Initial therapy, as an adjunct to diet & exercise, to improve glycemic control in patients w/ type 2 diabetes w/ HbA1c >8% whose hyperglycemia cannot be satisfactorily managed w/ diet & exercise alone. 2nd-line therapy when diet, exercise, & initial treatment w/ a sulfonylurea or metformin do not result in adequate glycemic control in patients w/ type 2 diabetes.
Renal disease or renal dysfunction, CHF requiring pharmacologic treatment, acute or chronic metabolic acidosis, including diabetic ketoacidosis w/ or w/o coma. Treatment should be temporarily discontinued in patients undergoing radiologic studies involving intravascular administration of iodinated contrast materials. Hepatic insufficiency, alcoholism, porphyria, lactation, in association w/ miconazole.
Lactic acidosis is rare & may occur in significant renal insufficiency. Regular renal monitoring, especially in the elderly, is needed. Avoid use in patients w/ clinical or lab evidence of hepatic disease. Patients should be cautioned against excessive alcohol intake. Concomitant medications that may affect renal function or result in significant hemodynamic change or may interfere w/ the disposition of metformin. Suspend therapy during surgery & clinical investigations using IV iodinated contrast media.
Iodinated contrast media, alcohol, cationic drugs that are eliminated by renal tubular secretion, furosemide, nifedipine. Decreases vit B12 absorption. Thiazide & other diuretics, corticosteroids, phenothiazines, thyroid products, estrogens, OC, phenytoin, nicotinic acid, sympathomimetics, Ca-channel blockers & INH may produce hyperglycemia & lead to loss of glycemic control. The hypoglycemic action of sulfonylureas may be potentiated by NSAIDs & other highly protein-bound drugs, salicylates, sulfonamides, chloramphenicol, probenecid, coumarins, MAOIs, β-blockers, ciprofloxacin, oral miconazole & other oral hypoglycemic agents.
Sign Out
