Glucophage instructions for use. Application for impaired renal function

10.07.2020 Products

Hypoglycemic (lowers blood glucose) agent.

Manufacturers:

France, Spain, unpacking and quality control - RF "Nanolek".

It is produced in the form of round tablets, covered with a thin shell (white), biconvex. The cut shows a homogeneous white mass.

Active ingredient:

metformin hydrochloride (500/850 / 1000mg).

Additional substances:

povidone;
magnesium stearate;
hypromellose (film shell).

Cardboard packaging, tablets in blasters.

Indications for use

In case of ineffective use for medical purposes of various special diets and physical activities in patients with type II diabetes.

Prevention of diabetes in prediabetes (the dose is prescribed by an endocrinologist).

Appointment

Adult patients

Children

As a stand-alone therapy or complex treatment(Glucophage plus insulin) for children from 10 years of age.

Contraindications to the use of funds

The presence of hypersensitivity to one active or several additional ingredients of the drug.
Violation carbohydrate metabolism in the body, accompanied by severe weakness, incessant thirst, frequent urination(including precoma and coma in diabetics, the presence of ketoacidosis, established as a result of laboratory tests).
Symptoms of functional renal impairment or renal failure.
Signs of primary symptoms of kidney dysfunction.
A serious decrease in the amount of water in the body (signs - diarrhea, vomiting, etc.).
Concomitant infections.
Heavy cardiovascular diseases, including myocardial infarction in the acute initial period.
Sharp and chronic form diseases (as a risk factor for hypoxia).
Respiratory failure.
Severe lactic acidosis in diabetics, including a history of when a large amount of lactic acid enters the blood compared to the amount excreted from the body.
The period of surgical intervention (including surgery for mechanical injuries).
Liver failure or functional disorders liver.
Ethanol poisoning.
Alcoholism.
For women - during the period of gestation.
Symptoms of lactic acidosis (signs - diarrhea, nausea, vomiting, abdominal pain).
A significant lack of insulin in the body.
A few days before any x-ray examination and a few days after it.
Subject to a strict low-calorie diet (calorie intake - less than a thousand kcal per day).

Note. Particular care should be taken when taking medication:

patients of mature age, starting from sixty years;
people engaged in hard physical labor;
with liver failure (creatine clearance rates from 45 to 59 milliliters per minute).
women who are breastfeeding.

Dosage

Oral tablets.

Adults

It is used as a monotherapy or combination therapy (with the appointment of other hypoglycemic agents).

Dosage:

The initial stage is 500 mg of the drug, in some cases - 850 mg (in the morning, at noon, and in the evening on a full stomach).

In the future, the dose is increased (as needed and only after consulting a doctor).

For supporting therapeutic effect the drug is usually needed daily dose- from 1500 to 2000 mg. The dosage must not be exceeded up to 3000 mg and above!

The daily amount must be divided into three or even four times, which is necessary to prevent the risk of side effects.

Note. It is necessary to increase the daily dose throughout the week, slowly, in order to avoid negative effects. Those patients who previously took drugs with the active substance metformin in an amount of 2000 to 3000 mg, Glucophage tablets should be taken at a dosage of 1000 mg per day.

If you plan to stop taking other drugs that affect hypoglycemic indicators, you should start taking Glucophage tablets in the minimum recommended amount, in the form of monotherapy.

Glucophage and insulin

If it is necessary to take additional insulin, the latter is used only in the dosage selected by the doctor.

Therapy with metmorphine and insulin is necessary to achieve a certain amount of glucose in the blood. The usual algorithm is a 500 mg tablet (rarely 850 mg) two or three times a day.

Dosage for children and adolescents

From ten years and older - both as an independent drug and as part of a complex treatment (together with insulin).

The optimal starting (single) daily dosage is one tablet (500 or 850 mg) taken with meals. It is allowed to take the drug within half an hour after eating.

Based on a certain amount of glucose in the blood, the dose of the drug is slowly adjusted (lines - at least one to two weeks). It is forbidden to increase the dose for children (more than 2000 mg). The medication intake should be divided into three, at least two doses.

For patients of mature and elderly age

It is necessary to take into account the functional indicators of the kidneys (determination of the level of creatinine - from two to four times a year).

Glucophage should be taken continuously. Any reason for discontinuation should be discussed with your doctor.

Overdose

Research. The amount of metformin, 43 times higher than the recommended dose, was not the cause of hypoglycemia, but it included the mechanism of the development of another disease (lactic acidosis), which was clinically confirmed.

Overdose relief:

Refusal to take the drug Glucophage.
Monitoring the patient in a hospital setting.
Laboratory tests and the appointment of symptomatic therapy to the patient.
Carrying out hemodialysis, if necessary, as the most effective method of cleansing the body.

Attention! You can not abruptly stop taking the drug or skip the next pill intake.

Interaction with other drugs and compatibility with medical research

Combinations that are not valid anyway

X-ray contrast agents (with iodine content). Radiological examination can be a catalyst for the development of lactic acidosis for a patient with symptoms of diabetes mellitus.

They stop taking Glucophage three days before the study and do not take it for another three days after it (in total, together with the day of the study - a week). If the renal function was found to be unsatisfactory according to the results, this period increases - until the organ is completely normalized.

It would be reasonable to refrain from using the drug if there is a large amount of Ethanol in the body (acute alcohol intoxication). This combination leads to the formation of conditions for the manifestation of symptoms of lactic acidosis. A low-calorie diet or malnutrition, especially with liver failure, greatly increases this risk.

Conclusion. If the patient is taking the drug, he must completely stop using any type of alcohol, including drugs that include ethanol.

Combinations where caution is needed

Danazol. The simultaneous use of Glucophage and Danazol is undesirable. Danazol is dangerous with hyperglycemic action. If it is impossible to refuse it for various reasons, a careful adjustment of the Glucophage dose and constant monitoring of blood glucose levels will be required.

Chlorpromazine in a large daily dose (more than 100 mg), which increases the concentration of glucose in the blood and reduces the possibility of insulin release. Dose adjustments are required.

Antipsychotics. Treatment of patients with antipsychotics must be agreed with the doctor. It is necessary to adjust the doses of Glucophage depending on the level of glucose in the blood.

GCS (glucocorticosteroids) negatively affect glucose tolerance - blood glucose levels rise in the blood, which can lead to the development of ketosis. In such cases, you should take Glucophage, based on the specific amount of glucose in the blood.

Loop diuretics, when taken simultaneously with Glucophage, lead to the risk of developing lactic acidosis. With QC from 60 ml / min and below, Glucophage is not prescribed.

Adrenomimetics. When taking Beta 2-adrenergic agonists, the level of glucose in the body also increases, which sometimes requires the patient to prescribe additional doses of insulin.

ACE inhibitors and all antihypertensive medications require dose adjustment of metformin.

Sulfonylurea, insulin, acarbose and salicylates, when taken together with Glucophage, can cause hypoglycemia.

Pregnancy and lactation. Features of appointment

Glucophage should not be taken during pregnancy.

Heavy diabetes- these are possible congenital malformations in the fetus. In the future, perinatal mortality. If a woman is planning to conceive or is in the early stages of pregnancy, it is necessary to refuse taking the drug Glucophage. Instead, insulin therapy is prescribed - to maintain the required glucose rate.

Side effects

Metabolism

A small percentage of the development of lactic acidosis. Long-term use Glucophage can lead to decreased absorption of vitamin B12. The problem should be considered in patients with symptoms of megaloblastic anemia.

Nervous system

Disturbance of taste sensations.

Digestive system

Symptoms are extensive:

Attacks of nausea and vomiting.
Diarrhea.
Stomach ache.
Loss of appetite.

Attention! Such signs are characteristic only in the first few days and weeks of taking the drug. Subsequently side effects pass by themselves.

Skin manifestations

Signs of erythema, slight itching, sometimes skin rashes.

Liver and biliary tract

Rarely observed cases of liver dysfunctions, even less often - manifestations of hepatitis. It is necessary to cancel metformin, which can completely neutralize the side effect.

Storage conditions of the drug

Store in a dark place at temperatures up to 24 ° C.

Keep out of the reach of children.

The shelf life is from three to five years.

For patients. Essential information on lactic acidosis

Lactic acidosis is not a common disease. However, everything should be done necessary measures, in order to eliminate the risk of its manifestation, since the pathology is characterized by severe complications and high rate mortality.

Lactic acidosis usually manifested itself in patients taking metamorphine who had severe renal failure associated with diabetes mellitus.

Other risk factors include:

Symptoms of decompensated diabetes mellitus.
Manifestations of ketosis.
Prolonged periods of malnutrition.
Acute phases of alcoholism.
Signs of hypoxia.

Important. You need to pay attention to the signs initial stage lactic acidosis. This is a characteristic symptomatology manifested in muscle cramps, dyspepsia, abdominal pain and general asthenia. The disease is also indicated by acidotic dyspnea and hypothermia, as signs preceding coma. Any symptomatology metabolic acidosis are the basis for immediate discontinuation of the drug and seeking urgent medical attention.

During surgical operations

If the patient is scheduled for surgery, metformin should be discontinued at least three days before the date of surgery. Resumption of taking the drug is carried out only after the study of renal function, the work of which was found to be satisfactory. In this case, Glucophage can be taken on the fourth day after surgery.

Kidney function tests

Metformin is excreted by the kidneys, therefore, the start of treatment is always associated with laboratory tests (amount of creatinine). For those whose kidney function is not impaired, it is sufficient to conduct a medical examination once a year. For people at risk, as well as elderly patients, the determination of CC (the amount of creatinine) must be performed up to four times a year.

If older people are prescribed diuretics and antihypertensive drugs, kidney problems may be impaired, which automatically means the need for careful monitoring by doctors.

In pediatrics

For children, the drug is prescribed only when the diagnosis is confirmed during general medical examinations.

Conducted clinical studies should also confirm the safety for the child (growth and puberty). Regular medical supervision in the treatment of children and adolescents is a must.

Precautionary measures

Control diet food, in which carbohydrates should be consumed in sufficient quantities and evenly.

If you are overweight, you can continue a hypocaloric diet, but only within the range of 1000 - 1500 kcal daily.

Important. Regular laboratory tests for the purpose of control should become a mandatory rule for everyone taking Glucophage.

Glucophage and driving

The use of the drug is usually not associated with a management problem vehicles or working mechanisms. But complex treatment can be a risk factor for hypoglycemia. In this case, a doctor's consultation is necessary.

Glucophage: instructions for use and reviews

Glucophage is a drug with hypoglycemic action.

Release form and composition

Glucophage is produced in the form of tablets:

500 or 850 mg: film-coated, white, biconvex, round, homogeneous in cross-section white mass(500 mg: 10 pcs. In blisters, 3 or 5 blisters in a cardboard box; 15 pcs. In blisters, 2 or 4 blisters in a cardboard box; 20 pcs. In blisters, 3 or 5 blisters in a cardboard box pack; 850 mg: 15 pcs. in blisters, 2 or 4 blisters in a cardboard box; 20 pcs. in blisters, 3 or 5 blisters in a cardboard box);
1000 mg: film-coated, white, biconvex, oval, with a line on both sides and the inscription "1000" on one side; cross-section - a homogeneous white mass (10 pcs. in blisters, 3, 5, 6 or 12 blisters in a cardboard box; 15 pcs. in blisters, 2, 3 or 4 blisters in a cardboard box).

The composition of 1 tablet includes:

Active ingredient: metformin hydrochloride - 500, 850 or 1000 mg;
Auxiliary components (respectively): povidone - 20/34/40 mg; magnesium stearate - 5 / 8.5 / 10 mg.

The composition of the film shell:

Tablets of 500 and 850 mg (respectively): hypromellose - 4 / 6.8 mg;
Tablets 1000 mg: pure opadry (macrogol 400 - 4.55%; hypromellose - 90.9%; macrogol 8000 - 4.55%) - 21 mg.

Pharmacological properties

Pharmacodynamics

Metformin reduces the manifestations of hyperglycemia, while preventing the development of hypoglycemia. Unlike sulfonylurea derivatives, the substance does not increase the production of insulin in the body and does not have a hypoglycemic effect on healthy individuals. Metformin reduces the sensitivity of peripheral receptors to insulin and enhances the utilization of glucose in cells, and also inhibits the synthesis of glucose in the liver due to inhibition of glycogenolysis and gluconeogenesis. The substance also slows down the absorption of glucose in the intestines.

Metformin activates glycogen synthesis by acting on glycogen synthase and increases the transport capacity of all types of membrane glucose transporters. It also has a beneficial effect on lipid metabolism, reducing the concentration of triglycerides, low density lipoproteins and total cholesterol.

Against the background of treatment with Glucophage, the patient's body weight either remains constant or moderately decreases.

Clinical studies confirm the effectiveness of the drug for the prevention of diabetes mellitus in patients in a pre-diabetic state who have identified additional risk factors for the development of overt type 2 diabetes mellitus, if the recommended lifestyle changes do not guarantee adequate glycemic control.

Pharmacokinetics

After oral administration, metformin is absorbed from the gastrointestinal tract quite completely. Absolute bioavailability reaches 50-60%. The maximum concentration of the substance in the blood plasma is reached approximately 2.5 hours after ingestion and is about 2 μg / ml or 15 μmol. When Glucophage is taken simultaneously with food, the absorption of metformin decreases and slows down.

Metformin is rapidly distributed throughout the tissues of the body and binds to proteins only to a small extent. The active component of Glucophage is very poorly metabolized and excreted in the urine. The clearance of metformin in healthy individuals is 400 ml / min (which is 4 times higher than the clearance of creatinine). This fact proves the presence of active tubular secretion. The half-life is approximately 6.5 hours. In patients with renal failure it increases and the risk of drug accumulation increases.

Indications for use

According to the instructions, Glucophage is prescribed for the treatment of type 2 diabetes mellitus, especially in obese patients, with ineffective physical activity and diet therapy:

Adults: as monotherapy or concurrently with other oral hypoglycemic drugs or insulin;
Children over 10 years of age: as monotherapy or concurrently with insulin.

Contraindications

Renal failure or impaired renal function (creatinine clearance (CC) less than 60 ml per minute);
Diabetic: ketoacidosis, precoma, coma;
Clinical pronounced manifestations of chronic or acute diseases that can lead to tissue hypoxia, including heart failure, respiratory failure, acute myocardial infarction;
Acute conditions in which there is a risk of developing renal dysfunction: severe infectious diseases, dehydration (with vomiting, diarrhea), shock;
Liver dysfunction, liver failure;
Injuries and major surgical operations (in cases where insulin therapy is indicated);
Lactic acidosis (including history);
Acute ethanol poisoning, chronic alcoholism;
Compliance with a low-calorie diet (less than 1000 kcal per day);
A period of at least 48 hours before and 48 hours after X-ray or radioisotope studies with intravenous administration iodine-containing contrast media;
Pregnancy;
Hypersensitivity to the components of the drug.

Glucophage should be taken with caution in patients over 60 years old, lactating women, as well as in patients performing heavy physical work (due to the high risk of lactic acidosis).

Instructions for the use of Glucophage: method and dosage

Glucophage should be taken orally.

For adults, the drug can be used as monotherapy or simultaneously with other oral hypoglycemic drugs.

At the beginning of treatment, Glucophage 500 or 850 mg is usually prescribed. The drug is taken 2-3 times a day with meals or immediately after meals. Depending on the concentration of glucose in the blood, a further gradual increase in the dose is possible.

The maintenance daily dose of Glucophage is usually 1500-2000 mg (maximum 3000 mg). Taking the drug 2-3 times a day can reduce the severity side effects from the gastrointestinal tract. Also, a gradual increase in the dose can improve the gastrointestinal tolerance of the drug.

Patients receiving metformin at doses of 2000-3000 mg per day can be transferred to Glucophage at a dose of 1000 mg (maximum 3000 mg per day, divided into 3 doses). When planning the transition from taking another hypoglycemic drug, you need to stop taking it and start using Glucophage at the above dose.

Metformin and insulin can be used concurrently to achieve better blood glucose control. Initial single dose Glucophage is usually 500 or 850 mg, the frequency of administration is 2-3 times a day. Insulin dosage should be adjusted based on blood glucose concentration.

For children over 10 years old, Glucophage can be taken as monotherapy or concurrently with insulin. The initial single dose is usually 500 or 850 mg, the frequency of administration is 1 time per day. The dose can be adjusted based on the blood glucose concentration after 10-15 days. The maximum daily dose is 2000 mg, divided into 2-3 doses.

For elderly patients, the dose of metformin should be selected under regular monitoring of renal function indicators (serum creatinine should be determined at least 2-4 times a year).

Glucophage is taken daily, without interruption. When discontinuing therapy, the patient must inform the doctor about it.

Side effects

Digestive system: very often - vomiting, nausea, diarrhea, lack of appetite, abdominal pain. Most often, these symptoms develop during the initial period of therapy and, as a rule, go away spontaneously. To improve gastrointestinal tolerance, it is recommended to take Glucophage during or after meals 2-3 times a day. The dose should be increased gradually;
Nervous system: often - taste disturbance;
Metabolism: very rarely - lactic acidosis; with prolonged therapy, the absorption of vitamin B12 may decrease, which should be taken into account especially in patients with megaloblastic anemia;
Liver and biliary tract: very rarely - hepatitis, abnormal liver function indicators. As a rule, adverse reactions after discontinuation of metformin completely disappear;
Skin and subcutaneous tissue: very rarely - itching, erythema, rash.

Side effects in children are similar in severity and nature to those in adult patients.

Overdose

When taking Glucophage at a dose of 85 g (this is 42.5 times higher than the maximum daily dose), most patients did not have manifestations of hypoglycemia, but the patients developed lactic acidosis.

A significant overdose or the presence of associated risk factors can provoke the development of lactic acidosis. In the event of the appearance of symptoms of such a condition, treatment with Glucophage is immediately stopped, the patient is urgently placed in a hospital and the concentration of lactate in the body is determined to clarify the diagnosis. Most effective way elimination of metformin and lactate is hemodialysis. Symptomatic therapy is also indicated.

special instructions

Due to the cumulation of metformin, a rare but serious complication, lactic acidosis, is possible (there is a high probability of mortality in the absence of emergency treatment). In most cases, the disease develops in patients with diabetes mellitus with severe renal failure. You also need to take into account other associated risk factors: ketosis, decompensated diabetes mellitus, alcoholism, liver failure, prolonged fasting and any conditions associated with severe hypoxia.

The development of lactic acidosis may be indicated by such nonspecific signs as muscle cramps accompanied by dyspeptic symptoms, abdominal pain and severe asthenia. The disease is characterized by acidotic dyspnea and hypothermia followed by coma.

The use of Glucophage should be discontinued 48 hours before scheduled surgical operations. Therapy can be resumed no earlier than 48 hours after the operation, provided that the renal function was found to be normal on examination.

Before you start taking Glucophage, as well as regularly in the future, you need to determine the creatinine clearance: in patients with normal renal function - at least once a year; in elderly patients, as well as with creatinine clearance at the lower limit of the norm - 2-4 times a year.

Special care is required when possible violation renal function in elderly patients, as well as with the simultaneous use of Glucophage with antihypertensive drugs, diuretics or non-steroidal anti-inflammatory drugs.

When using Glucophage in pediatrics, the diagnosis of type 2 diabetes must be confirmed before starting treatment. Metformin does not affect puberty and growth. However, due to the lack of long-term data, it is recommended to carefully monitor the subsequent effect of Glucophage on these parameters in children, especially during puberty. Children 10-12 years old need the most careful monitoring.

With monotherapy, metformin does not cause hypoglycemia, however, when it is used simultaneously with insulin or other hypoglycemic agents (including sulfonylurea derivatives, repaglinide), caution should be exercised when driving vehicles and using complex mechanisms.

Application during pregnancy and lactation

Decompensated diabetes mellitus during pregnancy increases the risk of congenital malformations of the fetus and perinatal mortality. Limited information obtained as a result clinical research confirm that taking metformin by pregnant patients does not increase the incidence of diagnosed malformations in newborns.

When planning pregnancy, as well as when pregnancy occurs during treatment with Glucophage for prediabetes and type 2 diabetes mellitus, the drug must be canceled. Patients with type 2 diabetes mellitus are prescribed insulin therapy. Plasma glucose levels should be maintained as close to normal as possible to minimize the risk of fetal birth defects.

Metformin is determined in breast milk... Adverse reactions in newborns with breastfeeding while taking Glucophage were not observed. However, since information on the use of the drug in this category of patients at the moment remains insufficient, the use of metformin during lactation is not recommended. Decision to terminate or continue breastfeeding taken after balancing the benefits of breastfeeding and the potential risk of adverse reactions The child has.

Drug interactions

Glucophage should not be used simultaneously with iodine-containing X-ray contrast agents.

The drug is not recommended to be taken together with ethanol (the risk of developing lactic acidosis in acute alcohol intoxication increases in the case of liver failure, adherence to a low-calorie diet and malnutrition).

Care should be taken to take Glucophage with danazol, chlorpromazine, glucocorticosteroids for local and systemic use, loop diuretics, beta2-adrenomimetics in the form of injections. With simultaneous use with the above drugs, especially at the beginning of treatment, more frequent monitoring of blood glucose may be required. If necessary, the dose of metformin should be adjusted during treatment.

Angiotensin-converting enzyme inhibitors and other antihypertensive drugs can lower blood glucose levels. If necessary, dose adjustment of metformin is necessary.

With the simultaneous use of Glucophage with acarbose, sulfonylurea derivatives, salicylates and insulin, hypoglycemia may develop.

Cationic drugs (digoxin, amiloride, procainamide, morphine, quinidine, triamterene, quinine, ranitidine, vancomycin and trimethoprim) compete with metformin for tubular transport systems, which can lead to an increase in its average maximum concentration (Cmax).

Analogs

Glyukofazh analogs are: Bagomet, Glukofazh Long, Glycon, Glyminfor, Glyformin, Metformin, Langerin, Metadien, Metospanin, Siofor 1000, Formetin.

Terms and conditions of storage

Keep out of the reach of children at temperatures up to 25 ° C.

Best before date:

Tablets of 500 and 850 mg - 5 years;
1000 mg tablets - 3 years.

A person with type 2 diabetes not only has to follow a diet and exercise, but also take medications that lower blood glucose levels. Glucophage 500 belongs to such drugs.

Forms of release and composition

The drug is produced in the form of round tablets for oral administration. They are covered with a white sheath. Tablets are nested in contour cells - 20 pcs. in each. 3 of these cells are in cardboard boxes, which are offered in pharmacies.

The tablets consist of several components, of which metformin hydrochloride is the active ingredient. Glukofazh 500 contains 500 mg of this substance. The auxiliary components are povidone and magnesium stearate. They enhance the therapeutic effect of the medication.

pharmachologic effect

Glucophage is a hypoglycemic drug. The decrease in plasma glucose is due to the presence of metformin in the drug. The drug has another effect - it promotes weight loss. For diabetics, this quality is important, since this disease is often accompanied by obesity.

In patients taking Glucophage, there is an improvement in cholesterol levels, which has a positive effect on the work of the cardiovascular system.

Pharmacokinetics

The drug is absorbed from the gastrointestinal tract. If the tablets are taken with food, the absorption process is delayed. The highest level of the active substance in the blood is observed 2.5 hours after taking the drug.

Metformin is rapidly distributed throughout the tissues of the body. The half-life is approximately 6.5 hours.

Indications for use

The drug is prescribed for patients who have been diagnosed with non-insulin dependent diabetes mellitus. The medicine is used as a monotherapeutic agent or in combination with Insulin.

Contraindications

Glucophage is contraindicated in the following conditions:

intolerance to any substance that is part of the medication (before use, you should carefully read the instructions for use);
diabetic precoma or coma;
pathologies that lead to tissue hypoxia;
surgical treatment for those patients who need to receive Insulin;
chronic alcoholism;
ethanol poisoning;
liver failure;
kidney failure;
lactic acidosis;
conducting studies using an iodine-containing contrast agent - 2 days before the procedure and within 48 hours after it;
adherence to a diet, if the amount of kcal received is less than 1000 per day.

Carefully

The drug is prescribed with caution to patients 60 years of age and older, since there is a high risk of developing lactic acidosis.

How to take Glucophage 500?

The tablets are taken with or after meals. The medicine should be taken with water. Do not self-medicate: the dosage and duration of therapy is determined by the doctor. The specialist takes into account various factors, the main of which is the blood sugar level. The patient's concomitant diseases are also taken into account.

Adults

In accordance with the instructions, the drug is taken according to the following scheme:

The initial dose is 500-850 mg per day. This amount is divided into 2-3 doses. Then the doctor conducts control studies, according to the results of which the dosage is adjusted.
The maintenance dose is 1500-2000 mg per day. This amount is divided into 3 doses per day.
3000 mg is the highest dose allowed. It should be divided into 3 steps.

For children

The instructions say that a child 10 years old or older is prescribed Glucophage in an average daily dose of 500-850 mg. In the future, an increase in dosage is possible, but the maximum daily dose cannot exceed 2000 mg.

To prevent the aggravation of congenital malformations in children, it is impossible to take medicine without the agreement of a doctor.

Diabetes mellitus treatment

If you need to take Glucophage and Insulin at the same time, then at the beginning of treatment, the daily dosage of the drug is 500-850 mg. Then the doctor changes the dosage of the drug by changing the amount of Insulin received.

Slimming

When using Glucophage 500 for weight loss, you should take 1 tablet 1 time per day for 3-5 days. If the drug is well tolerated, then the dosage may be increased to 1000 mg per day. But this is only allowed to be done by patients whose weight exceeds the norm by more than 20 kg.

The therapy lasts 3 weeks. After that, a 2-month break is required. If the first course did not give side effects, then it is allowed to increase the dosage during the second course. But you cannot take more than 2000 mg per day. This number is divided by 2 times. The interval between doses is 8 hours or more.

During the period of treatment, it is necessary to drink a lot of water in order to avoid toxic effects: the liquid will help the kidneys to quickly remove the decay products of the drug.

Side effects

Taking Glucophage can cause side effects.

Gastrointestinal tract

Poor appetite pain in the abdomen, diarrhea, nausea, vomiting - these symptoms are typical for the initial period of treatment. They appear in those patients who do not divide the daily dose into 2-3 doses.

central nervous system

Taste sensations are often disturbed in those taking the medicine.

From the urinary system

There is no information in the instructions about side effects from the urinary system.

From the liver and biliary tract

In rare cases, liver malfunctions occur, and hepatitis develops. When the pills are canceled, the side effects disappear.

special instructions

If you have a planned surgical operation, then you should stop taking Glucophage 2 days before the surgery. The course of treatment should be continued 2 days after the operation.

Taking Glucophage can cause the development of lactic acidosis. If convulsions, dyspeptic symptoms and other nonspecific signs appear during the period of therapy, you should stop taking the medication and seek medical help.

Alcohol compatibility

Cannot be consumed alcoholic drinks during the period of taking Glucophage. Should be avoided medications containing ethanol.

Influence on the ability to control mechanisms

People taking medicine with metformin, they can get behind the wheel of a car, since the drug does not have a negative effect on concentration and psychomotor reactions. It is also allowed to work with complex mechanisms.

Application during pregnancy and lactation

Women are not recommended to take Glucophage when carrying a fetus. When planning a pregnancy, the patient should consult a doctor, as a transition to insulin therapy is required. It is necessary to maintain blood sugar levels close to normal so as not to harm the fetus.

Interaction with other drugs

Contraindicated combinations

Contrast media containing iodine.

Medicines containing ethanol.

Combinations requiring caution

Danazol;
Chlorpromazine in high doses;
GCS (for oral and local use);
loop diuretics.

Analogs of Glyukofazh 500

Among hypoglycemic drugs with an action similar to Glucophage are the following:

Siofor;
Metformin;
Insufor;
Glucophage long.

Pharmacy dispensing conditions

It is a prescription medication.

Can you buy it without a prescription?

Employees of a number of pharmacies do not require a medical prescription, which violates the rules for the sale of medicines.

Price

The average cost of the drug is 170-250 rubles. per packing.

Storage conditions Glucophage 500

The temperature in the drug storage room should not exceed + 25 ° C.

Glucophage is an oral hypoglycemic drug. The preparation includes active ingredient- metformin - a substance with a pronounced hypoglycemic effect, which develops only under the condition of hyperglycemia.

In patients with normal level plasma glucose, the drug does not have a hypoglycemic effect. In patients with hyperglycemia, the drug lowers baseline plasma glucose levels, as well as postprandial glucose levels.

In this article, we will consider when doctors prescribe the drug Glucophage, including instructions for use, analogues and prices for this drug in pharmacies. If you have already used Glucophage, leave feedback in the comments.

Composition and form of release

Clinical and pharmacological group: oral hypoglycemic drug.

Active ingredient: metformin hydrochloride - 500, 850 or 1000 mg;
Excipients: povidone, magnesium stearate.

Dosage 500 mg, 850 mg: white, round, biconvex film-coated tablets. Cross-section - a homogeneous white mass.

What is Glucophage used for?

Diabetes mellitus type 2, especially in obese patients, with ineffective diet and exercise:

in adults, as monotherapy or in combination with other oral hypoglycemic agents, or with insulin;
in children from 10 years of age as monotherapy or in combination with insulin.

pharmachologic effect

The pharmacological action of Glucophage is the ability of the drug to inhibit glycogenolysis and gluconeogenesis, to reduce the absorption of glucose into gastrointestinal tract as well as increase the body's sensitivity to insulin. Moreover, the active ingredient of the drug leads to an improvement in the metabolism of fats, low density lipoproteins and cholesterol entering our body.

The main active component of the drug in question is metformin, a substance characterized by a clear hypoglycemic effect that develops exclusively under the condition that the patient has hyperglycemia ( increased content serum glucose).

In other words, metformin lowers plasma glucose levels in hyperglycemic patients, but does not in any way affect blood glucose levels in those in whom it is normal.

Instructions for use

There are no major differences in the use of 500 and 750 mg tablets. In any case, for the day of use, it is necessary to gain a fixed volume of the substance that provides the result.

The usual starting dose is 500 mg or 850 mg 2–3 times / day after or during a meal. Perhaps a further gradual increase in the dose, depending on the concentration of glucose in the blood.
The maintenance dose of the drug is usually 1500-2000 mg / day. For decreasing side effects from the gastrointestinal tract, the daily dose should be divided into 2-3 doses. Maximum dose is 3000 mg / day, divided into 3 doses.
Patients receiving metformin at doses of 2000-3000 mg / day can be switched to Glucophage 1000 mg. The maximum recommended dose is 3000 mg / day, divided into 3 doses.

Film-coated tablets of prolonged action Glucophage:

Adults are usually prescribed 1 tablet of the drug 1 time per day in the evening. 10-15 days after the start of drug therapy, the dose of metformin is adjusted depending on the level of glucose in the blood plasma. The dose of the drug should be increased once a week by 500 mg until the required hypoglycemic effect is achieved.

Slowly increasing the dose may help to improve gastrointestinal tolerance. If you plan to switch from taking another hypoglycemic drug, you must stop taking the other drug and start taking Glucophage at the dose indicated above.

Contraindications

Glucophage has a fairly large list of contraindications:

Hypersensitivity to active substance- metformin, as well as any of the excipients;
Liver dysfunctions;
Diabetic precoma, coma;
Heart or respiratory failure, myocardial infarction and other manifestations of acute and chronic diseases;
Acute poisoning, incl. alcohol, chronic alcoholism;
Kidney dysfunctions, and acute diseases that can cause such disorders: severe infectious diseases, dehydration, sepsis, shock, broncho-pulmonary diseases, fever;
Low-calorie diet.

Elderly people over 60 years old, engaged in heavy physical work, the use of the drug is not recommended.

Side effects

During the use of Glucophage, side effects may occur such as:

Lack of appetite, nausea and vomiting, metallic taste in oral cavity, flatulence, diarrhea, abdominal pain (as a rule, they appear at the beginning of treatment and go away on their own);
Lactic acid adidosis (drug withdrawal is necessary); lack of vitamin B12 due to malabsorption (with long-term treatment);
Megaloblastic anemia;
Skin rash.

Overdose

When metformin was used at a dose of 85 g (42.5 times the maximum daily dose), hypoglycemia was not observed. However, in this case, the development of lactic acidosis was observed. Significant overdose or associated risk factors can lead to the development of lactic acidosis

Treatment: if signs of lactic acidosis appear, treatment with the drug should be stopped immediately, the patient should be urgently hospitalized and, having determined the concentration of lactate, the diagnosis should be clarified. The most effective measure for removing lactate and metformin from the body is hemodialysis. Symptomatic treatment is also carried out.

special instructions

Since metformin is excreted by the kidneys, serum creatinine levels should be measured before starting treatment and regularly thereafter. Particular caution should be exercised in cases where renal function may be impaired, for example, during the initial period of antihypertensive therapy or diuretic therapy, and when initial therapy NSAIDs.

Glucophage should be discontinued 48 hours before and within 48 hours after the X-ray contrast study (urography, intravenous angiography).

If during treatment the patient has vomiting, abdominal pain, muscle pain, general weakness and severe discomfort, you must stop taking the drug and immediately consult a doctor. These symptoms can be a sign of incipient lactic acidosis. The patient must inform the doctor about the appearance of a bronchopulmonary infection or infectious disease genitourinary organs.
During treatment, you must refrain from drinking alcohol.

Analogs

The main analogues are represented by drugs: Bagomet, Glycon, Glyformin, Glyminfor, Langerin, Metospanin, Metadien, Metformin, Siafor and others.

Attention: the use of analogs must be agreed with the attending physician.

Prices

The price of Glucophage 1000 mg varies between 300-350 rubles. The price of Glucophage 850 mg is from 205 rubles. You can buy 500 mg tablets for 170-200 rubles.

Childhood use

In children aged 10 years and older, Glucophage can be used both as monotherapy and in combination with insulin. The usual starting dose is 500 mg or 850 mg once a day after or during a meal. After 10-15 days, the dose must be adjusted based on the blood glucose concentration. The maximum daily dose is 2000 mg, divided into 2-3 doses.

Use in the elderly

Due to a possible decrease in renal function in elderly patients, the dose of metformin should be selected under regular monitoring of renal function indicators (determine the serum creatinine content at least 2-4 times a year). The drug should be used with caution in patients over the age of 60 who perform heavy physical work (which is associated with an increased risk of developing lactic acidosis in them).

Storage conditions and periods

The drug should be stored out of the reach of children at a temperature not exceeding 25 ° C. The shelf life for tablets 500 mg and 850 mg is 5 years. Shelf life for 1000 mg tablets is 3 years.

Conditions of dispensing from pharmacies

The drug is available with a prescription.

Phezam tablets - instructions, reviews, analogues

The tablets contain an active substance - metformin hydrochloride 500, 850, 1000 mg each.

Additional ingredients: povidone and magnesium stearate.

The film coat consists of hypromellose, and for 1000 mg tablets it also consists of Opadry clia, macrogol 400 and 8000.

Release form

The medicine is available in white film-coated tablets. In this case, tablets of 500 and 850 mg have round shape and 1000 mg is oval. The drug is offered in 20 pieces. in a cell, 3 cells in a pack.

pharmachologic effect

The tablets have hypoglycemic effect.

Pharmacodynamics and pharmacokinetics

This drug is able to reduce hyperglycemia without causing development hypoglycemia ... At the same time, secretion is not stimulated. insulin , there is no hypoglycemic effect in healthy people.

An increase in the sensitivity of peripheral receptors in relation to insulin and recycling glucose cells. The production of glucose by the liver is reduced by inhibiting glycogenolysis and gluconeogenesis. The drug inhibits the absorption of glucose in the gastrointestinal tract.

Β2-adrenergic receptor stimulants can increase blood glucose levels. In this case, glycemic control is necessary, perhaps the appointment of insulin. Combination of Glucophage and derivatives sulfonylureas, insulin, acarbose, salicylates enhance the hypoglycemic effect.

Terms of sale

The medicine is dispensed strictly according to the prescription.

Storage conditions

For storing tablets, a dark, cool place is intended, out of the reach of children.

Best before date

The shelf life of Glucophage 500 and 850 mg is 5 years, Glucophage 1000 mg can be stored for 3 years.

Analogs

Matching ATX level 4 code:

The main analogues are represented by drugs: Baghomet, Glycon, Glyminfor, Langerin, Metospanin, Metadien, Siafor and others.

Glucophage and alcohol

It was found that alcohol can cause the development of lactic acidosis in acute alcoholic. The situation can be aggravated by the presence of liver failure, fasting, or following a low-calorie diet. Therefore, during this period, it is necessary to refrain from combinations with ethanol.

Glucophage for weight loss

It should be noted that this drug is very popular with people who are losing weight. However, doctors' reviews report that this method of dealing with excess weight is very dangerous and can cause serious complications. Nevertheless, it is this method that is discussed on various forums where users are interested - how to take Glucophage for weight loss?

At the same time, some people recommend taking Glucophage 500 mg, explaining that such a dosage will be enough to “start metabolic processes". Others, on the contrary, advise Glucophage 850 mg, since a higher dosage "will only speed up the process."

Interestingly, reviews for losing weight with this drug do not contain a description of specific results. But at the same time, there are reports of a deterioration in general well-being, the development of abdominal pain, nausea and even vomiting. Therefore, experts advise you to start monitoring your diet, which should be complete. It is necessary to exclude sweet, starchy and fatty foods from the diet and increase physical exercise.

Reviews about Glukofazh

In most cases, discussions of this drug associated with its use for weight loss. At the same time, some reviews of those losing weight about Glukofazh report that the doctor recommended this method to them, since diets and physical activity did not help eliminate excess weight. Other users are wondering how to take this medication to quickly lose those extra pounds. In addition, you can find stories of patients who took these pills in order to restore reproductive function.

However, the use of the drug for such purposes is far from always effective. Moreover, both the reviews of doctors and patients contain information about the development of serious pathologies against the background of such experiments.

Reviews about Glukofazh for weight loss also do not describe specific results. Although patients who take the medicine with, note its effectiveness and a gradual decrease in body weight.