Informet 500

Indications

Informet is indicated for the treatment of type 2 diabetes mellitus, particularly in overweight patients when dietary management and exercise alone are insufficient for controlling blood sugar levels.

• Adults: It can be used as monotherapy or in combination with other oral antidiabetic agents or insulin.
• Children (from 10 years) and adolescents: Informet XR can be used alone or with insulin.

Metformin has been shown to reduce diabetic complications in overweight adults with type 2 diabetes when used as initial therapy after dietary failure.

Pharmacology

Metformin, a biguanide type oral antihyperglycemic drug, effectively lowers both fasting and postprandial blood glucose levels. Unlike sulfonylureas, it does not induce hypoglycemia. Metformin works by decreasing hepatic glucose production, reducing intestinal glucose absorption, and enhancing insulin sensitivity by increasing peripheral glucose uptake and utilization.

Dosage & Administration

Metformin Immediate Release Tablet: Dosage of Metformin Hydrochloride should be tailored based on individual effectiveness and tolerance, without exceeding the maximum recommended daily doses.

• Adults: Initiate with 500 mg twice daily or 850 mg once daily, administered with meals. Increase dosage by 500 mg weekly or 850 mg every 2 weeks, up to a maximum of 2000 mg daily in divided doses. For patients needing additional glycemic control, doses up to 2550 mg daily with meals may be considered, particularly doses exceeding 2000 mg which may be better tolerated when taken thrice daily.
• Children: Start with 500 mg twice daily with meals. Increase weekly by 500 mg up to a maximum of 2000 mg daily in divided doses.

Metformin Extended Release Tablet: Swallow Metformin XR tablets whole; do not crush, cut, or chew.

• Adults: Begin with 500 mg once daily with the evening meal. Increase weekly by 500 mg, up to 2000 mg once daily with the evening meal, or alternatively, 1000 mg twice daily with meals. Patients using Metformin immediate release tablets may switch to Metformin extended release tablets up to the maximum recommended daily dose.
• Children: Metformin extended release tablets have not been studied in children.

Renal Impaired Patients: Avoid Metformin use in patients with eGFR below 30 mL/min/1.73 m². Assess the risk/benefit if eGFR falls below 45 mL/min/1.73 m².

Interaction

Informet may interact with various medications affecting renal tubular secretion, potentially impacting efficacy and safety.

Contraindications

• Hypersensitivity to metformin or any components.
• Acute metabolic acidosis, severe renal impairment, or conditions causing tissue hypoxia.

Side Effects

Common side effects include gastrointestinal symptoms like nausea, vomiting, diarrhea, and abdominal pain. Rare side effects include lactic acidosis and vitamin B12 deficiency-related symptoms.

Pregnancy & Lactation

Metformin use is not recommended during pregnancy due to potential fetal risks. Breastfeeding while using metformin is discouraged due to limited safety data.

Precautions & Warnings

Regular monitoring of renal function is advised. Use caution in elderly patients and those with conditions predisposing to renal dysfunction or dehydration. Adjust dosage in patients concurrently using sulfonylureas or cimetidine.

Use in Special Populations

Exercise caution in pediatric populations and elderly patients, adjusting dosage based on renal function.

Overdose Effects

Lactic acidosis is a potential complication of overdose, necessitating immediate medical attention. Hemodialysis is the preferred treatment method.

Therapeutic Class

Biguanides

Storage Conditions

Store below 30°C, protected from light and moisture. Keep out of reach of children.