Glucofage Long, 1000 mg 30 pcs

Interaction

Contraindicated combinations

Iodine-containing radiopaque agents: Against the background of functional renal insufficiency in patients with diabetes mellitus, radiological examination with iodine-containing radiopaque agents may cause development of lactocidosis. Glucophage® ^® Long should be discontinued depending on renal function 48 hours before or at the time of radiologic investigation with iodine-based radiopaque agents and should not be resumed until 48 hours after, provided that renal function was considered normal at the time of investigation.

Do not recommend combinations

Alcohol: Acute alcohol intoxication increases the risk of lactoacidosis, especially in cases:

– undernutrition, adherence to a low-calorie diet;

– hepatic insufficiency.

Alcohol and medicinal products containing ethanol should be avoided while taking the drug.

Combinations requiring caution

Drugs with indirect hyperglycemic effects (e.g., glucocorticosteroids (GCS) and tetracosactide (systemic and topical), beta₂-adrenomimetics, danazol, chlorpromazine when taken at high doses (100 mg daily) and diuretics): More frequent monitoring of blood glucose concentrations may be required, especially at the beginning of treatment. If necessary, the dose of Glucophage® Long may be adjusted during treatment and after discontinuation of treatment, based on the level of glycemia.

Diuretics: concomitant use of “loop” diuretics may lead to the development of lactoacidosis due to possible functional renal failure.

The concomitant use of Glucophage® Long with sulfonylurea derivatives, insulin, acarbose, salicylates may lead to hypoglycemia.

Nifedipine increases absorption and C_max metformin. Cationic drugs (amiloride, digoxin, morphine, procainamide, quinidine, quinine, ranitidine, triamterene, trimethoprim and vancomycin) that are secreted in the renal tubules compete with metformin for tubular transport systems and may lead to an increase in its C_max.

Colesevelam when used concomitantly with metformin in the form of sustained-release tablets increases plasma metformin concentrations (increased AUC without a significant increase in C_max).

Contraindications

• High sensitivity to metformin or any excipient.
• Diabetic ketoacidosis, diabetic precoma, coma.
• Renal failure or renal function impairment (creatinine clearance <45 ml/min).
• Acute conditions with risk of renal dysfunction: dehydration (with chronic or severe diarrhea, repeated vomiting), severe infectious diseases (e.g., respiratory tract infections, urinary tract infections), shock.
• Chronic manifestations of acute or chronic diseases that may lead to the development of tissue hypoxia (including acute heart failure, chronic heart failure with unstable hemodynamic parameters, respiratory failure, acute myocardial infarction).
• Extensive surgical procedures and injuries when insulin therapy is indicated (see section “Special Precautions”).
• Hepatic failure, liver dysfunction.
• Chronic alcoholism, acute alcohol poisoning.
• Pregnancy.
• Lactoacidosis (including anamnesis).
• Application less than 48 hours before and 48 hours after radioisotopic or radiological studies with iodine-containing contrast media (e.g., intravenous urography, angiography) (see “Interaction with other alcohols”).
• Maintenance on a caloric restricted diet (<1000 kcal/d).
• Children under 18 years of age due to lack of data for use.

With caution
Consider the use of the drug:

• in patients over 60 years of age who perform heavy physical work, due to the increased risk of lactoacidosis in them;
• in patients with renal insufficiency (clearancecreatinine 45-59 ml/min)
• when breastfeeding.

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Side effects

The frequency of side effects of the drug is rated as follows:
Very frequent: ≥ 1/10
Frequent: ≥ 1/100, < 1/10
Infrequent: ≥ 1/1000, < 1/100
Rare: ≥ 1/10,000, < 1/1000