Metta SR

Adjunct to diet & exercise to improve glycemic control in patients w/ type 2 DM. May be used concomitantly w/ sulfonylureas or insulin to improve glycemic control.

Monotherapy & combination w/ other oral antidiabetic agent Initially 500 mg once daily. Adjust dose after 10-15 days on the basis of blood glucose measurements. Max: 2,000 mg once daily. If glycaemic control is not achieved w/ 2,000 mg once daily, consider 1,000 mg bid. Combination w/ insulin Initially 500 mg once daily, while insulin dose is adjusted based on blood glucose measurement.

Should be taken with food: Take w/ evening meal. Swallow whole, do not chew/crush.

Hypersensitivity. Diabetic ketoacidosis, diabetic pre-coma; renal failure/dysfunction (CrCl <60 mL/min); acute conditions w/ potential to alter renal function eg, dehydration, severe infection, shock; acute or chronic disease which may cause tissue hypoxia eg, cardiac or resp failure, recent MI, shock; hepatic insufficiency, acute alcohol intoxication, alcoholism.

Reports of lactic acidosis, primarily in diabetic patients w/ significant renal failure; discontinue treatment & patient should be hospitalised immediately if metabolic acidosis is suspected. Monitor CrCl &/or serum creatinine levels before initiating treatment & regularly thereafter. Discontinue use prior to, or at the time of iodinated contrast administration & do not reinstitute until 48 hr afterwards & only after renal function has been re-evaluated to be normal. Discontinue treatment 48 hr before elective surgery w/ general spinal or peridural anaesth; therapy may restarted no earlier than 48 hr following surgery or resumption of oral nutrition provided normal renal function has been established. Should not be taken by patients w/ galactose intolerance, Lapp lactase deficiency or glucose-galactose malabsorption. Patients should continue their diet w/ regular distribution of carbohydrate intake during the day; overwt patients should continue energy-restricted diet. Tab shells may be present in the faeces. Risk of hypoglycaemia in combination w/ insulin or other oral antidiabetics (eg, sulphonylureas or meglitinides). Caution in impaired renal function; regular assessment is necessary. Not recommended during pregnancy & in patients planning to become pregnant. Breastfeeding is not recommended during treatment. Should not be used in childn. Consider the potential of decreased renal function in elderly.

GI disorders eg, nausea, vomiting, diarrhoea, abdominal pain & loss of appetite. Taste disturbance.

Increased risk of lactic acidosis in acute alcohol intoxication particularly in case of fasting or malnutrition, hepatic insufficiency. Intravascular administration of iodinated contrast agents may lead to renal failure resulting in metformin accumulation & risk of lactic acidosis. Dose adjustment & frequent blood glucose monitoring may be required when given w/ medicinal products w/ intrinsic hyperglycaemic activity (eg, systemic or local glucocorticoids & sympathomimetics). Increased risk of lactic acidosis w/ diuretics, especially loop diuretics.

Antidiabetic Agents

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

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