Formetin, 1 g tablets 60 pcs

Formethine has hypoglycemic effect.

Pharmacodynamics

Metformin inhibits gluconeogenesis in the liver, reduces glucose absorption from the intestine, increases peripheral glucose utilization, and increases tissue sensitivity to insulin.

With this it has no effect on insulin secretion by beta cells of the pancreas, does not cause hypoglycemic reactions. Reduces the level of triglycerides and low-density lipoproteins in the blood. Stabilizes or reduces body weight. Has a fibrinolytic effect due to inhibition of tissue-type plasminogen activator inhibitor.

Pharmacokinetics

After oral administration, metformin is slowly absorbed from the gastrointestinal tract. Bioavailability after a standard dose is 50-60%. Maximum plasma concentration is reached 2.5 hours after oral administration. It practically does not bind with plasma proteins.

It is accumulated in salivary glands, muscles, liver and kidneys. It is excreted unchanged by kidneys. Period of semiejection is 1.5-4.5 hours. Cumulation of the drug is possible in patients with impaired renal function.

Indications

Type 2 diabetes mellitus (especially in cases accompanied by obesity) when ineffective correction of hyperglycemia by diet therapy, including in combination with sulfonylurea drugs.

Active ingredient

Composition

1 tablet contains:

the active ingredient:

metformin hydrochloride 1 g;

excipients:

povidone medium molecular weight (polyvinylpyrolidone),

croscarmellose sodium,

magnesium stearate

How to take, the dosage

The dose of the drug Formetin is set by the doctor individually depending on the blood glucose level.

Take without chewing during or after a meal, with plenty of water. The initial dose is 0.5 g 1-2 times a day or 0.85 g once a day, gradually (once a week) the dose is increased to 2-3 g a day. The maximum daily dose is 3 g.

In elderly patients the daily dose should not exceed 1 g.

Because of the increased risk of lactoacidosis, in patients with severe metabolic disorders the dose of the drug should be reduced.

Interaction

Simultaneous use with sulfonylurea derivatives, acarbose, insulin, nonsteroidal anti-inflammatory drugs, monoamine oxidase inhibitors, oxytetracycline, angiotensin-converting enzyme inhibitors, clofibrate derivatives, cyclophosphamide, β-adrenoblockers may increase the hypoglycemic effect of metformin.

In concomitant use with glucocorticosteroids, oral contraceptives, epinephrine, sympathomimetics, glucagon, thyroid hormones, thiazide and “loop” diuretics, phenothiazine derivatives, nicotinic acid derivatives may decrease the hypoglycemic effect of metformin.

Cimetidine slows metformin excretion, resulting in an increased risk of lactoacidosis.

Metformin may weaken the effect of anticoagulants (coumarin derivatives).

The simultaneous use of alcohol may lead to lactoacidosis.

Nifedipine increases absorption, maximum concentration, slows metformin excretion.

The cationic drugs (amiloride, digoxin, morphine, procainamide, quinidine, quinine, ranitidine, triamterene, vancomycin) that are secreted in the tubules compete for tubule transport systems and may increase maximum drug concentration by 60% with long-term therapy.

Special Instructions

During treatment it is necessary to monitor renal function. At least twice a year, as well as in case of myalgia, plasma lactate content should be determined.
It is possible to use Formetin in combination with sulfonylurea derivatives. In this case it is necessary to monitor blood glucose level particularly carefully.

Impact on the ability to drive vehicles and operate machinery:

When used in monotherapy, Formetin does not affect the ability to drive or operate machinery.

When combining Formetin with other hypoglycemic agents (sulfonylurea derivatives, insulin, etc.) hypoglycemic states may occur, in which the ability to drive vehicles and engage in other potentially dangerous activities requiring increased attention and quick psychomotor reactions is impaired.

Contraindications

Side effects

Digestive system disorders: nausea, vomiting, “metallic” taste in the mouth, lack of appetite, diarrhea, flatulence, abdominal pain.

Metabolic disorders: in rare cases lactoacidosis (requires discontinuation of treatment); with long-term treatment – hypovitaminosis B12 (malabsorption).

Hematopoietic organs: in some cases – megaloblastic anemia.

Endocrine system disorders: hypoglycemia (when used in inadequate doses).

Allergic reactions: skin rash.

Overdose

In case of metformin overdose, lactoacidosis with fatal outcome is possible. The cause of lactocidosis may also be cumulation of the drug due to renal dysfunction.

The early symptoms of lactocidosis are general weakness, nausea, vomiting, diarrhea, decreased body temperature, abdominal pain, muscle pain, decreased arterial pressure, reflex bradyarrhythmia; fast breathing, dizziness, disturbance of consciousness and coma may be noted later.

Treatment: If signs of lactocidosis occur, metformin treatment should be stopped immediately, the patient should be hospitalized urgently and the lactate concentration determined to confirm the diagnosis.

The most effective measure for lactate and metformin elimination from the body is hemodialysis. Symptomatic treatment is also carried out.

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