Comet XR 1gm 6pcs

Uses of Metformin Hydrochloride

• Type 2 diabetes mellitus
• Polycystic ovary syndrome (PCOS)

How does Metformin Hydrochloride work?

It lowers glucose production in the liver, delays sugar absorption from the intestines, and increases insulin sensitivity.

Common Side Effects of Metformin Hydrochloride

• Nausea
• Vomiting
• Taste changes
• Diarrhea
• Abdominal pain
• Loss of appetite

Quick Suggestions:

• Prescribed to control blood sugar levels and reduce the risk of diabetic complications.
• Less likely to cause weight gain and low blood sugar compared to other diabetes medications.
• Carry a sugar source to manage potential low blood sugar levels.
• Inform your doctor if you experience rapid breathing, persistent nausea, vomiting, or stomach pain, which may indicate lactic acidosis.
• Long-term use may lead to vitamin B12 deficiency. Consult your doctor if you experience fatigue, pale skin, shortness of breath, or headache.
• Regular monitoring of blood sugar levels and kidney functions is necessary.

Pharmacology

Metformin is an antihyperglycemic agent that decreases glucose production in the liver, delays glucose absorption from the intestines, and increases insulin sensitivity.

Dosage & Administration

Adult Dose

• Type 2 Diabetes Mellitus:
  • Conventional Preparation: Start with 500 mg twice or thrice daily, or 850 mg 1-2 times daily. Gradually increase to 2000 mg daily. Maximum 2550 mg/day.
  • Modified-Release Preparation: Start with 500 mg once daily. Increase in increments of 500 mg to a maximum of 2000 mg once daily at night. If control is insufficient, split into 1000 mg twice daily.
• Polycystic Ovary Syndrome (PCOS):
  • Start with 500 mg daily in the morning for 1 week, then 500 mg twice daily for 1 week, then 1.5-1.7 g/day in divided doses.

Child Dose

• Type 2 Diabetes Mellitus (children >10 years): Start with 500 mg 1-2 times daily or 850 mg once daily. Gradually increase to a maximum of 2000 mg daily in divided doses.

Renal Dose

• Check eGFR before starting metformin.
• eGFR <30 mL/min/1.73 m²: Contraindicated.
• eGFR 30-45 mL/min/1.73 m²: Not recommended to start treatment.
• Monitor eGFR annually or more frequently in those at risk for renal impairment.
• If eGFR falls below 45 mL/min/1.73 m², reassess risks and benefits.
• Discontinue if eGFR falls below 30 mL/min/1.73 m².

Take the medicine as prescribed by your doctor. Swallow it whole with food. Do not chew, crush, or break it.

Interaction

• Additive effects with sulfonylureas.
• Thiazide diuretics, corticosteroids, phenothiazines, oral contraceptives, and others may worsen glycemic control.
• ACE inhibitors may reduce fasting blood glucose.
• Increased serum levels with cimetidine.
• Potentially fatal interaction with iodinated contrast agents.

Contraindications

• Acute or chronic metabolic acidosis.
• Renal failure or severe renal impairment.
• Severe liver impairment.
• Conditions affecting renal function (e.g., dehydration, severe infection, shock).
• Severe cardiac or respiratory conditions.
• Pregnancy and lactation.

Pregnancy & Lactation

Pregnancy: Uncontrolled diabetes during pregnancy (gestational or permanent) is associated with an increased risk of congenital abnormalities and perinatal mortality. When the patient plans to become pregnant and during pregnancy, it is recommended that diabetes is not treated with metformin but that insulin be used to maintain blood glucose levels as close to normal as possible, to reduce the risk of malformations of the fetus.

Breastfeeding: Metformin is excreted into human breast milk. No adverse effects were observed in breastfed newborns/infants. However, as only limited data are available, breastfeeding is not recommended during metformin treatment. A decision on whether to discontinue breastfeeding should be made, taking into account the benefits of breastfeeding and the potential risk of adverse effects on the child.

Precautions & Warnings

• Caution in patients with heart failure or those undergoing radiologic studies with iodinated contrast agents.
• Monitor renal function regularly.
• Not recommended during lactation.

Storage Conditions:

Store in a cool and dry place away from sunlight