Metformin is a substance that belongs to biguanides. Metformin is a medical medication used to treat diabetes.
The effect of the medication is based on the fact that it is able to slow down the process of gluconeogenesis in the cells of the hepatic tissue, reduces the rate of glucose absorption from the intestinal lumen and enhances the process of peripheral glucose utilization.
Additionally, Metformin 850 mg tablets help to increase insulin sensitivity in cells of the insulin-dependent tissues of the body.
The use of the drug has no particular effect on the process of insulin production in the pancreas, does not provoke in the body the development of a state of hypoglycemia. Taking the medicine allows you to lower the blood concentration of triglycerides and lipoproteins.
The composition of the drug and its pharmacological properties
The drug inhibits the development of the polyplication of smooth muscle elements of the walls of the vascular system. The positive effect of the medical device on the general state of the cardiac and vascular systems was revealed and prevented the development of diabetic angiopathy.
Diabetes treatment with Metformin can only be prescribed by the attending physician after a comprehensive examination of the patient. The duration of the treatment and the dose of the medication used are determined taking into account all the features of the course of the disease in the patient's body.
The active ingredient of the drug is Metformin hydrochloride. One tablet contains 850 mg of active chemical compound. In addition to the main compound, auxiliary chemical compounds are part of the medical preparation.
The chemical compounds that make up the medical device are the following:
- dibasic calcium phosphate,
- corn starch,
- sodium benzoate
- magnesium stearate,
- sodium starch glycolate
- titanium dioxide,
- ethyl cellulose,
- propylene glycol,
- polyethylene glycol.
Metformin intake does not affect the level of the hormone in the human body, but contributes to a change in its pharmacodynamics, which occurs due to a decrease in the ratio between bound insulin and free, there is an increase in the ratio in the human body between insulin and proinsulin. One of the most important stages in the mechanism of action of the drug is the stimulation of glucose utilization by muscle cells.
The active ingredient enhances the process of blood circulation in the liver tissue and accelerates the processing of glucose into glycogen. The use of Metformin 850 mg improves blood fibrinolytic properties. This is due to the suppression of a tissue-type plasminogen activator inhibitor.
Absorption of the active substance is carried out from the lumen of the gastrointestinal tract and is an indicator that ranges from 48 to 52%. The half-life of the active ingredient is about 6.5 hours.
The active substance is derived from the human body in its original form. The active component does not enter into connection with the protein complexes of blood plasma. The accumulation of the drug occurs in the salivary glands, muscle tissue, kidneys and liver.
Excretion from the body is carried out by the kidneys during the formation of urine.
Indications and contraindications to the use of medical equipment
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The main indications for use are the following:
- the presence of type 2 diabetes without a pronounced tendency to the occurrence of ketoacidosis,
- the presence of diabetes in the absence of effectiveness from the diet,
- treatment of type 2 diabetes in combination with insulin therapy, especially with a pronounced degree of obesity, which is accompanied by the emergence of secondary insulin resistance.
The main contraindications to the use of funds for the treatment of type 2 diabetes are as follows:
- development in the body of diabetic ketoacidosis, diabetic precoma or coma,
- disorders in the functioning of the kidneys,
- the emergence and progression in the patient's body of acute diseases occurring with the risk of impaired renal function - dehydration, fever, hypoxia, infectious diseases of the kidneys, development of bronchopulmonary ailments,
- the development of acute and chronic ailments that can provoke the progression of tissue hypoxia,
- carrying out serious surgical interventions in the body and the patient receiving serious injuries of the body,
- the occurrence and progression of disorders in the functioning of the liver,
- the patient has chronic alcoholism or acute alcohol poisoning,
- development in the body of lactic acidosis,
- the need to follow a low-calorie diet,
- gestation period,
- breastfeeding period
- the patient has hypersensitivity to the drug.
Instructions for use of the drug
In order to know how to take the medicine correctly, you should consult with your doctor. The patient should be studied instruction on the use of Metformin.
The dose of the drug is set exclusively by the attending endocrinologist. The doctor determines the dosage for each patient individually, taking into account the results obtained during the examination of the body and taking into account the characteristics of the patient. The dose of the drug, which should be drunk to the patient, largely depends on the level of glucose in the blood plasma in the patient's body.
In order to properly take Metformin, the initial dose should be from 500 to 1000 mg per day, which is 1-2 tablets. After 10-15 days of admission by the decision of the endocrinologist observing the patient, a further increase in dosage is possible, if this is required by a high content of glucose in the patient's body.
Instructions for use recommends using as a maintenance dose 1500-2000 mg of the drug, which is 3-4 tablets, and the maximum dose allowed to receive is 3000 mg during the day.
In the case of the treatment of type 2 diabetes in elderly patients, the dose used by the medical device should not exceed 1 g or 2 tablets per day.
Tablets should be taken orally without chewing in the process of eating or immediately after it. The drug should be taken with a small amount of liquid. In order to prevent the development of side effects in the body, the daily dosage is recommended to be divided into 2-3 doses.
Since when taking the drug, the likelihood of developing lactic acidosis, used to treat type 2 diabetes, is high, the dose of the drug is reduced if the patient has severe metabolic disorders.
In the case of simultaneous use with insulin in a dose of not more than 40 U per day, the dosage regimen of the drug remains unchanged. For treatment that requires the administration of a daily insulin dose of more than 40 U per day, the dosage regimen should be taken with extreme caution. The choice of dosage should be carried out in such a case in a hospital under the constant supervision of the attending physician.
Side effect of the drug on the body
With prolonged use of the drug may cause disorders in the body associated with the absorption of vitamin B12.
With long-term use of funds should be given special attention to monitoring the functional state of the hepatic tissue and kidneys.
When using the drug may manifest the following side effects:
- On the part of the functioning of the gastrointestinal tract, disorders are possible, manifested in the form of nausea, vomiting, pain in the abdomen, a decrease or lack of appetite, the appearance of a metallic taste in the mouth.
- On the part of the skin there is the possibility of allergic reactions in the form of a skin rash.
- The endocrine system is able to respond to the use of the drug by the formation of hypoglycemic states. Most often, such situations arise as a result of therapy with inadequate doses of the drug.
- On the part of passing metabolic processes in rare cases, when taking inadequate doses, the development of lactic acidosis in the body is likely. When such a situation arises, discontinuation of the drug is required.
- The circulatory system is able to respond to the intake of a drug by forming in some cases megaloblastic anemia.
Due to the high risk to the body, metformin in the presence of renal failure in a person should be stopped or taken under the supervision of a physician and in a small dosage.
In such a situation, many endocrinologists recommend the inability to take the drug completely, and its reception in a strongly reduced dosage, as sugar control is paramount.
Special instructions when using Metformin
When planning a pregnancy or when it occurs, the drug should be discontinued. In the case of pregnancy, the use of the drug for the period of carrying a child is replaced by insulin therapy.
Since there is no data on the possible penetration of the components of the drug and the active ingredient in the composition of milk, the use of the drug should be discontinued when breastfeeding is carried out. If there is an urgent need to use Metformin during lactation, breastfeeding should be stopped.
The use of the drug is prohibited for children and adolescents under the age of 18 years.
Doctors do not recommend the use of the tool in the treatment of diabetes in elderly people who have reached the age of 60 years and perform heavy work associated with increased physical exertion on the body. This recommendation is connected with the fact that such patients have a high probability of developing lactic acidosis in the body.
In the case of Metformin, it may be combined with sulfonylurea derivatives. With such a combination of medication, it is necessary to conduct particularly careful monitoring of the state of the glucose indicator in the body.
It is forbidden to consume alcoholic beverages and medicines containing ethanol in the course of the drug intake. Taking Metformin simultaneously with alcohol can trigger the development of lactic acidosis in the body of a patient with diabetes mellitus.
The cost of Metformin, its analogues and patient feedback on the use of the tool
Analogues of Metformin are the following drugs:
- Glucophage Long,
- Metfogamma 500, 850, 1000
- Metformin Richter
- Metformin Teva,
- Metformin hydrochloride,
- Nova Met,
- Siofor 1000,
- Siofor 500,
- Siofor 850,
- Formin Pliva.
Reviews of the use of the drug by patients for the treatment of diabetes mellitus indicate that this tool has an effective effect on the body, which allows you to control the concentration of glucose in the body.
A lot of reviews about the drug that indicate positive changes in the body when taking Metformin or its analogues and the emergence of positive dynamics in the treatment of diabetes.
Very often, patients suffering from diabetes and obesity, testify in their responses that the use of Metformin in the process of conducting drug therapy significantly reduced body weight.
The cost of the drug in pharmacies in the country depends on the region and the packaging of the drug.
The cost of the drug Metformin Teva 850 mg in the country averages 100 rubles per package, containing 30 tablets.
Such a drug as Metformin Canon 1000 mg has an average cost in the country of 270 rubles per package, which contains 60 tablets.
The cost of the drug depends on how many tablets are in the package. When purchasing a drug, it should be remembered that its release is conducted only on the prescription of the attending physician.
In the video in this article, Dr. Myasnikov will talk about the principle of action of Metformin in diabetes mellitus.
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With simultaneous use with sulfonylurea derivatives, acarbose, insulin, salicylates, MAO inhibitors, oxytetracycline, ACE inhibitors, clofibrate, cyclophosphamide, the hypoglycemic effect of metformin may be enhanced.
With simultaneous use with corticosteroids, hormonal contraceptives for oral administration, danazol, epinephrine, glucagon, thyroid hormones, phenothiazine derivatives, thiazide diuretics, nicotinic acid derivatives may reduce the hypoglycemic effect of metformin.
In patients receiving metformin, the use of iodine-containing contrast agents for the purpose of conducting diagnostic studies (including in / in urography, in / in cholangiography, angiography, CT) increases the risk of developing acute renal dysfunction and lactic acidosis. These combinations are contraindicated.
Beta2-adrenomimetiki in the form of injections increase the concentration of glucose in the blood due to stimulation of β2-adrenergic receptors. In this case, it is necessary to control the concentration of glucose in the blood. If necessary, it is recommended to appoint insulin.
Simultaneous use of cimetidine may increase the risk of lactic acidosis.
Simultaneous use of “loop” diuretics can lead to the development of lactic acidosis due to possible functional renal failure.
Pro concomitant use with ethanol increases the risk of lactic acidosis.
Nifedipine increases the absorption and Cmax of metformin.
Cationic drugs (amiloride, digoxin, morphine, procainamide, quinidine, quinine, ranitidine, triamterene, trimethoprim and vancomycin), secreted in the renal tubules, compete with metformin for tubular transport systems and can lead to an increase in its Cmax.
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Metformin (or Glucophage in another way) is taken by people only after 20 years of age with diabetes mellitus type II, and it reduces cholesterol levels well, albeit on the condition that insulin is produced in the body.
When you take this drug is a quick weight loss, which does not come back. Its process in the body is very simple, it blocks all the incoming fat and prevents it from accumulating in the body's “vaults”, the extra energy of a person begins to be spent. Therefore, many models, athletes and just people who want to lose weight in a short time, take Metformin.
Action on the body
Medicine reduces insulin production in the bodythe absorption of carbohydrates in the gastrointestinal tract, increases the consumption of glucose by muscle fibers, accelerates the oxidative processes of fatty acids and metabolism. All these actions on the body lead to a decrease and normalization of weight.
The main advantages of taking Metformin is that it:
- reduces a strong appetite
- reduces cravings for sweets
- with the right medication does not cause side effects,
- reduces and maintains normal blood glucose levels without the introduction of insulin,
- also reduces the level of harmful cholesterol in the body.
But the main thing is that the weight being dropped when taking the medicine will never return, of course, if a person does not abuse as before the excess nutrition and a sedentary lifestyle.
The disadvantages of frequent use of the drug are health complications, which can cause the development of unpleasant symptoms:
- Vomiting, nausea and other dyspeptic manifestations,
- Intestinal and stomach pain,
- Taste of metal in the mouth,
- Chronic relapses,
- Often causes the development of anemia for B12 deficiency.