Indications
Informet LA 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 LA 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
- Immediate release tablet: Start with 500 mg twice daily or 850 mg once daily with meals. Adjust dosage weekly or biweekly based on response, up to a maximum of 2000 mg daily in divided doses. Higher doses may be administered three times daily with meals if tolerated.
- Extended release tablet: Begin with 500 mg once daily with the evening meal, increasing weekly up to 2000 mg once daily with the evening meal or 1000 mg twice daily with meals for optimal glycemic control. Not studied in children. Avoid use in severe renal impairment (eGFR <30 mL/min/1.73 m²).
Interaction
Informet LA 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.
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