Description
Latin name
GLUCOPHAGE LONG
Release form
Sustained-release tablets.
Packing
30 pcs
Pharmacological action
Oral hypoglycemic preparation from the biguanide group, which reduces both basal and postprandial plasma glucose levels. It does not stimulate insulin secretion and therefore does not cause 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 glycogen synthesis by acting on glycogen synthetase. Increases transport capacity of all types of membrane glucose transporters.
Indications
Treatment of type 2 diabetes in adults with ineffective diet therapy and physical activity (especially in patients with obesity):
As monotherapy.
In combination with other oral hypoglycemic drugs, or in combination with insulin.
Contraindications
Diabetic ketoacidosis, diabetic precoma, coma.
Renal failure or impaired renal function (CC less than 60 ml / min).
Acute conditions with a risk of developing renal dysfunction, including dehydration (with diarrhea, vomiting), severe infectious diseases, shock.
Clinically expressed manifestations of acute and chronic diseases that can lead to the development of tissue hypoxia (including heart or respiratory failure, acute myocardial infarction).
Extensive surgery and injury when insulin therapy is indicated.
Hepatic failure, impaired liver function.
Chronic alcoholism, acute alcohol poisoning.
Lactic acidosis (including history).
Use for at least 48 hours before and within 48 hours after conducting radioisotope or x-ray studies with the introduction of iodine-containing contrast medium.
Compliance with a low-calorie diet (less than 1000 kcal / day).
Pregnancy.
Lactation (breastfeeding).
Age to 18 years.
Hypersensitivity to the drug.
Caution: the drug should be used in patients older than 60 years who perform heavy physical work, which is associated with an increased risk of developing lactic acidosis in them.
Use during pregnancy and lactation
When planning pregnancy, as well as in the case of pregnancy while taking the drug Glucofage Long, the drug should be discontinued, insulin therapy should be prescribed. The patient should inform the doctor about the onset of pregnancy while taking Glucofage Long.
Metformin is excreted in breast milk. Side effects in newborns during breastfeeding while taking metformin were not observed. However, due to the limited amount of data, the use of the drug during breastfeeding is not recommended.
Composition
1 tablet contains:
Active ingredient: metformin hydrochloride – 500 mg.
Excipients: carmellose sodium, hypromellose 2910, hypromellose 2208, microcrystalline cellulose, magnesium stearate.
Dosage and administration of
The drug is taken orally. The tablets are swallowed whole without chewing, washed down with a small amount of water.
The drug is taken during dinner (1 time / day) or during breakfast and dinner (2 times / day). Tablets should be taken only with meals.
The dose of the drug is determined based on the glucose content in blood plasma.
Monotherapy and combination therapy in combination with other hypoglycemic agents
Glucofage Long is prescribed in an initial dose of 500 mg (1 tab.) 1 time / day during dinner.
When switching from Glucofage (tablets with the usual release of the active substance), the initial dose of Glucofage Long should be equal to the daily dose of Glucofage.
Dose titration: depending on the glucose content in the blood plasma, every 10-15 days the dose is slowly increased by 500 mg to the maximum daily dose.
The maximum daily dose of Glucofage Long is 2 g (4 tablets) 1 time / day during dinner.
If glucose control is not achieved at the maximum daily dose taken 1 time / day, then you can consider dividing this dose into several doses per day according to the following scheme: 2 tab. during breakfast and 2 tab. during dinner.
When using the drug Glucofage Long with insulin, the usual initial dose of the drug is 500 mg (1 tab. ) 1 time / day, and the dose of insulin is selected based on the results of measuring glucose in the blood plasma.
Glucophage Long should be taken daily, without interruption. If treatment is discontinued, the patient should inform the doctor.
If you skip the next dose, the next dose should be taken at the usual time. Do not double the dose of the drug.
Special patient groups
In elderly patients and patients with reduced renal function: the dose is adjusted based on an assessment of renal function, which must be performed regularly at least 2 times a year.
Glucofage Long should not be used in children and adolescents under 18 years of age due to lack of data on the use.
Side effects
Determination of the frequency of side effects:
Very often ( 1/10).
Often ( 1/100, <1/10). Infrequently ( 1/1000, <1/100). Rarely ( 1/10 000, <1/1000). Very rarely (<1/10 000), single - cannot be evaluated with the available data. Side effects are presented in decreasing order of importance. From the side of the nervous system: often – taste disturbance (metallic taste in the mouth). From the digestive system: very often – nausea, vomiting, diarrhea, abdominal pain, lack of appetite. Most often they occur in the initial period of treatment and in most cases pass spontaneously. To prevent symptoms, it is recommended that you take metformin with meals. Slow dose increases can improve gastrointestinal tolerance. From the skin: very rarely – erythema, itching, urticaria. From the side of metabolism: very rarely – lactic acidosis. With prolonged use of metformin, a decrease in the absorption of vitamin B12 is possible, accompanied by a decrease in its concentration in the blood serum. If megaloblastic anemia is detected, the possibility of such an etiology must be considered. From the hepatobiliary system: there are few reports of impaired liver function or hepatitis after the withdrawal of metformin, adverse events completely disappear. If dyspeptic symptoms do not disappear, treatment with metformin should be discontinued. Drug Interaction Contraindications combinations On the background of functional renal failure in patients with diabetes, radiological examination using iodine-containing contrast agents may cause the development of lactic acidosis. Long glucose should be abolished 48 hours before and not resumed earlier than 2 days after radiological examination using iodine-containing contrast media, provided that renal function was recognized as normal during the examination. Recommended combinations Ethanol intake increases the risk of lactic acidosis during acute alcohol intoxication, especially in the case of malnutrition, low-calorie diets, and hepatic insufficiency. Ethanol-containing drugs should not be used during treatment. Combinations with caution Drugs with indirect hyperglycemic action (eg, ACS and tetracosactide for systemic and topical use, beta2-adrenomimetics, danazol, chlorpromazine at high doses (100 mg / day) and may be diuretic: blood glucose levels, especially at the beginning of treatment If necessary, the dose of glucose Long may be adjusted during treatment and after discontinuation based on the level of glycemia. Concurrent intake of loop diuretics may lead to the development of lactic acidosis due to possible functional renal failure. Do not prescribe Long Glucose if the QC is less than 60 ml / min. ACE inhibitors can reduce blood glucose. Metformin dose should be adjusted as necessary. With the simultaneous use of the drug Glucophage Long with derivatives of sulfonylurea, insulin, acarbose, salicylates may develop hypoglycemia. Nifedipine increases the absorption and Cmax of metformin. Cationic drugs (amiloride, digoxin, morphine, procainamide, quinidine, quinine, ranitidine, triamterene, trimethoprim and vancomycin) secreted in the renal tubules, compete with metformin for tubular transport systems and may increase its Cmax. Increased blood glucose monitoring may be required when administered with the above medicines, especially at the beginning of treatment. If necessary, the dose of metformin can be adjusted during treatment and after discontinuation. overdose Symptoms: with the use of metformin at a dose of 85 g (42.5 times the maximum daily dose), no hypoglycaemic development occurred and Significant overdose or associated risk factors may lead to the development of lactic acidosis. Treatment: In the event of signs of lactic acidosis, treatment with the drug is required immediately. prekratyt, and patient urgently hospytalyzyrovat, opredelyv concentrations of lactate, clarify the diagnosis. Hemodialysis is the most effective measure to eliminate lactate and metformin. Symptomatic treatment is also carried out. Storage conditions Keep out of the reach of children at a temperature not exceeding 25 ° C. The Expiration of is 3 years. Deystvuyuschee substances Metformin Terms of sale from pharmacies Prescription Dosage form Dosage form tablets Nanolek, Russia
