Tab. Metfo 850 mg

Ingredients:
Each tablet contains:
Metformin Hydrochloride 850 mg

Direction of Use:
Take orally with or after meals to reduce gastrointestinal side effects.
Swallow the tablet whole with a glass of water.
Do not crush or chew.
Use as prescribed by a physician.

Indication:
Management of Type 2 Diabetes Mellitus, particularly in overweight patients, when diet and exercise alone are insufficient.
Can be used as monotherapy or in combination with other antidiabetic agents, including insulin.

Pharmacology:
Metformin is a biguanide oral antidiabetic agent. It lowers blood glucose levels by:
Decreasing hepatic glucose production (gluconeogenesis)
Increasing insulin sensitivity
Enhancing peripheral glucose uptake and utilization
Delaying intestinal glucose absorption
It does not stimulate insulin secretion, so it generally does not cause hypoglycemia when used alone.

Dosage & Administration:
Usual dose: One tablet (850 mg) once or twice daily with meals.
Start with a lower dose (e.g., 500 mg) and gradually increase to minimize gastrointestinal side effects.
Maximum recommended daily dose is 2550 mg in divided doses.
Dose adjustment may be required in patients with renal impairment.

Interaction:
Increased risk of hypoglycemia when combined with insulin or sulfonylureas.
Use with caution with drugs that impair renal function (e.g., NSAIDs, diuretics).
Alcohol increases the risk of lactic acidosis.
Cimetidine may increase metformin concentration.

Contraindications:
Known hypersensitivity to Metformin
Renal impairment (eGFR <30 mL/min/1.73 m²)
Metabolic acidosis, including diabetic ketoacidosis
Severe hepatic impairment
Acute or chronic conditions associated with tissue hypoxia (e.g., heart failure, respiratory failure)

Side Effects:
Common:
Nausea
Vomiting
Diarrhea
Abdominal discomfort
Loss of appetite

Rare but Serious:
Lactic acidosis (medical emergency)

Pregnancy & Lactation:
Pregnancy: Use only if clearly needed; insulin is preferred for glycemic control in pregnancy.
Lactation: Metformin is excreted in breast milk but generally considered safe. Use with caution.

Precautions & Warnings:
Regularly monitor renal function before and during treatment.
Discontinue temporarily before contrast imaging procedures.
Caution in elderly or dehydrated patients.
Educate patients about signs of lactic acidosis (fatigue, muscle pain, breathing difficulty).

Overdose Effects:
Large overdose or accumulation can lead to lactic acidosis, which can be fatal.
Treatment includes supportive care, correction of acidosis, and hemodialysis.

Therapeutic Class:
Oral Antidiabetic (Biguanides)

Storage Conditions:
Store below 30°C in a dry place.
Protect from light and moisture.
Keep out of reach of children.