules, compete with metformin for tubular transport systems and can lead to an increase in C max up to 60%.
The hypoglycemic effect of metformin can be reduced by phenothiazines, glucagon, estrogens, including as part of oral contraceptives, phenytoin, sympathomimetics, nicotinic acid, isoniazid, slow calcium channel blockers.
Levothyroxine may reduce the hypoglycemic effect of metformin. Monitoring of blood glucose concentration is recommended, especially during the initiation or termination of thyroid hormone therapy, and if necessary, the dose of metformin should be adjusted.
With the simultaneous use of metformin with NSAIDs, MAO inhibitors, oxytetracycline, derivatives of fibroic acid, cyclophosphamide, probenecid, chloramphenicol, sulfonamide antimicrobials, it is possible to increase the hypoglycemic effect of metformin.
In healthy volunteers in studies on a single dose of metformin and propranolol, as well as metformin and ibuprofen, there was no change in their pharmacokinetic parameters.
Metformin may reduce the therapeutic effect of the anticoagulant fenprocoumone. When used together, careful monitoring of MHO is recommended.
During pregnancy and lactation
Uncontrolled diabetes during pregnancy is associated with an increased risk of congenital malformations and perinatal mortality. A limited amount of data suggests that taking metformin in pregnant women does not increase the risk of developing congenital malformations of the fetus. Animal studies have not shown harmful effects on pregnancy, the development of the embryo or fetus, the course of labor and postnatal development.
When planning pregnancy, as well as in the event of pregnancy on the background of taking metformin, the drug should be discontinued and insulin therapy should be prescribed.
It is necessary to maintain the blood glucose level at the level closest to normal to reduce the risk of malformations in the fetus.
Metformin passes into breast milk. Side effects in newborns / infants while taking metformin were not observed. However, due to limited data, the use of the drug during breastfeeding is not recommended. The decision to stop breastfeeding should be made taking into account the benefits of breastfeeding and the potential risk of side effects in the baby.
When using Metformin, the following side effects may occur, which are divided into organ-system classes in accordance with the MedDRA classification. Determination of the frequency of side effects according to the WHO classification: very often (≥10%), often (≥1% and From the blood and lymphatic system: frequency is unknown - hemolytic anemia.
From the side of metabolism and nutrition: very rarely - lactic acidosis, decreased absorption of vitamin B 12 in patients with megaloblastic anemia, the frequency is unknown - peripheral neuropathy in patients with vitamin B 12 deficiency.
From the nervous system: often - a distortion of taste, the frequency is unknown - encephalopathy.
From the digestive tract: very often - nausea, vomiting, diarrhea, abdominal pain, loss of appetite. These unwanted effects most often occur during the initiation of therapy and in most cases resolve on their own. To prevent their occurrence, it is recommended to take a daily dose of metformin for 2 or 3 doses during or after a meal. A slow increase in the dose of the drug can help improve tolerance from the digestive tract.
On the part of the skin and subcutaneous tissues: very rarely - erythema, skin itching, urticaria, frequency unknown - photosensitivity.
On the part of the liver and biliary tract: very rarely - increased activity of hepatic transaminases or hepatitis, disappearing after drug withdrawal.
Influence on the results of laboratory and instrumental studies: the frequency is unknown - a decrease in the concentration of TSH in plasma in patients with hypothyroidism, hypomagnesemia against the background of diarrhea.
Children and teens
Published data, data of post-registration use, as well as the results of controlled clinical trials in a limited population of children in the 10-16 year old group who were treated with metformin for 1 year, show that adverse events in children are similar in nature and severity to those in adult patients.
Lactic acidosis is a rare, but serious (high mortality in the absence of immediate treatment), metabolic complication that may occur as a result of cumulation of metformin. There are reports of cases of lactic acidosis during treatment with metformin in patients with diabetes mellitus and with severe renal failure or acute impairment of renal function. Particular attention should be paid to situations where renal dysfunction may occur, for example, in the case of dehydration (with severe diarrhea or vomiting) or at the beginning of antihypertensive therapy or diuretic therapy (especially “loopback”), as well as at the beginning of NSAID therapy. In the event of these acute conditions, therapy with Metformin Zentiva should be temporarily discontinued.
Other associated risk factors should also be considered, such as decompensated diabetes mellitus, ketosis, prolonged fasting, excessive alcohol consumption, liver failure and any condition associated with severe hypoxia (for example, heart failure with unstable hemodynamics, respiratory failure, acute myocardial infarction )
The risk of lactic acidosis should be considered when nonspecific symptoms appear, such as muscle cramps, dyspeptic disorders, abdominal pain, and severe asthenia. Patients should be instructed to immediately inform their doctor about the occurrence of these symptoms, especially if the patient previously tolerated metformin therapy well. In this case, therapy with Metformin Zentiva should be discontinued, at least temporarily, until the situation is clarified. The question of the resumption of therapy must be decided individually, taking into account the benefit / risk ratio, and also taking into account the state of renal function in this patient.
Diagnosis: lactate acidosis is characterized by acidotic shortness of breath, abdominal pain, hypothermia, followed by coma. Laboratory indicators include: a decrease in blood pH (less than 7.25), a concentration of lactic acid in blood plasma above 5 mmol / l, and increased anionic gap and the ratio of lactate / pyruvate. If metabolic acidosis is suspected, it is necessary to stop taking metformin and immediately hospitalize the patient.
Doctors should inform patients about the risk of lactic acidosis and its symptoms.
You should stop taking the drug Metformin Zentiva 48 hours before the planned surgical intervention under anesthesia, spinal or epidural anesthesia. Therapy can be resumed no earlier than 48 hours after surgery or after the restoration of food intake and only with normal renal function.
Because metformin is excreted by the kidneys, the QC indicator should be monitored before starting therapy and then regularly:
- at least once a year in patients with normal renal function,
- at least 2-4 times a year in patients with a CC value at the lower limit of normal and in elderly patients.
With KK 2 body surfaces) the use of the drug Metformin Zentiva is contraindicated.
Deterioration in kidney function in elderly patients is often asymptomatic.
Particular caution should be exercised in case of possible impaired renal function in case of dehydration or with the simultaneous use of antihypertensive drugs, diuretics (especially “loopback” ones) or NSAIDs. In these cases, it is also recommended to check the status of renal function before starting therapy with Metformin Zentiva.
Patients with heart failure have a higher risk of developing hypoxia and renal failure. In patients with stable chronic heart failure, the drug Metformin Zentiva can be used subject to regular monitoring of heart function and kidney function.
The use of the drug Metformin Zentiva is contraindicated in patients with acute or chronic heart failure with unstable hemodynamics.
Metformin did not affect the reproductive function of male or female rats when used in doses up to 600 mg / kg / day, which is approximately 3 times higher than the maximum recommended daily dose in humans according to comparison based on body surface area.
Children and teens
The diagnosis of type 2 diabetes mellitus should be confirmed before starting treatment with Metformin Zentiva.
In controlled clinical trials lasting one year, the effect of metformin on the growth and puberty of children was not found. However, due to the lack of long-term data, it is recommended to carefully monitor the subsequent effect of metformin on these parameters in children taking Metformin Zentiva, especially in children aged 10-12 years.
- Patients should follow a diet with regular carbohydrate intake throughout the day. Overweight patients should continue to adhere to a low-calorie diet (but not less than 1000 kcal per day).
- Regular laboratory tests should be carried out regularly to control diabetes.
-Metformin does not cause hypoglycemia during monotherapy, however, caution is advised when used in combination with insulin or other hypoglycemic agents (for example, sulfonylureas, repaglinide).
- Long-term therapy with metformin is accompanied by a decrease in the concentration of vitamin B 12 in the blood plasma, which can cause peripheral neuropathy. Regular monitoring of plasma vitamin B 12 concentrations is recommended.
Influence on the ability to drive vehicles and control mechanisms
The use of the drug Metformin Zentiva as monotherapy does not affect the ability to drive vehicles and mechanisms.
When combining Metformin Zentiva with other hypoglycemic agents (including sulfonylureas, insulin, meglitinides), it is necessary to warn patients about the possibility of developing hypoglycemic conditions in which the ability to drive vehicles and engage in other potentially dangerous activities requiring increased attention is worsened and rapid psychomotor reactions.
Metformin for weight loss: instructions for use, reviews and how much does it cost?
When the observance of special programs that help to reduce excess weight does not give visible results, many people begin to use drugs that help to lose weight.
One of these drugs is Metformin, which not only effectively fights extra pounds, but also improves the metabolism and improves the functioning of internal organs.
However, many are interested in how to take Metformin for weight loss in order to achieve visible results and maintain the effect.
What is metformin?
Metformin - a medicine, also called Glucofage, is available in the form of tablets and is used to lower blood sugar. It is often used to treat a disease such as diabetes.
The drug has the following therapeutic properties on the human body:
- Eliminates bad cholesterol and prevents the occurrence of atherosclerosis disease
- Prevents the occurrence of diseases such as stroke due to the progression of diabetes
- It is used to prevent the development of diabetes
- Appetite suppressant
The drug has side effects and requires special tests and medical advice to prescribe the correct dosage of the drug.
How much to take?
How much do you need to take this substance in order to have a result?
To treat the disease, diabetes is assigned an individual dose for each patient.
Most often, the standard dosage of the drug is 2 tablets per day in the morning and evening. The drug is used with meals.
The tablet should be washed down with plenty of water. Depending on the degree of the disease, an increase in the dose of the drug as prescribed by the doctor is possible. This type of drug is not used for ages under 20 years.
Can I lose weight while taking Metformin?
The use of the drug reduces the absorption of sugar and reduces the formation of adipose tissue. Of course you can lose weight, but it can turn out a long way if you do not follow all the rules.
To reduce weight, the drug has the following positive effect on the body:
- Reduces the absorption of carbohydrates and removes them naturally
- Oxidizes fatty acids and inhibits their absorption
- Eliminates excess weight by converting fat cells into energy for the body
- Promotes partial glucose uptake by muscle tissue
- Eliminates the feeling of constant hunger.
You should know that the drug alone can not eliminate the extra pounds. To do this, you must first observe proper nutrition, and reduce the consumption of harmful food. It is also very important to perform basic physical exercises that will help maintain and strengthen the result.
How does Metformin help to lose weight?
- Using Metformin reduces sugar absorption and boosts the metabolism, as a result, fat deposits break down into smaller particles, part of which is converted into energy, the rest of the fat particles are removed from the body.
- In addition, the carbohydrates that a person consumes are enveloped in a kind of shell, which prevents their digestion, as a result, carbohydrates are excreted from the body.
- The drug helps eliminate bad cholesterol, which enters the body along with junk food, and improves the transport of nutrients to internal organs, thereby improving their function.
- Proper nutrition helps prevent harmful substances from entering the body. and the accumulation of fat cells, and the use of the drug eliminates extra pounds.
How to drink Metformin for weight loss?
Very often, the use of the drug occurs without a doctor's prescription, so at first you should use the most minimal dose of the drug.
For the first time 10 days, it is recommended to use no more than two tablets per day, in the morning and in the evening. The tool is taken after a meal, you need to drink a tablet with plenty of water.
Eliminate foods such as:
- Fatty meats and fish.
- Carbonated drinks.
- Smoked meats.
- Canned food.
After several weeks of a standard dosage of the drug, it is possible to increase the dose to three tablets per day. The course of use of the drug is not more than one month, after which it is necessary to take a break of at least three months. If you take Metformin for a longer period, addiction and a decrease in the result may occur.
Metformin zentiva is actively used in medical practice as one of the drugs for type 2 diabetes. Today, the pharmaceutical industry produces a large number of various sugar-lowering medications, and metformin zentiva is one of them.
One of the main advantages of the drug is that, unlike drugs derived from sulfonylureas, it does not cause hypoglycemia. This property is explained by the fact that Metformin is not a stimulant of insulin secretion by pancreatic beta cells.
Instructions for use
Tablets are taken orally. It is not recommended to chew or cut the tablet. The therapeutic course is calculated on a daily intake of the drug, for 1 month.
Dosage for adults:
- It is recommended to start taking it with a dosage of 500 mg, with a maximum daily dosage of 1.5 g,
- gradually, after 10 days, the dosage is increased by 850 mg 2-3 times a day or up to 1000 mg, with a maximum daily dose of 3 g.
In some cases, a transition from 500 mg to 1000 mg immediately is allowed. The calculation of the dosage and course is carried out by the doctor, depending on the condition of the patient.
Innovation in diabetes - just drink every day.
During therapy with Metformin Zentiva, obese patients experience a decrease in body weight or its stabilization!
Metformin-Richter tablets should be taken whole during or immediately after a meal, washed down with a small amount of liquid (a glass of water). To reduce side effects from the gastrointestinal tract, the daily dose should be divided into 2-3 doses.
Due to the increased risk of lactic acidosis, the dose should be reduced in severe metabolic disorders.
Composition, release forms
The medication is in tablets with a content with a concentration of metformin: 500, 850 or 1000 mg.
Associated components: sodium carboxymethyl starch, povidone-40, aerosil, corn starch, E-572.
Film Coating Components: Sepifilm-752 (White) Macrogol-6000.
500 mg - round, convex on both sides, covered with a white protective layer.
850 mg and 1000 mg are elongated, convex, in a white coating. On one of the surfaces of the 500 mg pills there is a dividing strip that facilitates breaking, and on the 1000 mg preparation it is applied on both sides.
Packed in blister plates of 10 pcs. In a pack of thick cardboard - 3/6/9 plates along with a description-guide.
The drug is intended for oral administration. Sugar-lowering effect is provided by its main compound - metformin. The substance is included in the group of biguanides - compounds with hypoglycemic properties that can regulate the glycemic content in the body. It differs from other sulfonylurea derivatives in that it does not affect the cells of islets of Langerhans that synthesize endogenous insulin, and therefore does not contribute to the occurrence of hypoglycemia.
After penetration into the body, it enhances the receptor sensitivity to insulin and activates the processing of glucose. In addition, it inhibits the formation of substances in the liver by suppressing the mechanisms of glycogenolysis, gluconeogenesis and blocks its absorption in the digestive tract.
Metformin improves the passage of glucose, has a beneficial effect on the ratio of harmful and beneficial cholesterol. Virtually no effect on the set of extra pounds.
The substance is absorbed in the digestive tract, its highest concentration in the blood is formed after 2-2.5 hours. The rate of assimilation may fall due to food intake, as absorption is slowed down. Metformin almost does not react with plasma proteins, but it is able to pass inside red blood cells.
The substance almost does not form metabolic compounds, it is excreted by the kidneys in almost the same form.
Cross drug interactions
Average price: 500 mg: (30 pcs.) - 133 rub., (60 pcs.) - 139 rub. 850 mg: (30 pcs.) - 113 rub., (60 pcs.) - 178 rub. 1000 mg: (30 pcs.) -153 rub., (60 pcs.) - 210 rub.
Glycemia control using Metformin Zentiva should take into account the characteristics of combination with other drugs. Otherwise, the simultaneous administration of medications of different properties can lead to unpredictable reactions and the development of severe side effects.
Tablets are contraindicated to drink with iodine-containing contrast agents. Manufacturers recommend interrupting the use of metformin two days before the X-ray examination. Resume reception is allowed after the end of the procedures, also after two days. If the patient ignores contraindications, the result of the interaction of the drugs will be functional renal failure, which will lead to the accumulation of metformin in the body and cause a life-threatening condition - lactic acidosis.
Alcohol. Taking pills against the background of acute alcohol poisoning contributes to the formation of lactic acidosis. A threatening condition manifests itself especially severely if the patient is starving or poorly fed (diets, fasts) or he has functional liver / kidney disorders. In order not to provoke a serious deterioration in health, while taking Metformin, you need to exclude the intake of drinks with alcohol, drugs with ethanol.
The combination of metformin with other drugs that require symptom control
- Danazole: it is undesirable to combine with metformin due to a possible hyperglycemic effect. If it is not possible to cancel Danazol, the dosage of metformin should be constantly monitored and adjusted according to sugar indicators.
- Chlorpromazine is able to increase glycemia in large doses, inhibiting the release of insulin.
- GCS reduces glucose tolerance, increases glycemia, in some cases it can provoke ketosis. During the administration of GCS and after their cancellation, you need to change the dosage regimen of metformin.
- Diuretics Joint administration can provoke lactic acidosis due to a decrease in renal function.
- Β2-adrenergic agonists by acting on the corresponding receptors increase the blood glucose content. It is necessary to constantly check the dosage of metformin or replace it with insulin.
- Drugs with sulfonylurea, insulins and salicylates when interacting with Zentiva pills enhance the hypoglycemic effect.
- Nifedipine enhances the absorption of metformin and increases its concentration in the body.
- Medications of the cationic group, due to the fact that they are excreted by the renal tubules, enter into competition with metformin and therefore are able to significantly enhance its content.
- The action of Metformin Zentiva is weakened under the influence of phenositins, estrogens (including as part of oral contraceptives), sympathomimetics, nicotinic acid, BKK, anti-TB agent Isoniazid.
- Strengthening the action of tablets with metformin can be observed when combined with NSAIDs, MAOI, the antibiotic Oxytetracycline, fibrates, cyclophosphamide, sulfonamides.
- Drugs can weaken the effect of Fenprokumon.
The control of glycemia with the help of Metformin Zentiva pills may be accompanied by undesirable effects in the form of various disorders:
- Blood and lymph: hemolytic anemia.
- Metabolism and nutrition: lactic acidosis, impaired absorption of cyanocobalamin in patients with B12 folio-deficiency pathology. Also, the occurrence of peripheral nephrompathy in patients with vit deficiency is not excluded. AT 12.
- NS: dysgeusia, encephalopathy.
- Gastrointestinal tract: nausea, bouts of vomiting, diarrhea, abdominal pain, decreased desire to eat. Undesirable effects most often occur at the beginning of the treatment course and then gradually disappear as tablets continue to be taken. To prevent their appearance, the daily dosage is recommended to be divided into 2-3 doses and drink during or after meals. This technique will ensure the gradual penetration of the drug into the cells and contribute to a softer perception of the body.
- The skin and s / c layers of the dermis: itching, urticaria, erythema, in some patients - an increase in the susceptibility of the skin to solar and UV radiation.
- Liver: sometimes an increase in the activity of enzymes that disappear after the cessation of the course, hepatitis.
- Laboratory test data: decrease in thyroid hormone TT content in patients with hypothyroidism, hypomagnesemia due to diarrhea.
If necessary, you can use medicines that have a similar composition with Metformin, these include:
- Novo Formin.
Regardless of the type of analogue drug, it is necessary to study the instructions in detail and get acquainted with the side effects.
To reduce the weight of one drug will not be enough. To obtain a visible result, it is necessary to comprehensively approach the problem. Using Metformin allows you to start the process of splitting fat deposits, however, in case of non-compliance with diet and physical activity, this drug will not be effective.
Reviews of people about metformin:
Metformin zentiva for weight loss, instruction
If these cells become resistant, that is, insulin insensitive, then they cannot receive glucose from the blood. Oral hypoglycemic agents, with the exception of insulin. Very rarely skin reactions, including erythema, pruritus, urticaria.
With simultaneous use with sulfonylurea derivatives, acarbose, insulin salicylates, MAO inhibitors, oxytetracycline inhibitors of ACE, with clofibratomycyclophosphamide, the hypoglycemic effect of metformin may be enhanced.
It turns out a vicious cycle that results in obesity, insulin resistance and hyperinsulinism.
However, there is no data on the effects of growth metformin and puberty with a longer weight loss of metformin, therefore, careful monitoring of these parameters in children who are treated with metformin, especially during puberty, is recommended.
Metformin: instructions for use for weight loss
What can replace Siofor? The sugar-lowering effect of the drug is clearly visible and is observed in all patients. Film-coated tablets.
After taking metformin tablets, you can drink alcohol in moderation almost immediately, it is not necessary to wait. You can take vitamin B12 courses once a year to prevent deficiency during continuous treatment with metformin.
This situation has developed with Metformin, which is primarily intended to maintain normal sugar levels in diabetes. Of course, with the exception of cases when excess weight accompanies diabetes. To reduce the complications of diabetes in adult patients with type 2 diabetes mellitus overweight as a first-line drug with diet therapy ineffectiveness.
Metformin: reviews of losing weight
Siofor for weight loss Siofor and other metformin tablets can be taken for weight loss not only for patients with type 2 diabetes, but also for healthy people. Above on this page, you read what the dosage regimen should be to avoid diarrhea, flatulence, bloating and other side effects.
As a result, over a short period I added almost 20 kg. What is the maximum dose per day? Do not use before surgery and within 2 days after they are performed. Zentiva Slovakia Please note that the original drug is not Siofor, but Glucophage.
Metformin tablets benefit and harm to the body
"Metformin" is an oral hypoglycemic agent indicated for use in the treatment of type 2 diabetes mellitus.
• What is Metformin release form and composition?
The active chemical compound is metformin hydrochloride, the content of which is 500 milligrams. Excipients are: talc, povidone K90, in addition, crospovidone, corn starch, titanium dioxide, magnesium stearate, macrogol 6000.
The drug Metformin is available in tablets, they are round in shape and white. Delivered in blisters of 10 pieces. Prescription drugs are sold.
• What is Metformin's mechanism of action?
Metformin belongs to the group of biguanides and has characteristic pharmacological actions aimed at lowering and stabilizing the level of glucose in the bloodstream, without significantly affecting the synthesis of insulin.
Metformin tablets can enhance the processes of glucose uptake and utilization by peripheral tissues, especially muscle, which leads to a decrease in carbohydrate levels. It is important to remember that effective sugar utilization will require a sufficient amount of physical activity.
The drug suppresses the processes of biological synthesis of carbohydrates in the liver, which positively affects the content of not only glucose, but also dangerous triglycerides. Normalization of lipid levels has a positive effect on the course of diabetes, preventing the development of complications.
Metformin helps reduce and stabilize the patient’s body weight. True, this does not eliminate the need to adhere to a special diet with a reduced content of carbohydrates and fats.
The drug has a fibrinolytic effect, the cause of which is a partial blockage of the tissue plasminogen activator inhibitor. Improving the blood circulation of tissues serves to prevent the development of vascular complications that often accompany diabetes.
Metformin is actively adsorbed in the intestine. The therapeutic concentration of the drug develops 2.5 hours after administration. The medicine is prone to cumulation and can accumulate in such tissues: salivary glands, liver, in addition, kidneys, muscles.
Excretion of metformin hydrochloride is carried out with urine. The elimination half-life makes from 9 to 12 hours. With kidney disease, this important indicator may increase.
• What does Metformin do, what is the benefit for the human body from it?
The administration of a sugar-lowering drug Metformin (tablets) allows for the use of diabetes mellitus of the second type (with the ineffectiveness of diet therapy, physical activity, especially in combination with a significant degree of obesity).
Metformin in type 2 diabetes mellitus should be taken under the supervision of specialists with the results of laboratory studies of the patient. Unauthorized use can lead to serious consequences.
The use of Metformin for type 2 diabetes is unacceptable in the cases indicated below:
• Severe disorders in the liver, • Renal failure, • Pregnancy, • Fever, • Severe infectious diseases, • Need for surgical treatment, • Lactic acidosis, • Acute alcohol intoxication,
In addition, the tool is not used for hypoxic conditions.
• What is the dose for metformin? How to take Metformin for diabetes?
An effective and safe dosage usually ranges from 500 milligrams to 1 gram of metformin hydrochloride per day. In the future, depending on the level of glucose, you can adjust the amount of medication taken. The maximum daily dosage is 3 grams.
The drug Metformin, which we continue to talk about on this page www.rasteniya-lecarstvennie.ru, should not be crushed or chewed. It is recommended to take the medicine 2 to 3 times a day, after meals, with a half glass of water. Treatment is often lifelong.
• Is Metformin Overdose Possible?
Symptoms are: decreased body temperature, diarrhea, vomiting, nausea, dizziness, and increased breathing. The treatment is as follows: urgent hospitalization, hemodialysis, symptomatic therapy.
• What are the side effects of metformin?
When taking Metformin, the description - an annotation enclosed in the package, warns patients that treatment with the drug may be accompanied by negative symptoms. For example, it can be: abdominal pain, diarrhea, loss of appetite, metallic taste in the mouth, heartburn, allergic reactions, dizziness, headache, in addition, weakness, as well as changes in blood tests.
Hypoglycemic conditions are accompanied by weakness and dizziness. This is worth remembering if the patient is forced to adhere to a comprehensive treatment involving the use of metformin and other sugar-lowering drugs. With monotherapy, such consequences almost never occur.
• How to replace metformin?
Metadiene, Siofor 500, Bagomet, Metformin Novartis, Metospanin, Metformin-Teva, Metformin-BMS, Langerine, Metformin-Canon, Sofamet, Nova Met, Gliformin, Formin Pliva, Glucofage long, Metformin hydrochloride, Metfogamma 850, Metfogamma 1000, Metfogamma 1000, Metfogamma 1000, , Metformin MV-Teva, NovoFormin. Siofor 1000, Glycon, Glucophage, Metformin Zentiva, Metformin Richter, Siafor, Glyformin Prolong, Glyminfor, Diaformin OD, Metformin, Metfogamma 500, as well as Formine.
Patients should remember that taking sugar-lowering drugs does not eliminate the need to follow a low-carb diet. In addition, physical activity and the need for regular monitoring of glucose are important. Do not forget about the need to abandon bad habits.
Metformin for weight loss: how to take it, what to be afraid of + reviews of those who have lost weight and doctors
On the agenda, a very interesting substance that has already taken a wide niche in the treatment of diabetes, can sometimes be used on the way to a slim body and is actively being studied as an anti-aging drug. Metformin for weight loss: how to take it right, who can try it, and who better to do without it, reviews of doctors and people who have lost weight from forums and in real practice.
What is metformin?
This is a blood sugar lowering medicine that works through the periphery. It does not directly stimulate the pancreas to synthesize insulin, but it affects the speed and intensity of carbohydrate metabolism in other organs and tissues of the body - outside the pancreas.
Quick article navigation:
What are the mechanisms by which metformin acts on the body
The list of basic mechanisms is impressive. In the manufacturer’s dry feed, you can read it in any official instructions (request “metformin instructions for use”).
In simple words, the main benefits of the drug are described in the illustration below.
The listed mechanisms of action effectively fit into the treatment of many pathologies:
- Diabetes mellitus,
- Disorders of glucose tolerance ("prediabetes"),
- Obesity and metabolic syndrome,
- Cleopolycystic ovary in women.
Metformin is also used in sports medicine and for the prevention of aging.
The drug reduces protein glycation - one of the main causes of systemic senile inflammation. There are already communities of enthusiasts using the medicine to prolong youth. The famous Elena Malysheva has repeatedly voiced laudatory reviews of metformin. This is not a fake or a private exaggeration, but the current conclusions of modern science.
Hyperinsulinism - The Problem of Overweight People
Insulin is a hormone that the pancreas produces. Its role is a conductor for glucose molecules in our cells: “Hello! Do we know each other! I am with provisions, we will have lunch! ”
Hyperinsulinism is a pathological situation when the pancreas produces enough insulin for food intake, but it is poorly absorbed from the blood due to a decrease in the sensitivity of tissue receptors.
“We don’t recognize him - increase the concentration!” - the requirement for the pancreas follows. The gland fulfills: there is even more insulin in the blood.
And this is a trap for increasing fat reserves in the body!
Because a constantly high concentration of insulin contributes to the storage of fats: unspent carbohydrates and proteins are even more efficiently processed into fat.