Metformin

Description overdue on 28.10.2011

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Hypoglycemic agents (group biguanide). Metformin decreases the rate of hepatic of gluconeogenesis Increases tissue sensitivity to insulin enhances glucose utilization in the circumferential direction, reduces intestinal absorption   glucose. The drug has no effect on the production of insulin   beta cells, does not provoke a hypoglycaemic response. Under the action of metformin reduces the concentration of LDL triglyceride. The drug can stabilize and even reduce weight. By inhibiting tissue plasminogen achieved pronounced fibrinolytic action .
Absorption of the drug occurs in the gastrointestinal tract, the bioavailability is 60%, it does not bind to plasma proteins. Accumulation metformin occurs in the liver, muscular system, salivary glands and kidneys. It accumulates in the body for violations of the renal system.

Indications:

Diabetes   type 2, with poor diet, addiction to ketoacidosis . Metformin is used in combination therapy with insulin in type 2 diabetes in obese, insulin resistance.

Contraindications:

Ketoacidosis, hyperglycemic coma, liver disease, chronic renal failure, acute myocardial infarction , Heart failure, dehydration, respiratory disorders, alcoholism, trauma and surgery, infectious diseases,   lactic acidosis , Reduced-calorie diet, and pregnancy. Metformin do not appoint two days before the of operative intervention, roentgenologic, radioisotope researches with the introduction of contrast substance (recommended to refuse from reception of of the drug in for 2 days after procedures). Be wary appoint patients older than 60 years, when performing heavy physical work (risk of lactic acidosis ).

Side effect:

GI: metallic taste in the mouth, loss of appetite, flatulence , Dyspepsia. When assigning antispasmodic, atropine , Antacids above symptoms cropped. Metabolism: B12 vitamin deficiencies, lactic acidosis. Bodies of hematopoiesis: megaloblastnaya anemia . Endocrine system: hypoglycemia . Allergies.

Mode of application:

Metformin is taken orally after meals: 1 g twice a day for 3 days, followed by 1g three times a day, from the 15th day of dosing reduces and corrected for glucose. Retard tablets contain 850 mg meformina take on 1t morning and evening.

Overdose:

In excess doses meformina may develop lactic acidosis, including death. Overdose can occur when cumulation drug in the body as a result of pathology the renal system. Manifested dyspepsia, decreased body temperature, muscle pain, abdominal pain, rapid breathing, impaired consciousness, dizziness, coma development. The need for hospitalization, urgent to determine the level lactate . Hemodialysis and symptomatic therapy. No specific antidote.

Special instructions:

During treatment with metformin is necessary to monitor the condition of the renal system, to control the concentration of lactate in the blood two times a year and myalgia. The treatment is stopped when the first signs of development lactic acidosis . Metformin not appoint at severe course of of infectious diseases, dehydration, traumas. Combination therapy of metformin and of insulin is conducted in the conditions of of a stationary of treatment.

Drug Interactions:

Metformin is recommended Mr. simultaneously from danazol (possibly increasing hyperglycemic effect). With care prescribe a drug chlorpromazine: at a dose of 100 mg per day reduced the release of insulin, increases glycemia . The need for correction dose of the drug Metformin when of simultaneous appointment with neuroleptics . Acarbose, MAO inhibitors, sulfonylureas, NSAIDs, ACE inhibitors, oxytetracycline, cyclophosphamide, proizvonye clofibrate, beta-blockers increase the hypoglycemic effect of the drug. Oral contraceptives, corticosteroids, glucagon , Thiazide iuretiki, hormones of the thyroid gland, sympathomimetics, epinephrine, loop diuretics, derivatives of of nicotinic acid, phenothiazine derivatives reduces the gipoglikemiceski effect of metformin. Under the influence of the drug cimetidine slows excretion from the body, increases the risk of lactic acidosis. Meformin weakens the effect of coumarin derivatives, anticoagulants . Simultaneous use of alcohol provokes lactic acidosis, particularly in the low-calorie diet, fasting, liver failure.