Metformin/Glucophage Tablets

Metformin is a biguanide with antihyperglycemic effects, which reduces postprandial and basal plasma glucose. It does not stimulate insulin secretion, so it does not cause hypoglycemia.

Metformin works through 3 mechanisms:

• reduction of hepatic glucose production by inhibiting gluconeogenesis and glycogenolysis.
• in the muscle, increasing insulin sensitivity, improving peripheral glucose uptake, and its use.
• and delayed intestinal glucose absorption.

Metformin stimulates the intracellular synthesis of glycogen by acting on glycogen synthetase. Metformin increases the transport capacity of all types of glucose membrane transporters (GLUT) known to date.

Metformin is used to treat patients with type 2 diabetes (also called "non-insulin-dependent diabetes") when diet and exercise alone have not been sufficient to control their blood glucose level. It is especially used in overweight patients.

Adults can take Metformin alone or with other medicines to treat diabetes (medicines taken by mouth or insulin). Children from 10 years and adolescents can take Metformin alone or with insulin.

Always take Metformin exactly as your doctor has told you. Ask your doctor or pharmacist if you have doubts.

These Glucophage tablets can replace the benefits derived from a healthy lifestyle. Continue to follow any diet advice your doctor has told you and exercise regularly:

Children from 10 years and adolescents generally start with 500 mg or 850 mg of Metformin once a day. The maximum daily dose is 2000 mg divided into 2 or 3 doses. The treatment of children between 10 and 12 years old is only recommended on the specific advice of their doctor since the clinical experience in this group of patients is limited.

Adults generally start with 500 mg or 850 mg of Metformin or three times a day. The maximum daily dose is 3000 mg divided into 3 doses. If you have reduced kidney function, your doctor may prescribe a lower dose.

If you also use insulin, your doctor will tell you how to start taking Metformin.

Monitoring:

Your doctor will perform tests to check your blood glucose and will adjust your dose of Metformin to your blood glucose level. Be sure to speak regularly with your doctor. This is particularly important for children, teens, or if you are elderly.

Your doctor will also check, at least once a year, how your kidneys work. You may need more frequent check-ups if you are elderly or if your kidneys are not working normally.

How to take Metformin 850 mg

Take the tablets with or after meals. This will prevent you from suffering adverse effects that affect your digestion.

Do not break or chew the tablets. Swallow each tablet with a glass of water.

• If you take one dose a day, take it in the morning (at breakfast).
• If you take two doses a day, take them in the morning (breakfast) and in the evening (dinner).
• If you take three doses a day, take them in the morning (breakfast), at noon (lunch), and in the evening (dinner).

Like all medicines, this medicine can cause side effects, although not everybody gets them.

Metformin can cause a very rare side effect (may affect up to 1 person in 10,000), but a very serious one, called lactic acidosis. If this occurs, you should stop taking Metformin and Contact a doctor or nearest hospital immediately, as lactic acidosis can lead to a coma.

The following side effects may occur.

Very common side effects (may affect more than 1 in 10 people):

• Digestive problems, such as nausea, vomiting, diarrhea, stomach pain (abdominal pain), and loss of appetite. These side effects occur more frequently at the beginning of treatment with Metformin. It helps to spread the doses throughout the day and if you take the tablets during or immediately after a meal. If symptoms continue, stop taking Metformin and consult your doctor.

Common side effects (may affect up to 1 in 10 people):

• Alteration of taste.

Very rare side effects (may affect up to 1 in 10,000 people):

• Lactic acidosis. It is a very rare but serious complication, especially if your kidneys are not working properly. Symptoms of lactic acidosis are not specific.
• Liver function test abnormalities or hepatitis (inflammation of the liver; this can cause tiredness, loss of appetite, weight loss, with or without yellowing of the skin or whites of the eyes). If this happens to you, stop taking Metformin and contact your doctor immediately.
• Skin reactions such as redness of the skin (erythema), itching, or an itchy rash (urticaria).
• Low concentration of vitamin B12 in the blood.

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