A person suffering from type 2 diabetes mellitus has not only to abide by the diet and exercise physical activity, but also take medicines that reduce blood glucose levels. Glucophage 500 refers to these drugs.

Forms of release and composition

The drug is produced in the form of round tablets for intake. They are covered with white shell. Tablets are embedded in contour cells - 20 pcs. in each. 3 such cells are in cardboard bundles, which are offered in pharmacies.

Tablets consist of several components acting from which is metformin hydrochloride. Glucophage 500 this substance contains 500 mg. Auxiliary components - pose and magnesium stearate. They strengthen the therapeutic effect of the medication.

pharmachologic effect

Glucophage is a hypoglycemic drug. The decrease in the level of glucose plasma is due to the presence of metformin medication. The drug has another action - 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 indicators, which positively affects the work of the cardiovascular system.

Pharmacokinetics

The medicine is absorbed from the gastrointestinal tract. If the tablets are accepted together with food, then the absorption process is delayed. The greatest level active substance Blood is observed 2.5 hours after taking the drug.

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

Indications for use

The drug remedy is prescribed to patients who are diagnosed with insulin-dependent diabetes. The medicine is used as a monotherapeutic agent or in an insulin complex.

Contraindications

Glucophage is contraindicated to apply under the following states:

• intolerance of any substance included in the composition medication (Before use, you should carefully read the instructions for use);
• diabetic precomme or coma;
• pathologies that lead to tissue hypoxia;
• surgical treatment of those patients who need insulin;
• alcoholism flowing in chronic form;
• ethanol poisoning;
• liver failure;
• renal failure;
• lactacidosis;
• research with the use of iodine-containing contrast agent - 2 days before the procedure and within 48 hours after it;
• compliance with the diet if the number of kcal obtained is less than 1000 per day.

Carefully

The drug remedy is prescribed with caution to patients 60 years and older, as a large risk of lactoacidosis.

How to take glucophage 500?

Tablets are accepted while eating or after. The medicine should be dried with water. Do not deal with self-medication: the dosage and the duration of therapy is determined by the doctor. The specialist takes into account various factors, the main of which is the level of blood sugar. The accompanying diseases available in the patient are taken into account.

Adults

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

1. The initial dose is 500-850 mg per day. This amount is divided into 2-3 receptions. The doctor then conducts control research, according to the results of which the dosage is adjusted.
2. Supporting dose - 1500-2000 mg per day. This amount is divided into 3 receptions per day.
3. 3000 mg is the largest allowed dose. It should be divided into 3 receptions.

Children

The instructions say that a child is 10 years old or older glucophage is prescribed in the daily dose of 500-850 mg. In the future, it is possible to increase the dosage, but the maximum daily dose can not exceed 2000 mg.

In order for the exacerbation of congenital defects in children, without coordination with the doctor, it is impossible to take medicine.

Treatment of diabetes

If it is required to make glucophage and insulin simultaneously, then at the beginning of the treatment, the daily dosage of the drug is 500-850 mg. The doctor then changes the dosage of the drug due to the change in the amount of insulin obtained.

For weight loss

When using glucophage 500 for weight loss, take 1 tablet 1 time per day for 3-5 days. If the drug is transferred well, the dosage is allowed to increase to 1000 mg per day. But it is allowed to do only to patients whose weight exceeds the norm by more than 20 kg.

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

During the treatment period, it is necessary to drink plenty of water to avoid toxic influence: the liquid will help the kidneys faster to bring the disintegration of drugs to the medication.

Side effects

Glucophage can cause side effects.

Gastrointestinal

Bad appetite painfulness In the abdomen, diarrhea, nausea, vomiting - such symptoms are characteristic of the initial period of treatment. They appear in those patients who do not share daily dose for 2-3 reception.

central nervous system

Often the receiving medicine breaks the taste.

From the urinary system

The instructions have no information about side effects from the system of urinary.

From the side of the liver and biliary tract

In rare cases, disorders occur in the work of the liver, hepatitis develops. When canceling tablets, side effects disappear.

special instructions

If there is a planned surgical operation, it is necessary to stop taking glucophage 2 days before surgery. Continue the course of treatment should be 2 days after the operation.

Glucophage intake can cause lactoacidosis development. If the period of therapy appears convulsions, dyspeptic symptoms and other non-desigital signs, you should stop taking medication and seek medical attention.

Compatible with alcohol

Cannot be used alcoholic beverages During the reception of glucophage. Medical means containing ethanol should be avoided.

Impact on the ability to manage mechanisms

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

Application during pregnancy and during lactation

Women when entering the fetus, it is not recommended to take glucophage. Planning pregnancy, the patient should consult a doctor, as it takes a transition to insulin therapy. 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 substances with iodine content.

Medications containing ethanol.

Combinations requiring caution

• Danazole;
• Chlorpromazine in high doses;
• GKS (for oral and local use);
• loop diuretics.

Analogs of glucophage 500

Among the hypoglycemic drugs with a similar glucopup formation are as follows:

• SIOFOR;
• Metformin;
• Insuph;
• Glucophage Long.

Pharmacy leave

This is a prescription drug.

Can I buy without a recipe?

Employees of a number of pharmacies do not require a medical recipe than the rules of sale violate medicines.

Price

The average price of the drug - 170-250 rubles. for packaging.

Glucophage Storage Conditions 500

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

Form release

Tablets covered with film shell.

1 tablet contains:

Active substance: metformin hydrochloride - 500 mg.

Auxiliary substances: Povidone - 20 mg, magnesium stearate - 5.0 mg.

The composition of the film shell: hypimosellos - 4.0 mg.

Packaging

60 pcs. 0.5 g

pharmachologic effect

Oral hypoglycemic drug from group of biguanids.

Glucophage reduces hyperglycemia, without leading to the development of hypoglycemia. Unlike sulfonylurea derivatives, does not stimulate the secretion of insulin and does not have hypoglycemic action in healthy faces.

Increases the sensitivity of peripheral receptors to insulin and the utilization of glucose cells. Reduces the production of glucose liver due to the inhibition of gluconeogenesis and glycogenolysis. Holds the absorption of glucose in the intestines.

Metformin stimulates the synthesis of glycogen, affecting glycogenesis. Increases the vehicle of all types of glucose membrane carriers.

In addition, it has a favorable effect on lipid metabolism: reduces the content of total cholesterol, LDL and TG.

Against the background of taking metrophum, the patient's body mass either remains stable or moderately decreases.

Indications

Type 2 diabetes mellitus, especially in patients with obesity, with ineffectiveness of diet and physical exertion:

In adults as monotherapy or in combination with other oral hypoglycemic drugs, or with insulin;

In children from 10 years as a monotherapy or in combination with insulin.

Prevention sugar diabetes 2 types in patients with prediabet with additional risk factors for the development of type 2 diabetes mellitus, in which changes in lifestyle have not allowed to achieve adequate glycemic control.

Contraindications

• Diabetic ketoacidosis.
• Diabetic prema.
• Diabetic coma.
• Disturbance of the kidney function (CC
• Renal failure.
• The acute states under which there is a risk of developing a violation of the kidney function: dehydration, (with diarrhea, vomiting), heavy infectious diseases, status, shock.
• Clinical pronounced manifestations of sharp and chronic diseaseswhich can lead to the development of tissue hypoxia (incl. respiratory failure, heart failure, acute myocardial infarction).
• Extensive surgical operations and injuries (when insulin therapy is shown).
• Liver failure.
• Violations of the liver function.
• Chronic alcoholism, acute poisoning with ethanol.
• Lactacidosis (including a history).
• A period of at least 48 hours before and within 48 hours after radioisotope or radiological studies with the introduction of a iodine-containing contrast agent.
• Compliance with the hypochalorial diet (
• Pregnancy.
• Increased sensitivity to the components of the drug.

With caution: the drug should be applied in patients over 60 years of age performing severe physical work (which is associated with increased risk of development of lactacidosis); during breastfeeding.

Application in pregnancy and breastfeeding

The drug is contraindicated to use during pregnancy.

Decompensated diabetes mellitus is associated with an increased risk of congenital defects and perinatal mortality. A limited amount of data indicates that the use of metformin in pregnant women does not increase the risk of developing congenital defects in children.

When planning pregnancy, as well as in the case of pregnancy, against the background of admission of metformin, the drug must be canceled, and insulin therapy is appointed. It is necessary to maintain the content of glucose in the blood plasma at the level closest to the norm to reduce the risk of malfunction of the fetus.

Metformin is allocated by S. breast milk. Side effects in newborns with breastfeeding against the background of metformin intake were not observed. However, due to a limited amount of data, the use of the drug in breastfeeding is not recommended. The decision to stop breastfeeding should be taken into account the benefit of breastfeeding and the potential risk of the occurrence of side effects in the child.

Method of application and dose

The drug is taken inward.

Adults

Monotherapy and combined therapy with other oral hypoglycemic drugs

The usual initial dose is 500 mg or 850 mg 2-3 times / day after or during meals. It is possible to further gradually increase the dose, depending on the concentration of glucose in the blood.

The supporting dose of the drug is usually 1500-2000 mg / day. For decreasing side phenomena On the part of the gastrointestinal dossi dose should be divided into 2-3 receptions. Maximum dose It is 3000 g / day, divided into 3 receptions.

Slow increase in dose can contribute to the improvement of gastrointestinal tolerance.

Patients receiving metformin in doses of 2-3 g / day can be transferred to the reception of the drug glucophage 1000 mg. The maximum recommended dose is 3000 mg / day, divided into 3 receptions.

In the case of the transition planning from the reception of another hypoglycemic drug: it is necessary to stop the reception of another drug and to begin receiving the drug glucophage in the dose indicated above.

Monotherapy with prediabete:

The usual dose is 1000-1700 mg per day after or during meals, divided into 2 receptions. It is recommended to regularly carry out glycemic control to assess the need further application drug.

Combination with insulin

To achieve better control of glucose in the blood, Metformin and insulin can be used in the form of combined therapy. The usual initial dose of the drug glucophage is 500 mg or 850 mg 2-3 times / day, while the insulin dose is selected on the basis of blood glucose concentration.

Children and teenagers

In children aged 10 years and older: glucophage can be used both in the form of monotherapy and in combination with insulin. The usual initial dose is 500 mg or 850 mg 1 time / day after or during food intake. After 10-15 days, the dose must be adjusted on the basis of blood glucose concentration. The maximum daily dose is 2000 mg, divided into 2-3 receptions.

Elderly patients

Due to the possible reduction in the function of the kidney dose of metformin, it is necessary to select under regular control of the functions of the kidney function (determining the content of creatinine in the serum at least 2-4 times a year). Gyboofed should be taken daily, without a break. In case of cessation of treatment, the patient must inform the doctor about this.

Side effects

Determination of the frequency of side effects:

• Very often (≥ 1/10).
• Often (≥ 1/100,
• Infrequently (≥ 1/1000,
• Rarely (≥ 1/10,000,
• Rarely (

Side effects are provided in the order of reducing significance.

From the metabolism: very rarely - lactacidosis; for long use It is possible to reduce the absorption of vitamin B12. Reducing the level of vitamin B12 must be taken into account in patients with megaloblastic anemia.

From side nervous system: Often - violation of taste.

From side digestive system: Very often - nausea, vomiting, diarrhea, abdominal pain, lack of appetite. Most often, these symptoms arise in the initial period of treatment and in most cases go spontaneously. To prevent symptoms, it is recommended to take metformin 2 or 3 times / day during or after eating. Slow increase in dose can improve gastrointestinal tolerability.

From the side of the skin and subcutaneous fabrics: very rarely - erythema, itching, rash.

From the side of the liver and biliary tract: very rarely - violation of the functions of the liver function, hepatitis. After canceling metformin adverse reactions Fully disappear.

Published data, postmarketing data, as well as data controlled clinical studies In a limited children's population in the age group, from 10 to 16 years, it is shown that the side effects in children in nature and severity are similar to those in adult patients.

special instructions

Lactacidosis

Lacacidosis is rare, but serious (high mortality in the absence emergency treatment) Complication that may arise due to the cumulation of metformin. Cases of lactacidase in the reception of metformmins occurred mainly in patients with diabetes mellitus with severe renal failure.

Other conjugate risk factors should also be taken into account, such as decompensated diabetes mellitus, ketosis, long fasting, alcoholism, liver failure and any condition associated with severe hypoxia. This can help reduce the frequency of cases of lactacidosis.

The risk of developing lactacidosis should be taken into account when nonspecific signs appear, such as muscle cramps, accompanied by dyspex symptoms, abdominal pain and pronounced asthenia. Laccidosis is characterized by acidotic shortness, pain in the abdomen and hypothermia followed by a coma.

Diagnostic laboratory indicators are a decrease in blood pH (less than 7.25), the content of lactate in the blood plasma over 5 mmol / l, elevated anionic gap and the relationship of lactate / pyruvate. With suspected metabolic acidosis It is necessary to stop taking the drug and immediately consult a doctor.

Surgical operations

The use of metformin must be discontinued 48 hours before planned surgical operations and can be continued no earlier than 48 hours after, provided that during the survey the renal function was recognized normally.

Kidney function

Since Metformin is excreted by the kidneys, before starting treatment and regularly subsequently, it is necessary to determine QC: at least once a year in patients with normal kidney function, and 2-4 times a year in elderly patients, as well as in patients with QC on the bottom The boundaries of the norm.

Special caution should be taken when possible violation Kidney functions in elderly patients, while using antihypertensive drugs, diuretics or NSAIDs.

Use in pediatrics

The diagnosis of type 2 diabetes mellitus must be confirmed before the treatment started.

During clinical studies, the duration of 1 year was shown that Metformin does not affect the growth and puberty. However, due to the lack of long-term data, it is recommended to carefully control the subsequent influence of metformin on these parameters in children, especially during puberty. The most careful control is necessary for children aged 10-12 years.

Other precautions

Patients are recommended to continue to comply with a diet with uniform consumption of carbohydrates during the day. Patients with overweight are recommended to continue to follow the hypochalerial diet (but at least 1000 kcal / day).

Metformin with monotherapy does not cause hypoglycemia, but it is recommended to be caution when applied in combination with insulin or other hypoglycemic drugs (including sulfonylurea derivatives, repaglinide).

Impact on the ability to driving vehicles and control mechanisms

Monotherapy with glucophage does not cause hypoglycemia, so does not affect the ability to manage vehicles and mechanisms. Nevertheless, it is necessary to warn patients about the risk of hypoglycemia in the use of metformin in combination with other hypoglycemic drugs (including with sulfonylurea derivatives, insulin, repaglinide).

Medicinal interaction

Contraindicated combinations

Iodine-containing radiopatruts: Against the background of functional renal failure in patients with diabetes mellitus, radiological examination with the use of iodine-containing radiocontrase can cause lactacidosis development. The treatment with the drug glucophage must be canceled depending on the function of the kidneys 48 hours before or at the time of x-ray studies using iodine-containing X-ray-repeat agents and not renewing 148 hours after, provided that during the survey the renal function was recognized as normal.

Alcohol: with acute alcoholic intoxication The risk of developing lactacidosis is increasing, especially in the case of:

• Insufficient nutrition, compliance with low-calorie diet.
• Hepatic insufficiency.

During the drug intake, taking alcohol and medicines containing ethanol should be avoided.

Combinations requiring caution

The simultaneous reception of Danazole is not recommended to avoid the hyperglycemic action of the latter. If you need to treat Danazole and, after stopping the reception of the latter, the dose correction of the drug glucophage is required under the control of blood glucose concentration.

Chloropromazine when taking high doses (100 mg / day) increases blood glucose concentration, reducing insulin release. When treating neuroleptics and after stopping the reception of the latter, the dose correction is required under the control of blood glucose concentration.

GKS for system and local application Reduce glucose tolerance, increase blood glucose concentration, sometimes causing ketosis. In the treatment of GCS and after stopping the reception of the latter, the dose correction of glucophage is required under the control of glucose concentration in the blood.

The simultaneous reception of "loop" diuretics can lead to the development of lactacidase due to possible functional renal failure. Glucophage should not be prescribed if KC is less than 60 ml / min.

Beta2-adrenomimetics in the form of injections increase blood glucose concentration due to the stimulation of β2-adrenoreceptors. In this case, control of blood glucose concentration is necessary. If necessary, it is recommended to assign insulin.

With the simultaneous use of the above drugs, more frequent control of blood glucose content may be required, especially at the beginning of treatment. If necessary, the dose of metformmin can be adjusted during the treatment process and after its termination.

APF inhibitors And other antihypertensive drugs can reduce glucose concentration in blood. If necessary, a dose of metformin should be corrected.

With the simultaneous use of the drug glucophage with sulfonylurevine derivatives, insulin, aculin, aculcycosome, hypoglycemia is possible.

Nifedipine increases absorption and Cmax metformin.

Cationic drugs (amyloride, digoxin, morphine, procanamide, quinidine, chinin, ranitidine, triamteren, trimethopris and vancomycin), secreted in renal tubules, compete with Metform for the channel transport systems and can lead to an increase in its CMAX.

Overdose

Symptoms: When using metformin in a dose of 85 (42.5 times greater than the maximum daily dose), hypoglycemia was observed, but the development of lactacidosis was noted. Significant overdose or conjugate risk factors can lead to lactacidosis development.

Treatment: immediate cancellation of glucophage, urgent hospitalization, determination of blood lactate concentration; If necessary, spend symptomatic therapy. Hemodialysis is most effective from the organism of lactate and metformin.

Storage conditions

Store in an inaccessible place at a temperature not higher than 25 ° C.

It's no secret that a huge number of people in the modern world dreams of having a slim and tightened figure. Especially they want to lose a fair sex. However, how many such people really seek this? Internet expanses are filled with information on how it is necessary to eat, what exercises to perform and what procedures to carry out, in order for weight to be painless. However, it is much easier to just buy magic pills that will do everything for you. The only thing that you stay is to live, as before: to use a large number of harmful products and conduct a sedentary lifestyle.

Very often, people just go to the pharmacy in search of a means that will help them reset a few kilograms for the week without any effort. And their logic is as follows: once the pills are sold in the pharmacy, it means that they cannot be harmful to health. However, very often people who succumb to the influence of advertising are buying medicines, not knowing their true destination. In this article, we will look at what is a Glucophage preparation. Held reviews really confirm that the tool is very effective. However, the medication itself is intended for people suffering from a second degree diabetes.

Release form and medication

The most important active component of this drug is metformin hydrochloride. However, it also includes auxiliary components. This can be attributed to the poveline, magnesium stearate, microcrystalline cellulose and hypimonelosis. The Glucophage preparation (removal reviews are described below) has a form of tablets that differ in the amount of active substance content. For example, in one pill may be 500, 850 or 1000 mg of the active substance. Each tablet has an oval biconvecake shape and covered with a white film shell. One package usually contains thirty tablets.

Why this tool leads to weight loss

Tablets "Glucophage" Instructions for use describes as a means intended for the treatment of a diabetes of the second type. However, the medication is very often used for weight loss. Why does this drug use so very popular with losing weight people?

The metformin is able to reduce blood sugar levels, which increases significantly after each meal. Such processes are completely natural in the body, but they are violated during diabetes. Also, hormones produced by the pancreas are also connected to this process. It is they who contribute to the transformation of sugars into fat cells.

So, taking this drug, patients can control the level of sugar, as well as normalize hormonal processes in the body. Metformin has a very interesting impact on human body. It significantly reduces blood sugar due to admission directly to muscle tissues. Thus, glucose begins to burn, and not turning into fat deposits. In addition, there are other advantages for the Glucophage preparation. High reviews confirm that this remedy is very good to dull the feeling of appetite. As a result, a person simply does not use an excessive amount of food.

"Glucophage": instructions for use

Consider, to engage in self-medication - this is definitely not a way out. Such a medicine should be appointed only by a specialist. In fact, a very large number of health workers allow their patients to take pills "glucophage" precisely to reduce weight. Such a means should be used, guided by a special scheme. Usually the course of treatment lasts from 10 to 22 days, after which it is recommended to make a two-month break. After this time, if there is a need, the course can be repeated. Consider if you use the drug more often, there is a high probability that your body will simply get used to active componentSo, the fat burning process will be suspended.

The dosage is selected by the doctor individually. The specialist must take into account the state of your health, as well as gender, weight and growth. However, the minimum daily dosage is one tablet containing 500 mg of active substance per day. But most often for weight loss is not as accepted by the Glucophage preparation. Welding reviews confirm that very good results can be achieved only if we take two tablets daily for this medication. At the same time, it is necessary to do it in the lunch and evening. Very rarely dosage increases to three tablets per day. However, such a number this drug It can be appointed only by a doctor.

Many people are interested in the question: what is better - "glucophage" or "Long glucophage"? Your attending physician will be able to answer this question. If you are suitable for sufficiently high dosages of metformin, then it is better to pay attention to the second drug, since it has a longer impact on the body. Each tablet must be taken directly before meals or during it. Squeeze the pills with a small amount of water. It is best to increase the dosage gradually. It will have a positive effect on gastrointestinal.

Do not forget that "glucophage", the price of which is listed below, is not a vitamin bioodus. This drug is made with a specific purpose of treating a diabetes mellitus of a second type. Therefore, it is necessary to take it with extreme caution, as the medicine has many contraindications.

Consider, the wrong selection of dosage can simply lead to the fact that the human body will cease to respond to insulin-produced themselves. And this, sooner or later, will lead to the development of diabetes. And this may even happen if you are not subject to the development of such a dangerous disease.

In no case do not take the Glucophage preparation (the price of the Neho varies in the area of \u200b\u200btwo hundred and four hundred rubles), if you have seen an increased sensitivity to the elements included in the composition. Also, do not take this medicine for the purpose of weight loss if you have diseases of cardiovascular and excretory systems. Of course, it is impossible to use the means to children, as well as pregnant and lactating women. Do not take it if you suffer from diseases that are at the stages of exacerbation. Also, do not experiment with your health if you have diabetic deviations. For example, do not use the drug for the treatment of a second type diabetes if you suffer the first type diabetes.

Glucophage: Side Effects

Do not forget that this tool is designed specifically to maintain the condition of the patient's patient with diabetes. The drug is very serious, so it is simply a huge list of side effects. Very often, patients taking this remedy for weight loss are complaining of side effects on the part of the digestive system. Often there are nausea and vomiting, as well as diarrhea or, on the contrary, constipation. If you have noticed that they began to suffer with enhanced gas formation in the intestine, it means that you eat an excessive amount of carbohydrates. In this case, you will have to correct your diet. If you notice nausea, it means that the dosage of the drug was chosen incorrectly. You will have to reduce it.

Very often accompanied side effects At the beginning of the treatment, the reception of the drug "glucophage" for weight loss. Reviews of doctors and patients are described below, and you need to familiarize yourself with them before starting receiving this fund. However, a few days later, the patient begins to feel fine.

In some cases, lactacidosis disease can begin to develop. It occurs as a result of a lactic acid impaired in the organism. It makes itself felt in the form of incessant vomiting and nausea. Sometimes there are pain in the abdomen. Often, patients begin to lose consciousness. In this case, the reception of this drug should be urgently terminated. To eliminate negative manifestations, doctors are usually prescribed symptomatic treatment. Consider the incorrect and uncontrolled medication containing metformin, may cause serious damage to your health. Therefore, we assume it with all the responsibility. Increased doses of metformmin may lead to irreversible processes arising in the brain.

If you still decided for weight loss to take the drug "glucophage", the dosage should be minimal. At the same time, if you do not comply with the principles of proper nutrition, you can not count on good results at all. You will have to exclude from your diet products containing a large amount of carbohydrates. First of all, it is necessary to attribute sweets and dried fruits.

Also try not to eat rice porridge, potatoes and pasta. In no case are not sitting on a low-calorie diet, during which you will eat less than a thousand cyclealorium. Also note that "glucophage" and alcohol are absolutely incompatible. But spices and salt you can use in any quantity. There are no special restrictions for them.

Is it possible to play sports while taking a weight loss medication

Recently, physicians said that, engaged in sports, you will reduce the entire effect of consuming the "glucophage" tablets for weight loss. However, thanks to the implementation of recent studies, scientists concluded that physical exercise and conducting an active lifestyle, on the contrary, accelerate the process of discharge of excess weight several times. Even patients receiving the drug "glucophage" in very small dosages and sports are very satisfied with the results. Do not forget that Metformin contributes to the flow of glucose directly to muscle tissue. Therefore, performing exercise, you immediately burn all the food you eaten. In the other case, glucose, sooner or later, still turn into fat deposits on your body. If you still decided to make a weight loss with the help of this medication, be sure to develop a plan for physical exertion, as well as review the diet. And then the positive results will not make themselves waiting for a very long time.

The tablets contain an active substance - metformin hydrochloride 5 500, 850, 1000 mg.

Additional components: Povidone and magnesium stearate.

The film shell consists of hypimlolose, and at 1000 mg tablets also from Opadry Klia, macrogol 400 and 8000.

Form release

The medicine is produced in tablets covered with a white film sheath. At the same time, 500 and 850 mg tablets have round shape, and 1000 mg - oval. It is proposed to preparation for 20 pcs. In the cell, 3 cells in a bundle.

pharmachologic effect

Tablets possess hypoglycemic effect.

Pharmacodynamics and pharmacokinetics

This drug is able to reduce hyperglycemia without causing development hypoglycemia . This is not stimulated secretion insulin , no hypoglycemic effect is manifested in healthy people.

An increase in the sensitivity of peripheral receptors in relation to insulin and disposal glucose cells. Glucose livestock decreases, by inhibiting glycogenolysis and gluconeogenesis. The drug slows down the process of suction of glucose into the gastrointestinal tract.

The β2-adrenoreceptor stimulants are capable of increasing the content of glucose in the blood composition. This requires control of glycemia, it is possible to assign insulin. Combination of glucophage and derivatives sulfonylurea, insulin, aculbose, salicylate Enhance hypoglycemic action.

Terms of sale

The medicine is released strictly by recipe.

Storage conditions

For storage of tablets, a dark, cool place is inaccessible for children.

Shelf life

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

Analogs

Key analogs are represented by drugs: Bagtomet, Glicon, Glimpor, Langerine, Metospanin, Metadiene, Siaphor and others.

Glucophage and alcohol

It has been established that alcohol is able to cause the development of acidic acid acid with acute alcoholic. Exacerbate the situation may have liver failure, starvation or adherence to a low-calorie diet. Therefore, in 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 losing weight people. However, doctors reported that such a way to combat overweight is very dangerous and can cause serious complications. However, this method is discussed in various forums, where users are interested in - how to make glucophage for weight loss?

At the same time, some people recommend taking glucophage 500 mg, explaining that such a dosage will be enough to "run exchange processes" Others, on the contrary, advise glucophage 850 mg, as the higher dosage "only speeds up the process."

Interestingly, feedback from this drug does not contain descriptions of concrete results. But at the same time there are reports of the worsening of general well-being, the development of pain in the abdomen, nausea and even vomiting. Therefore, experts advise to start watching their nutrition, which should be full. It should be deleted from the diet sweet, flour and fat and increase physical exertion.

Glucophage reviews

In most cases, discussions of this drug are related to its use for weight loss. At the same time, some reviews of thin glucopide reported that this method recommended the doctor, since diet and physical exertion did not help eliminate overweight. Other users are interested in how to take this medicine to quickly reset extra kilograms. In addition, you can meet the stories of patients who took these pills to restore the reproductive function.

However, the use of the drug for such purposes is not always effective. Moreover, both the reviews of doctors and patients contain information on the development of serious pathologies against the background of such experiments.

Reviews about Glucophage for weight loss also do not describe concrete results. Although patients who take medicine are noted by its effectiveness and gradual decrease in body weight.

Glucophage price where to buy

Price glucophage 1000 mg varies within 300-350 rubles.

The price of glucophage 850 mg is from 205 rubles.

Buy 500 mg tablets can be 170-200 rubles.

Medicine glucophage, designed specifically for weight loss, is not released.

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Healthcare

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Pharmacy dialogue

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Glucophage 1000 mg №60 TableNanolek LLC.

MNN: Metformin

Manufacturer: Merck S.L.

Anatomy-therapeutic-chemical classification: MetFormin.

Registration number in Kazakhstan: № RK-LS-5№020405

Registration period: 11.03.2014 - 11.03.2019

KNF (LS Included in the Kazakhstan National Medicinal Form)

Alo (included in the list of free outpatient medicinal support)

UG (included in the LS List in the GBCM, to be purchased from the Unified Distributor)

Version Purchase price in the Republic of Kazakhstan: 11.16 KZT.

Instruction

Tradename

Glucophage®

International non-proprietary title

Metformin

Dosage form

Tablets coated with film shell 500 mg, 850 mg and 1000 mg

Structure

One tablet contains

active substance - metformin hydrochloride 500 mg, 850 mg or 1000 mg,

excipients: Povidone, magnesium stearate,

the composition of the film shell - Hydroxypropylmethylcellulose, in 1000 mg tablets - Oddrai pure ys-1-7472 (hydroxypropylmethylcellulose, macrogol 400, macrogol 8000).

Description

Glucophage. 500 mg and 850 mg: Round, biconavie pills covered with film shell white

Glucophage. 1000 mg: Oval, biconvecake tablets, covered with a film shell of white, with a risk for fault on both sides and labeling "1000" on one side of the tablet

Pharmacotherapeutic group

Tools for treating diabetes. Sugarization preparations for oral administration. Biguanides. Metformin.

ATH Code A10V02.

Pharmacological properties

Pharmacokinetics

After oral administration of metformin tablets, the maximum concentration (Cmax) in the plasma is achieved by approximately 2.5 hours (Tmax). Absolute bioavailability in healthy individuals is 50-60%. After oral administration, 20-30% of metformin is displayed through the gastrointestinal tract (gastrointestinal tract).

When using metformin in conventional doses and receiving modes, the constant concentration in the blood plasma is achieved for 24-48 hours and is generally less than 1 μg / ml.

The degree of binding of metformin with blood plasma proteins is insignificant. Metformin is distributed in red blood cells. The maximum level in the blood is lower than in the plasma and is achieved at approximately at the same time. The average distribution volume (VD) is 63-276 liters.

Metformin is excreted unchanged with urine. No metabolites for human metabolites are not identified.

The renal clearance of metformin is more than 400 ml / min, which indicates the removal of metformin with the help of glomerular filtration and the tubular secretion. After receiving the inside, the half-life is approximately 6.5 hours.

In disruption of the kidney function, the kidney clearance decreases in proportion to creatinine clearance, and thus, the half-life increases, which leads to an increase in the level of metformin in the blood plasma.

Pharmacodynamics

Metformin - Biguanide with an antihyperglycemic effect, which reduces both basal and postprandial glucose levels in blood plasma. It does not stimulate the secretion of insulin and in connection with this does not cause hypoglycemia.

Metformin has 3 mechanisms of action:

reduces the production of glucose liver due to the inhibition of gluconeogenesis and glycogenolysis;

improves the capture and disposal of peripheral glucose in the muscles by increasing the sensitivity to insulin;

holds the absorption of glucose in the intestines.

Metformin stimulates the synthesis of intracellular glycogen, affecting glycogenesis. It also improves the ability of all types of glucose membrane transporters (GLUT).

In clinical studies, the reception of metformin did not affect the body weight or slightly reduced it.

Regardless of its action on Glycemia, Metformin has a positive effect on lipid metabolism. During controlled clinical studies with the use of therapeutic doses, it was found that Metformin reduces the content of total cholesterol, low density lipoproteins and triglycerides.

Indications for use

Glucophage is shown for the treatment of type 2 diabetes, in particular, in patients with overweight, when only diet therapy and exercise do not provide sufficient control of glycemia.

in adult glucophage, can be used in the form of monotherapy, in combination with other oral antidiabetic agents or insulin;

in children from 10 years, glucophage can be used in the form of monotherapy or in combination with insulin.

Method of application and dose

Adults:

Monotherapy and combined therapy with other oral antidiabetic agents:

The usual initial dose is 500 or 850 mg of glucophage preparation

2-3 times a day during or after meals.

After 10-15 days from the beginning of therapy, it is necessary to adjust the dose of the drug based on the results of blood glucose measurement results. Slow increase in dose can contribute to the improvement of gastrointestinal tolerance.

In patients receiving a high dose of metformin hydrochloride (2-3 g per day), two glucophage pills with a dosage of 500 mg can be replaced with one glucophage dosage tablet with a dosage of 1000 mg. The maximum recommended dose is 3 g per day (divided into three receptions).

In the case of planning a transition from another anti-diabetic agent: it is necessary to stop the reception of another means and begin the reception of the drug glucophage in the dose indicated above.

Insulin combination:

To achieve a better control of glucose glucose glucophage and insulin can be used as combined therapy. The usual initial dose of the glucophage preparation is 500 mg or 850 mg 2-3 times a day, while the insulin dose is selected based on the results of the blood glucose measurement results.

Children and teenagers:

In children from 10 years of age, glucophage can be used both in monotherapy and in combination with insulin. The usual initial dose is 500 mg or 850 mg once a day during or after eating. After 10-15 days of the treatment, the dose of the drug must be corrected on the basis of the results of measuring blood glucose. Slow increase in dose can improve gastrointestinal tolerability. The maximum recommended dose is 2 g of glucophage preparation per day, divided by 2-3 reception.

Elderly patients:

Due to the possible decrease in the renal function in the elderly, the dose of the drug glucophage must be chosen based on the parameters of the kidney function. It is necessary to carry out a regular assessment of the kidney function.

Patients with impaired kidney function:

Metformin can be used in patients with moderate disorders of the kidney function - stage 3a chronic disease kidneys (creatinine clearance [CLKR] 45-59 ml / min or the estimated speed of glomerular filtration [RSKF] 45-59 ml / min / 1.73 m2) - only in the absence of other states that can increase the risk of lactatacidosis, and the next time Dose adjustment: The initial dose of metformin hydrochloride is 500 mg or 850 mg 1 time per day. The maximum dose is 1000 mg per day, divided into 2 receptions. It is necessary to conduct attentive monitoring of the kidney function (every 3-6 months).

If the values \u200b\u200bof the CLKR or RSKF will decrease to levels<45 мл/мин или <45 мл/мин/1,73 м2, соответственно, то следует немедленно прекратить применение метформина.

Side effects

At the beginning of treatment, the most frequent side reactions are nausea, vomiting, diarrhea, abdominal pain and appetite loss, which in most cases run spontaneously. To prevent the development of these symptoms, it is recommended to take glucophage in 2 or 3 receptions with a gradual increase in dose.

In the course of treatment with glucophage, the following adverse reactions may be observed. The frequency of such reactions is classified as follows: very frequent (≥1 / 10), frequent (≥1 / 100,<1/10), нечастые (≥1/1 000, <1/100), редкие (≥1/10 000, <1/1 000), очень редкие (<1/10 000).

Side effects for each frequency group are presented in order to reduce their severity.

Violations of metabolism and nutritional disorders

Rarely:

lactatacidosis

with prolonged use of metformin, the absorption of vitamin B12 may decrease, which is accompanied by a decrease in its serum level. When found megaloblastic anemia, it is necessary to take into account the possibility of such etiology.

Nervous System Violations

Partabout:

violation of taste

Violations from the gastrointestinal tract

Often:

target disorders, such as nausea, vomiting, diarrhea, abdominal pain, lack of appetite. Most often, these unwanted reactions occur at the beginning of treatment and, as a rule, run spontaneously. To prevent the development of these symptoms, it is recommended to take glucophage in 2 or 3 receptions before or after meals with a slow increase in dose

Violations by the liver and biliary tract

Rarely:

there were isolated cases of deviations in functional hepatic samples or hepatitis, which took place after the suspension of the application of metformin

Skin and subcutaneous fabric disorders:

Very rareabout:

skin reactions such as erythema, itching, urticaria

Children's patients:

Side effects in children were similar in nature and severity with effects that were noted in adults.

After the start of treatment with glucophage, it is necessary to report all suspicious side effects. This will continuously control the profile of the benefit ratio / risk of this drug.

Contraindications

increased sensitivity to metformine or to any auxiliary substance;

diabetic ketoacidosis, diabetic prema;

chronic kidney disease (stage 3b, 4 and 5) or kidney dysfunction (CLKR<45 мл/мин или рСКФ <45 мл/мин/1,73 м2) ;

acute states that can lead to a violation of the kidney function: dehydration, severe infection, shock;

acute or chronic diseases that are accompanied by tissue hypoxia: decompensated heart failure, respiratory failure, recently suffered myocardial infarction, shock;

liver failure;

acute alcoholic intoxication, alcoholism.

Medicinal interactions

Alcohol:the risk of developing lactatacidosis is intensified in acute alcohol intoxication, especially in the case of starvation or insufficient nutrition and liver failure. During treatment with glucophage®, taking alcohol and medicines containing alcohol should be avoided.

The intravascular administration of iodine-containing contrast agents may cause renal failure. This can lead to the cumulation of metformin and cause lactatacidosis.

Patients with RSKF\u003e 60 ml / min / 1.73 m2 The use of metformin must be stopped before or during the study using iodine-containing contrast agents, not to renew earlier than 48 hours after the study and only after re-evaluating the kidney function, which showed Normal results provided that it will not deteriorate subsequently.

In patients with impaired kidney function of moderate severity (RSKF 45-60 ml / min / 1.73 m2) Meetformming must be stopped 48 hours before the use of iodine-containing contrast agents and not renew earlier than 48 hours after the study and only after repeated Estimates of the kidney function, which showed normal results and, provided that it will not deteriorate later.

Combinations requiring caution

Medicinal preparations that are inherent hyperglycemic action (glucocorticoids (system and local action) and simpotomimetics): It may require more frequent definition of glucose in the blood, especially at the beginning of treatment. If necessary, you should adjust the dosage of metformin with the appropriate drug before the abolition of the latter.

Diuretics, especially looped diureticscan increase the risk of lactatacidosis due to their potential negative impact on the kidney function.

special instructions

Lactatacidosis

Lacatacidosis is a very rare, but serious metabolic complication with high mortality in the absence of urgent treatment, which may develop due to the accumulation of metformin. The noted cases of lactatacidosis in patients who received metformin developed mainly in patients with diabetes and pronounced renal failure or with acute deterioration of the kidney function. Care should be taken in situations where the kidney function can be broken, for example, in the case of dehydration (severe diarrhea, vomiting) or the purpose of antihypertensive, diuretic therapy, or non-steroidal anti-inflammatory therapy (NSAID) therapy. With the specified acute states, the Metform therapy needs to temporarily suspend.

It is necessary to take into account other concomitant risk factors, such as poorly controlled diabetes, ketosis, long fasting, excessive alcohol use, liver failure and any condition associated with hypoxia (such as decompensated heart failure, acute myocardial infarction).

The diagnosis of lactatacidosis should be considered in the event of nonspecific symptoms, such as muscle spasms, abdominal pain, and / or severe asthenia. It is necessary to inform patients that they should report the appearance of these symptoms to their attending physician, especially if patients had previously noted the good tolerance of metformin. In case of suspected lactatacidosis, it is necessary to cease treatment with glucophage. The resumption of the use of glucophage drug should be considered on an individual basis only after taking into account the benefit / risk ratio and kidney function.

Diagnosis

The lactatacidosis is characterized by the appearance of acidotic shortness, pain in the abdomen and hypothermia followed by a coma. Diagnostic laboratory indicators are a decrease in blood pH, a plasma lactate level over 5 mmol / l, an increase in the anionic interval and lactate / pyruvate ratio. In suspected lactatacidosis, the patient should immediately hospitalize. Doctors should notify patients about risks and symptoms of lactatacidosis.

Kidney function

Since Metformin is highlighted by the kidneys, before starting and regularly during treatment with glucophage®, it is necessary to check the creatinine clearance (by determining the level of creatinine in blood serum using the Cocroft-Golta formula):

not less than 1 other year in patients with normal kidney function;

not less than 2-4 times a year in elderly patients, as well as in patients with creatinine clearance at the lower boundary of the norm.

In case CLKR<45 мл/мин (рСКФ <45 мл/мин/1,73 м2), применение метформина противопоказано.

Reducing the function of the kidneys in elderly patients occurs often and proceeds asymptomatic. It is recommended to observe special caution in cases where the kidney function can be impaired, for example, in the case of the beginning of antihypertensive therapy, receiving diuretics or non-steroidal anti-inflammatory drugs.

Heart function

Patients with heart failure are more predisposed by the risk of hypoxia and renal failure. In patients with stable chronic heart failure, Metformin can only be applied with regular monitoring of the function of the heart and kidneys.

Patients with acute and unstable heart failure glucophage contraindicated.

Surgical interventions

The reception of the drug glucophage should be stopped 48 hours before planned surgical interventions conducted under general, spinal or epidural anesthesia. Typically, treatment with glucophage® should not be renewed earlier than 48 hours after surgical interventions or after renewing food intake, as well as after re-evaluating the kidney function, which showed normal results.

Other precautions

Patients need to comply with a diet with the correct distribution of carbohydrate use during the day. Persons with overweight should stick to a low-calorie diet.

It is necessary to regularly carry out laboratory tests for monitoring the course of the disease.

The use of the drug glucophage cannot cause hypoglycemia, but patients should be advised to exhibit caution when admitting it in combination with insulin or with sulfonylurea derivatives.

Patients of children's age

Before the treatment of glucophage, it is necessary to confirm the diagnosis of type 2 diabetes mellitus.

In controlled clinical studies with one-year duration, the influence of metformin on the growth and sexual development of children was not found, but there are no data for a longer period of time. Therefore, it is recommended to observe the action of metformin on these indicators in children and, especially, in the preperser period.

Children aged 10 to 12 years

Controlled clinical studies included only 15 children with age 10-12 years. Although the effectiveness and safety of metformin in children under 12 years old do not differ from those in older children and adolescents, caution should be taken when appointing metformin children aged 10 to 12 years.

Pregnancy and lactation period

Pregnancy

Uncontrolled diabetes during pregnancy (including gestational) is associated with an increased risk of congenital pathologies and perinatal mortality.

Limited data on the use of metformin in pregnant women do not indicate the risk of congenital disorders.

When planning and during pregnancy, it is not recommended to use metformin. To maintain blood glucose levels, insulin should be used as close as possible to the norm in order to reduce the risk of disorders of the fetus development.

Period lactation

Metformin penetrates breast milk. No undesirable effects in newborns / babies fed up with breast milk were not observed. However, due to the limited amount of data, it is not recommended to breastfeed during treatment with glucophage. It is necessary to decide on the interruption of breastfeeding, taking into account the benefit of breastfeeding and the potential risk of adverse reactions for the child.

Features of the effect of the drug on the ability to control the vehicle or potentially hazardous mechanisms

Monotherapy with glucophage does not cause hypoglycemia and therefore does not affect the ability to control the car and work with the mechanisms. However, patients must remember the possibility of hypoglycemia when using the glucophage drug in combination with other antidiabetic drugs (sulfonylurea derivatives, insulin or meglitinides).

Overdose

When applying the drug glucophage at a dose of 85 g, the development of hypoglycemia was not observed. However, in this case, the development of lactatacidosis was observed. Significant overdose of metformin or related risks can lead to the development of lactatacidosis. Lacatacidosis is an urgent medical condition that requires hospitalization.