Glikos

Metformin HCl.

Glikos 500: Each film-coated caplet contains Metformin HCl 500 mg.
Glikos 850: Each film-coated caplet contains Metformin HCl 850 mg.

Pharmacology: Metformin is an oral antihyperglycemic substance of the biguanide group. Mechanism of metformin is to reduce blood sugar levels and does not increase insulin excretion.
Metformin does not metabolized in the liver, it is excreted as an unchanged form in urine for the most part and a few in the stool.

For therapy in patients with non-insulin dependent diabetes and overweight which the sugar content cannot be controlled just by diet. This drug may be used as a solo medication or administered as a combination with Sulfonylurea.
For additional therapy in diabetics with dependence on insulin whose symptoms are difficult to control.

Film-coated caplet is taken during meal or after meal: Adults: Initially: an 850mg film-coated caplet twice daily, or a 500mg film-coated caplet 3 times daily.
The effects can be achieved within a few days but sometimes the effects can be achieved after 2 weeks. If the desired result is not achieved the dose can be increased carefully to 3 grams daily. If the symptoms of diabetes can be controlled, the dose can be reduced.
In concomitant use with sulfonylureas, initially a film-coated caplet (500 mg) or ½-1 film-coated caplet (850 mg) daily, then dose can be raised slowly until optimal control is obtained. The dose of sulfonylurea can be reduced, in some patients it is not even necessary to take it again.
Treatment may be continued with Metformin as a single drug.
In concomitant use with insulin.
a. If the usage of insulin is less than 60 units daily, initially, give 1 film coated caplet (500 mg) or ½-1 film coated caplet (850 mg) daily, reduced (4 units every 2-4 days). The use of film coated caplet can be increased every weekly interval.
b. If the usage of insulin is more than 60 units daily, giving Metformin sometimes lower blood sugar levels quickly. Such patients should be carefully observed during the first 24 hours after administration of Metformin. After that it can be followed by point (a) previously-mentioned.
Single-dose trial: Blood sugar levels test after administering a single trial dose cannot be used as a clue if a patient would respond to Metformin for weeks. Therefore, a single trial dose cannot be used as an assessment.

Symptoms: Hypoglycemia may occur in concomitant use with Sulfonylurea, insulin or alcohol.
Excessive doses may lead to acidosis.
Countermeasures: Give the supportive therapy intensively, especially to improve fluid loss and metabolic disorders.

Hypersensitivity.
Diabetic coma and ketoacidosis.
Severe kidney dysfunction.
Chronic liver disease, heart failure and myocardial infarction, alcoholism, history or any circumstances associated with lactic acidosis such as shock or pulmonary insufficiency and conditions related to hypoxemia.
Pregnancy and lactation.

Caution to use in patients with impaired renal function.
Not recommended for use in conditions where it causes dehydration or in patients who are recovering from serious infections or trauma.
Periodic checks of vitamin B12 levels on long-term use is fully recommended.
Due to the possibility of hypoglycemia in combination treatment with Sulfonylurea, blood sugar levels should be monitored periodically.
Combination of metformin and insulin treatment should be done in hospital to achieve a steady combination ratio of both drugs.
Careful of usage in elderly patients with impaired renal function.
Not recommended for children.

This drug is contraindicated in pregnant & lactating women.

Metformin may be well received by patients, and just caused a bit gastrointestinal disturbance that is usually happen temporarily. This can be avoided if Metformin is taken with food or reducing the dose temporarily.
If the symptoms of intolerance appear, the therapy doesn't need to be stopped immediately, usually such side effects will not appear on subsequent use.
Anorexia, nausea, vomiting, diarrhea.
Reduced the absorption of Vitamin B12.

Interactions between Metformin and certain anticoagulants might be happened. In this case, it is necessary to adjust the anticoagulant dose.
Reduction of metformin renal clearance by co-administration with Cimetidine, so the dose should be reduced.

Store below 30°C in a closed container and avoid the sunlight.

Antidiabetic Agents

A10BA02 - metformin ; Belongs to the class of biguanides. Used in the treatment of diabetes.

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