home Auditorium 7 Metformin: how long can it be taken and is it addictive? Metformin

Metformin: how long can it be taken and is it addictive? Metformin

Metformin is an antihyperglycemic drug used to treat type 2 diabetes in obese people and other types of non-insulin-dependent diabetes.

Metformin is produced by several manufacturers. Among them are Metmorphin “Richter”, “Teva”, “Long”, “BMS”, “Canon”, “MV-Teva”, “Zentiva”. All companies provide a drug containing active substance 500, 850 and 1000 mg per tablet, respectively.

Each tablet contains 500, 850 or 1000 mg of metmorphine, as well as excipients, namely: povidone K 90, corn starch, crospovidone, magnesium stearate, talc. The shell consists of methacrylic acid, methyl methacrylate copolymer or macrogol 6000, titanium dioxide and talc. Due to the difference in composition, the shell can be either enteric-soluble or less stable.

Release form, price and terms of release from pharmacies

Metmorphine is available in the form of film- and enteric-coated tablets in blisters of ten pieces. Cardboard packages contain from one to six blisters.

Drugs from various manufacturers can be purchased at pharmacies. Metformin is available with a doctor's prescription. On average, for a package of 30 tablets of 500, 850 and 1000 mg you will need to pay about 80, 100 and 120 rubles, respectively. Depending on the manufacturer, this figure may vary.

Indications and contraindications for the use of the drug

Metformin is used for non-insulin-dependent diabetes mellitus in the elderly, as well as in obese and insulin-dependent diabetes mellitus in combination with insulin. In addition, the possibility of prescribing Metformin for gestational diabetes mellitus, which occurs in some women against the background of hyperglycemia during pregnancy, as well as for polycystic ovary syndrome, is being investigated.

The drug is contraindicated in:

Also, the drug is contraindicated for any conditions and diseases that contribute to the development of lactic acidosis. This group includes kidney diseases, liver and pulmonary diseases, as well as alcoholism.

Various forms of heart failure were also previously considered to provoke lactic acidosis with the use of Metaformin, however, due to the fact that it is the safest for this group of people, in comparison with other drugs, it has become the only possible choice.

Before radiographic studies using iodine as a contrast agent, it is necessary to stop taking the drug for a couple of days due to decreased renal function and possible development Lactic acidosis. People over 60 years of age who are constantly exposed to intense physical activity should take the drug with caution for the same reasons.

Instructions for use of the drug

Depending on the form of release, the tablets are taken in different dosage. It is important to follow the doctor’s prescription, which will indicate the time of administration, frequency per day, and number of tablets. The drug is taken orally with food or immediately after a meal.

Diabetics who do not take insulin take 1 g of metformin twice a day or 500 mg three times a day in the first three days of use. From days 4 to 14, take 1 g three times a day, after which a blood and urine test for glucose is done and an adjustment can be made to reduce it. For further support, take 1-2 g of metformin per day.

Metformin 850 mg extended-release tablets are taken twice daily after breakfast and dinner. Take a maximum of 3 g per day. simultaneous administration with unsulin up to 40 units/day, metformin is taken according to the same regimen, but the insulin dose is reduced to a minimum.

At increased intake insulin, taking matformin is possible only under the supervision of the attending physician in a hospital.

Side effects and drug overdose

With the correct approach to taking the drug, most side effects can be minimized. To reduce negative impact, it is necessary to carefully monitor the changes that occur in the body and consult with your doctor about possible adjustments.

Metformin affects gastrointestinal tract, causing malfunctions in its functioning. In this regard, symptoms such as retching and vomiting, diarrhea, flatulence, loss of appetite, pain in the stomach, bad taste in the mouth. In addition, violations are possible respiratory function, tachycardia, skin rashes, peeling and itching of the skin.

With the diseases listed in the “contraindications” section, the development of lactic acidosis, a disease associated with the penetration of lactic acid into the blood, is possible. With lactic acidosis, the first signs are weakness, drowsiness, increased fatigue, nausea and vomiting.

Long-term use in this case can cause problems with the liver. If you suspect lactic acidosis, you should immediately consult a doctor and tell them you are taking Metformin.

In case of an overdose of the drug, which can occur when taking more than 5 g, nausea, vomiting, diarrhea, and abdominal pain are observed. Hypoglycemia and hyperglycemia are also sometimes observed.

The most dangerous thing in case of an overdose of the drug is lactic acidosis. When symptoms appear, the patient urgently needs to be hospitalized.

Doctors perform sodium bicarbonate rinses and perform other necessary procedures.

Using Metformin for weight loss

When used in obese diabetic patients, it has been observed that Metformin also leads to weight loss. However, this drug may cause serious complications, so you can take it only as prescribed by a doctor. In addition, Metformin itself does not burn body fat, but only contributes to starting the process of spending them.

Taking the drug is accompanied by special diet, excluding or minimizing the consumption of sweets, flour, starchy foods and alcohol. Nutrition is developed by the attending physician, it should not lead to starvation, and is also accompanied by plenty of drinking.

In combination with taking the drug, physical exercise. In any case, Metformin will not help in losing weight without the patient’s counter efforts. The intake cycle should last no more than six months.

The effect of the drug on excess weight explained by a decrease in the feeling of hunger, acceleration of glucose absorption muscle tissue, less absorption of carbohydrates, oxidation of fats.

An appointment can be scheduled only after a thorough examination of the body in order to accurately determine the balance of harm and benefit. If there are contraindications for use, Metformin cannot be used for weight loss.

Compatibility with other drugs

Metformin in the treatment of diabetes has serious effects on the kidneys and can also lead to hypoglycemia, especially when joint reception with insulin and similar substances that increase its effect. Therefore it is important to pay Special attention on which drugs are used concomitantly with metformin.

The hypoglycemic effect of metaphormin is enhanced not only by insulin. Strengthening of the drug is observed when taken together with:

The effectiveness of metformin is reduced when taken simultaneously with:

diuretics;
corticosteroids;
analogues of samostanin;
thyroid hormones;
phenytoin;
glucagon;
hormones thyroid gland;
estrogens, even those included in oral contraceptives;
nicotinic acid;
sympathomimetics;
calcium antagonists;
isoniazid.

When taken with cimetidine, the removal of metformin from the body is slowed down, which increases the risk of developing lactic acidosis.

In this article you can find instructions for use medicinal product Metformin. Feedback from site visitors - consumers - is presented of this medicine, as well as the opinions of specialist doctors on the use of Metformin in their practice. We kindly ask you to actively add your reviews about the drug: whether the medicine helped or did not help get rid of the disease, what complications were observed and side effects, perhaps not stated by the manufacturer in the annotation. Metformin analogues, if available structural analogues. Use for the treatment of type 2 diabetes mellitus and obesity (weight loss) in adults, children, as well as during pregnancy and lactation. Composition and interaction of the drug with alcohol.

Metformin- inhibits gluconeogenesis in the liver, reduces the absorption of glucose from the intestine, enhances peripheral glucose utilization, and also increases tissue sensitivity to insulin. At the same time, it does not affect the secretion of insulin by beta cells of the pancreas and does not cause hypoglycemic reactions. Reduces the level of triglycerides and low-density lipoproteins in the blood. Stabilizes or reduces body weight. It has a fibrinolytic effect due to the suppression of tissue-type plasminogen activator inhibitor.

Compound

Metformin hydrochloride + excipients.

Pharmacokinetics

After oral administration, metformin is absorbed from the gastrointestinal tract. Bioavailability after taking a standard dose is 50-60%. Practically does not bind to plasma proteins. Accumulates in salivary glands, muscles, liver and kidneys. It is excreted unchanged by the kidneys. If renal function is impaired, cumulation (accumulation) of the drug is possible.

Indications

diabetes mellitus type 2 without a tendency to ketoacidosis (especially in obese patients) with ineffective diet therapy;
in combination with insulin - for type 2 diabetes mellitus, especially with severe obesity, accompanied by secondary insulin resistance.

Release forms

Film-coated tablets 500 mg, 850 mg and 1000 mg.

Instructions for use and dosage regimen

The dose of the drug is determined by the doctor individually depending on the level of glucose in the blood.

The initial dose is 500-1000 mg per day (1-2 tablets). After 10-15 days, further gradual increase doses depending on blood glucose levels.

The maintenance dose of the drug is usually 1500-2000 mg per day (3-4 tablets) Maximum dose- 3000 mg per day. (6 tablets).

Metformin tablets should be taken whole during or immediately after meals with a small amount of liquid (a glass of water). To reduce side effects from the gastrointestinal tract, the daily dose should be divided into 2-3 doses.

Due to increased risk development of lactic acidosis, the dose of the drug must be reduced in case of severe metabolic disorders.

Side effect

nausea, vomiting;
metallic taste in the mouth;
lack of appetite;
diarrhea;
flatulence;
stomach ache;
lactic acidosis (requires discontinuation of treatment;
hypovitaminosis B12 (malabsorption);
megaloblastic anemia;
hypoglycemia;
skin rash.

Contraindications

diabetic ketoacidosis, diabetic precoma, coma;
renal dysfunction;
acute diseases that occur with the risk of developing renal dysfunction: dehydration (with diarrhea, vomiting), fever, severe infectious diseases, hypoxia conditions (shock, sepsis, kidney infections, bronchopulmonary diseases);
clinically pronounced manifestations acute and chronic diseases which can lead to the development of tissue hypoxia (cardiac or respiratory failure, acute heart attack myocardium);
serious surgical operations and trauma (when insulin therapy is indicated);
liver dysfunction;
chronic alcoholism, acute poisoning alcohol;
use for at least 2 days before and for 2 days after radioisotope or X-ray studies with the introduction of iodine-containing contrast agent;
lactic acidosis(including in medical history);
following a hypocaloric diet (less than 1000 cal per day);
pregnancy;
lactation period;
hypersensitivity to the drug.

Use during pregnancy and breastfeeding

When planning a pregnancy, as well as in the event of pregnancy occurring while taking Metformin, it should be discontinued and insulin therapy prescribed. Since penetration data breast milk no, then this drug contraindicated during breastfeeding. If necessary, use Metformin during breastfeeding, breastfeeding should be stopped.

Use in children

Contraindicated in children and adolescents under 18 years of age.

Use in elderly patients

It is not recommended to use the drug in persons over 60 years of age performing heavy lifting. physical work, which is associated with an increased risk of developing lactic acidosis. In elderly patients, the recommended daily dose should not exceed 1 g (2 tablets).

special instructions

During treatment, it is necessary to monitor kidney function. At least 2 times a year, and also when myalgia appears, the lactate content in plasma should be determined. In addition, once every 6 months it is necessary to monitor the level of creatinine in the blood serum (especially in elderly patients). Metformin should not be prescribed if the blood creatinine level is above 135 µmol/L in men and 110 µmol/L in women.

It is possible to use the drug Metformin in combination with sulfonylurea derivatives. In this case, particularly careful monitoring of blood glucose levels is necessary.

Metformin should be stopped 48 hours before and 48 hours after X-ray contrast (urography, intravenous angiography).

If a patient develops a bronchopulmonary infection or infectious disease genitourinary organs You should immediately inform your doctor about this.

During treatment, you should refrain from drinking alcohol and medications containing ethanol. With simultaneous intake of alcohol, the development of lactic acidosis is possible.

Impact on the ability to drive vehicles and operate machinery

The use of the drug in monotherapy does not affect the ability to drive vehicles or operate machinery.

When Metformin is combined with other hypoglycemic agents (sulfonylurea derivatives, insulin), hypoglycemic conditions may develop, in which the ability to drive vehicles and engage in other potentially dangerous activities is impaired. dangerous species activities requiring increased attention and quick psychomotor reactions.

Drug interactions

Concomitant use of danazol is not recommended to avoid the hyperglycemic effect of the latter. If treatment with danazol is necessary and after stopping the latter, a dose adjustment of metformin is required under the control of glycemic levels.

Combinations requiring special caution: chlorpromazine - when taken in large doses(100 mg per day) increases glycemia, reducing insulin release.

When treated with antipsychotics and after stopping the latter, dose adjustment of metformin is required under the control of glycemic levels.

When used simultaneously with sulfonylurea derivatives, acarbose, insulin, nonsteroidal anti-inflammatory drugs (NSAIDs), MAO inhibitors, oxytetracycline, ACE inhibitors, clofibrate derivatives, cyclophosphamide, beta-blockers may enhance the hypoglycemic effect of metformin.

When used simultaneously with glucocorticosteroids (GCS), oral contraceptives, epinephrine, sympathomimetics, glucagon, thyroid hormones, thiazide and loop diuretics, phenothiazine derivatives, nicotinic acid derivatives, the hypoglycemic effect of metformin may be reduced.

Cimetidine slows down the elimination of metformin, thereby increasing the risk of developing lactic acidosis.

Metformin may weaken the effect of anticoagulants (coumarin derivatives).

Alcohol intake increases the risk of developing lactic acidosis during acute alcohol intoxication, especially in cases of fasting or observing low calorie diet, as well as in liver failure.

Analogues of the drug Metformin

Structural analogues according to active substance:

If there are no analogues of the drug for the active substance, you can follow the links below to the diseases for which the corresponding drug helps, and look at the available analogues for the therapeutic effect.

Diabetes mellitus is one of the most serious problems modern medicine. He is elevated to this rank high price treatment, frequent and severe (even disability) complications, high mortality rate. Thus, among patients suffering diabetes mellitus Type 2, mortality is 2-3 times higher than that in the general population. The oral hypoglycemic drug metformin is designed to fight precisely this disease, which sounds “sweet”, but is not at all what it is in fact. Today this drug cannot be called some kind of innovative breakthrough: it has been introduced into endocrinological practice since the late 50s. last century. Currently, metformin, without exaggeration, is the most frequently prescribed tableted hypoglycemic agent. The mechanism of its action is almost completely explained, and this also plays to its advantage. Metformin inhibits the process of gluconeogenesis (glucose synthesis) in the liver, reduces the absorption of glucose into small intestine, increases the ability of peripheral tissues to utilize glucose, increases the receptor sensitivity of tissues to insulin. The most important thing is that the drug does not affect the production of its own insulin by the pancreas and does not cause hypoglycemic reactions characteristic of some sugar-lowering drugs ( extreme which may result in hypoglycemic coma).

Among the others pharmacological effects The drug should include a decrease in the concentration of triglycerides and “bad” lipoproteins (LDL) in the blood, stabilization (and in some cases even reduction) of the patient’s own weight, fibrinolytic (antithrombic) effect.

The dose of metformin is determined by the doctor in each specific case and depends on baseline blood glucose. By general recommendations The drug is started at 500-1000 mg (equivalent to 1-2 tablets). After 10-14 days, it is allowed to increase the dose, based on the current indicators of its concentration in the blood. The maintenance dose of metformin ranges from 1500-2000 mg, the maximum is 3000 mg. Elderly patients - a special case. First of all, it should be noted that in people in their seventh decade who, despite their age, continue to engage in heavy physical labor, metformin can cause lactic acidosis. In this regard, taking the drug in such patients is contraindicated. Otherwise, older people should take no more than 1000 mg of metformin per day. It is recommended to take the tablets during or immediately after meals with a glass of water. Daily dose, as a rule, is divided into 2-3 doses.

Pharmacology

An oral hypoglycemic agent from the biguanide group (dimethylbiguanide). The mechanism of action of metformin is associated with its ability to suppress gluconeogenesis, as well as the formation of free fatty acids and fat oxidation. Increases the sensitivity of peripheral receptors to insulin and the utilization of glucose by cells. Metformin does not affect the amount of insulin in the blood, but changes its pharmacodynamics by reducing the ratio of bound to free insulin and increasing the ratio of insulin to proinsulin.

Metformin stimulates glycogen synthesis by acting on glycogen synthetase. Increases the transport capacity of all types of membrane glucose transporters. Delays the absorption of glucose in the intestines.

Reduces the level of triglycerides, LDL, VLDL. Metformin improves the fibrinolytic properties of blood by suppressing tissue-type plasminogen activator inhibitor.

While taking metformin, the patient's body weight either remains stable or decreases moderately.

Pharmacokinetics

After oral administration, metformin is slowly and incompletely absorbed from the gastrointestinal tract. Cmax in plasma is reached after approximately 2.5 hours. With a single dose of 500 mg, absolute bioavailability is 50-60%. With simultaneous food intake, the absorption of metformin is reduced and delayed.

Metformin is quickly distributed into body tissues. Practically does not bind to plasma proteins. Accumulates in the salivary glands, liver and kidneys.

It is excreted unchanged by the kidneys. T1/2 from plasma is 2-6 hours.

In case of impaired renal function, accumulation of metformin is possible.

Release form

10 pieces. - contour cell packaging (3) - cardboard packs.
10 pieces. - contour cell packaging (5) - cardboard packs.
10 pieces. - contour cell packaging (6) - cardboard packs.
10 pieces. - contour cell packaging (10) - cardboard packs.
10 pieces. - contour cell packaging (12) - cardboard packs.
15 pcs. - contour cell packaging (2) - cardboard packs.
15 pcs. - contour cell packaging (4) - cardboard packs.
15 pcs. - contour cell packaging (8) - cardboard packs.

Dosage

Take orally, during or after meals.

The dose and frequency of administration depends on the used dosage form.

For monotherapy, the initial single dose for adults is 500 mg, depending on the dosage form used, the dosage frequency is 1-3 times a day. It is possible to use 850 mg 1-2 times a day. If necessary, the dose is gradually increased at intervals of 1 week. up to 2-3 g/day.

For monotherapy for children aged 10 years and older, the initial dose is 500 mg or 850 1 time / day or 500 mg 2 times / day. If necessary, at intervals of at least 1 week, the dose can be increased to a maximum of 2 g/day in 2-3 doses.

After 10-15 days, the dose must be adjusted based on the results of blood glucose determination.

At combination therapy with insulin, the initial dose of metformin is 500-850 mg 2-3 times a day. The dose of insulin is selected based on the results of determining blood glucose.

Interaction

When used simultaneously with sulfonylurea derivatives, acarbose, insulin, salicylates, MAO inhibitors, oxytetracycline, ACE inhibitors, clofibrate, cyclophosphamide, the hypoglycemic effect of metformin may be enhanced.

When used simultaneously with GCS, hormonal contraceptives for oral administration, danazol, epinephrine, glucagon, thyroid hormones, phenothiazine derivatives, thiazide diuretics, nicotinic acid derivatives may reduce the hypoglycemic effect of metformin.

In patients receiving metformin, the use of iodine-containing contrast agents for the purpose of carrying out diagnostic studies(including IV urography, IV cholangiography, angiography, CT) increases the risk of developing acute disorder renal function and lactic acidosis. These combinations are contraindicated.

Injectable beta 2 adrenergic agonists increase blood glucose concentrations due to stimulation of beta 2 adrenergic receptors. In this case, monitoring of blood glucose concentration is necessary. If necessary, it is recommended to prescribe insulin.

Concomitant use of cimetidine may increase the risk of developing lactic acidosis.

Concomitant use of loop diuretics may lead to the development of lactic acidosis due to possible functional renal failure.

When taken simultaneously with ethanol, the risk of developing lactic acidosis increases.

Nifedipine increases the absorption and Cmax of metformin.

Cationic medicines(amiloride, digoxin, morphine, procainamide, quinidine, quinine, ranitidine, triamterene, trimethoprim and vancomycin), secreted in renal tubules, compete with metformin for tubular transport systems and can lead to an increase in its Cmax.

Side effects

From the outside digestive system: possible (usually at the beginning of treatment) nausea, vomiting, diarrhea, flatulence, feeling of discomfort in the abdomen; in isolated cases - impaired liver function indicators, hepatitis (disappear after cessation of treatment).

Metabolic disorders: very rarely - lactic acidosis (cessation of treatment is required).

From the hematopoietic system: very rarely - impaired absorption of vitamin B 12.

Profile adverse reactions in children aged 10 years and older is the same as in adults.

Indications

Diabetes mellitus type 2 (non-insulin dependent) with ineffective diet therapy and physical activity, in obese patients: in adults - as monotherapy or in combination with other oral hypoglycemic agents or with insulin; in children aged 10 years and older - as monotherapy or in combination with insulin.

Contraindications

Acute or chronic metabolic acidosis, diabetic ketoacidosis, diabetic precoma and coma; renal failure, renal dysfunction (KR<60 мл/мин); обезвоживание организма, тяжелая инфекция, гипогликемический шок, которые могут привести к нарушению функции почек; клинически выраженные симптомы острых и хронических заболеваний, которые могут привести к развитию тканевой гипоксии (в т.ч. сердечная недостаточность, острый инфаркт миокарда, дыхательная недостаточность); применение контрастных йодсодержащих веществ для внутрисосудистого введения (в т.ч. при проведении в/в урографии, в/в холангиографии, ангиографии, КТ); острая алкогольная интоксикация, хронический алкоголизм; повышенная чувствительность к метформину.

Features of application

Use during pregnancy and breastfeeding

There have been no adequate and strictly controlled studies of the safety of metformin during pregnancy. Use during pregnancy is possible in cases of extreme necessity, when the expected benefit of therapy for the mother outweighs the possible risk to the fetus. Metformin penetrates the placental barrier.

Metformin is excreted in small quantities into breast milk, and the concentration of metformin in breast milk may be 1/3 of the concentration in maternal plasma. No side effects were observed in breastfeeding newborns while taking metformin. However, due to limited data, use during breastfeeding is not recommended. The decision to stop breastfeeding should be made taking into account the benefits of breastfeeding and the potential risk of side effects in the baby.

Preclinical studies have shown that metformin does not have a teratogenic effect at doses that are 2-3 times higher than therapeutic doses used in humans. Metformin does not have mutagenic potential and does not affect fertility.

Use for liver dysfunction

Contraindicated in cases of severe liver dysfunction.

Use for renal impairment

Contraindicated in cases of severe renal impairment.

special instructions

Do not use before surgery and within 2 days after surgery.

Metformin should be used with caution in elderly patients and people performing heavy physical work, which is associated with an increased risk of developing lactic acidosis. Elderly patients often experience asymptomatic renal dysfunction. Particular caution is required if renal dysfunction is caused by taking antihypertensive drugs or diuretics, as well as NSAIDs.

If during treatment the patient develops muscle cramps, indigestion (abdominal pain) and severe asthenia, it should be borne in mind that these symptoms may indicate the onset of lactic acidosis.

During treatment, it is necessary to monitor renal function; Determination of lactate content in plasma should be carried out at least 2 times a year, as well as when myalgia appears.

When metformin is used as monotherapy in accordance with the dosage regimen, hypoglycemia, as a rule, does not occur. However, when combined with insulin or sulfonylurea derivatives, there is a risk of developing hypoglycemia. In such cases, particularly careful monitoring of blood glucose concentrations is necessary.

During treatment, patients should avoid drinking alcohol due to the risk of developing lactic acidosis.

Preclinical studies have shown that metformin does not have carcinogenic potential.

Diabetes is one of the most common diseases in the world. Every year the number of cases doubles. Diabetes mellitus develops when there are two types of metabolic disorders - if the body does not produce enough of its own insulin (type 1) and if the effect of insulin on tissues is disrupted (type 2). Type 2 diabetes occurs in 80-90 percent of all cases and is often complicated by such an unpleasant factor as obesity. In the treatment of the disease, the drug “Metformin” has proven itself best - tablets, which, due to their properties, have become very popular among those who want to lose weight, although they do not have diabetes.

What is Metformin

"Metformin" and its analogues are hypoglycemic drugs prescribed for the treatment of diabetes - primarily of the second type, but in some cases the drug is also taken for the first type. Since its introduction in 1957, Metformin has remained the leading drug in the treatment of diabetes, especially with such complications as obesity. Insulin promotes fat deposition, and Metformin, by reducing insulin levels in the body, helps get rid of it. It is due to this action that many people use Metformin as diet pills.

Composition of Metformin tablets

The composition of the tablets includes the active ingredient metformin hydrochloride, which is produced from natural substances obtained from French lilac and goat rue. The excipients of the drug are talc, corn starch, magnesium stearate, titanium dioxide, as well as povidone K90, crospovidone and macrogol 6000.

Indications for taking Metformin

First of all, “Metformin” is a tablet that is prescribed for those without a tendency to ketoacidosis (impaired carbohydrate metabolism due to lack of insulin). The drug is especially indicated for obese patients if diet therapy has proven ineffective. Also, for obesity, it can be prescribed in combination with insulin.

For a diagnosis such as diabetes mellitus, Metformin tablets are prescribed both as a stand-alone drug and in combination with glucose-lowering drugs of other groups, if we are talking about the second type. In the first type, it is prescribed as an addition to basic insulin therapy.

Recent scientific studies have shown that Metformin is also successfully used in the treatment of diabetes-related cancers.

Action of metformin

Metformin increases cell sensitivity to insulin. Blood glucose and cholesterol levels decrease. The active ingredients of the drug activate the process of fat oxidation, do not allow carbohydrates to be absorbed and thereby prevent the accumulation of fats in the body.

Insulin triggers the process of fat deposition, especially in problem areas (particularly the abdomen). Therefore, most diets are based on eliminating foods that increase sugar levels from the diet. Metformin also suppresses insulin-induced hunger.

Release form and dosage

"Metformin" - film-coated tablets, 500, 850 and 1000 mg, which are available in blisters of 10 pieces, are white. Begin therapy with 500-1000 mg per day, that is, 1-2 tablets. The dose, depending on the blood sugar level, after the first 10-15 days of therapy can be gradually increased, but should not be taken more than 3000 mg per day. Maintenance dose - 1000-2000 mg (3-4 tablets). Metformin instructions also do not recommend taking doses of more than 1000 mg per day for older people.

The tablets are taken whole during or after meals, washed down with water. Sometimes the question arises about whether it is possible to divide the tablet (Metformin) in half. If we are talking about a dose of 500 mg, then it is not advisable to do this, since a smaller dose does not give the required effect, and it is also not recommended to break the coating if it covers the tablet. If it is simply difficult to swallow because of its size, then it can be divided in two and taken in parts - but at once, one part after another.

Since Metformin can cause side effects in the gastrointestinal tract, the daily dose should be taken not at once, but in two or three doses throughout the day, preferably with meals. If serious metabolic disorders are observed, the dose must be reduced.

In case you must take other medications at the same time as taking Metformin (tablets), the instructions for use contain information about which medications can be combined with Metformin and which cannot. It is also necessary to consult with your doctor about the interaction of various drugs with Metformin.

Analogs

In most cases, patients are interested in analogues of drugs - cheaper or more effective, including if they need pills for diabetes. Metformin has many analogues that have a similar principle of action. First of all, these are Glucophage and Siofor, one of the most popular alternatives to Metformin, as well as a number of other drugs that have the same active substance, as a result of which they affect the body in a similar way and have the same indications for use as Metformin tablets. Reviews about analogues can be read on the Internet, you can also compare instructions for use in order to draw conclusions and choose the optimal drug.

Analogues of "Metformin" are:

"Bagomet";
"Hexal";
"Glycon";
"Gliminfor";
"Metospanin";
"Metfogamma" (500, 850, 1000);
"Nova Met";
"NovoFormin";
"Sophamet";
"Formetin" and some others.
"Siofor" (500, 850, 1000) - a German drug taken orally, has a hypoglycemic effect, an excellent replacement for insulin injections.

As for Glucophage, it is more expensive than Metformin, but when taking it, patients are 50 percent less likely to suffer from gastrointestinal disorders. Glucophage is indicated for type 2 diabetes and is used both independently and in combination with other drugs. The Glucophage Long variation has an extended validity period.

Basically, all these drugs have the same principle of action on the body, since they have one active substance at their core.

There are also dietary supplements that help lower blood glucose levels:

“Vijar” (also reduces cholesterol levels, activates the immune system, prevents the development of viral and bacterial infections);
“Spirulina” (useful for metabolic disorders and in the fight against excess weight);
"Glucoberry" (reduces the risk of diabetes complications) and others.

"Metformin" for diabetes

Metformin is one of the best antidiabetic drugs today. It is very effective in the treatment of type 2 diabetes; it can be taken in combination with insulin, and the dose is adjusted depending on the amount of glucose in the blood.

In the treatment of diabetes, it suppresses glucogenesis without affecting blood insulin levels. It also increases blood circulation in the liver, causing glucose to be converted into glycogen faster.

Metformin can be prescribed for life. If it is prescribed in combination with others, it is necessary to monitor glucose levels to avoid hypoglycemia. When taking the drug separately, hypoglycemia does not develop.

In addition, it is used in the treatment of patients suffering from obesity, which often accompanies diabetes, as it suppresses appetite and reduces the absorption of glucose from food in the gastrointestinal tract.

In the first type, the drug is used as an addition to insulin and other diabetic medications; it can be taken separately only for type 2 diabetes. When starting treatment with Metformin, other hypoglycemic agents should be stopped.

Treatment with Metformin also has a beneficial effect in the presence and disturbance of lipid metabolism.

Metabolic syndrome is a condition of the body in which a number of factors are combined: carbohydrate metabolism is impaired, the patient suffers from arterial hypertension, obesity, etc. The syndrome is accompanied by an increased risk of developing cardiovascular diseases. This condition is based on insulin resistance, which, according to recent scientific research, is closely related to diabetes mellitus and vascular damage.

As for lipid metabolism disorders, as a result of the studies it was found that the level of triglycerides, total cholesterol and LDL decreases if you take the diabetes pill Metformin. Reviews of scientists about this drug also contain information about its effectiveness in the second type of carbohydrate intolerance.

"Metformin" for weight loss

The special properties of the drug and proven weight loss in diabetic patients have led to Metformin becoming popular among those who want to lose weight.

Despite the fact that the drug does trigger processes that help burn excess fat and prevent the formation of new fat deposits, it should be used by people who do not have diabetes with caution, and it is important to take into account a number of conditions.

First of all, it is necessary to remember that the drug itself does not burn fat, but only helps to use up its excess if this is also accompanied by active physical activity and a special diet. “Metformin” is not a miraculous tablet, but only an additional remedy. Even among doctors there is no clear opinion about who can take Metformin tablets: the benefits and harm to the body from this drug must be assessed in each case individually. Some doctors prescribe it specifically so that the patient can quickly lose weight, others consider it very harmful to the body. Therefore, when losing weight with Metformin, a preliminary examination and consultation with a specialist are necessary in order to make the right decision.

Next, it is necessary to take into account a number of contraindications. For example, if you have type 1 or type 2 diabetes without insulin production, you can prescribe Metformin and solve problems with weight loss only with the help of an endocrinologist.

Under no circumstances should you take the drug if you have renal, cardiac, or pulmonary failure, liver disease, or anemia.

The drug cannot be used when the body is weakened - after operations, injuries, serious illnesses; it should be avoided during acute infectious diseases.

It is forbidden to take Metformin if you are on a low-calorie diet.

The main processes that occur in the body during Metformin therapy and contribute to weight loss are:

rapid oxidation of fats;
decreased absorption of carbohydrates;
better absorption of glucose by muscle tissue;
decreased feelings of hunger, resulting in decreased body weight.

If you lose weight uncontrolled with this drug, side effects are common, especially if you took a larger dose than allowed according to the instructions. In addition to significant problems with the gastrointestinal tract, you may become weak, drowsy, lethargic, lactic acidosis and other serious pathologies may develop.

Also, when taking Metformin, you must follow a diet. It excludes sweets, pasta, potatoes, and alcoholic drinks. Meals should be regular, you should not starve, but the nutritional value should not exceed 2500 kcal per day. During this period, you need to drink as much ordinary clean water as possible.

Despite the fact that Metformin eliminates the need to engage in strenuous exercise, this does not mean that any physical activity can be avoided. Morning exercises, active recreation, and non-exhausting physical activity in combination with the drug will help you get rid of excess fat much faster. You should not hope that Metformin will do everything for you without additional effort on your part!

You should not get carried away with the drug and take it according to the principle “the more the better”: you should not exceed the dosage if you are taking Metformin (tablets). The instructions for use give clear instructions about the maximum dose of the drug, which, if not followed, can significantly harm the body. In addition, this drug can be taken for no longer than three months, then you need to take a break.

Now you can find many reviews from those who took Metformin tablets for weight loss. The reviews are quite varied: some got rid of excess fat quickly and for a long time, others were prevented from doing so by bad habits or side effects. But in general, we can conclude that those who were helped by Metformin took it under the supervision of a doctor, after examinations, while following the necessary diet and did not neglect physical exercise.

Contraindications to Metformin

Before starting Metformin therapy, regardless of whether you have diabetes or want to lose weight, you need to familiarize yourself with the impressive list of contraindications and consult with your doctor.

Contraindications include renal, cardiac, pulmonary failure, severe pathologies of the liver and biliary tract; chronic pathologies of the respiratory organs. The drug should not be taken in the post-traumatic and postoperative periods, as well as after myocardial infarction during the rehabilitation period. Taking Metformin is contraindicated in infectious and inflammatory processes and exacerbations of any chronic diseases, severe forms of anemia.

The drug is prohibited during pregnancy and lactation. When planning pregnancy or its occurrence while taking Metformin, you need to stop taking the drug and switch to insulin therapy. Breastfeeding, if there is a need for treatment with Metformin, should be discontinued, because there is no data on the effect of the drug on breast milk, but even a small proportion of the drug that gets into the milk is dangerous for the child, since contraindications include age under 18 years. Metformin is not prescribed to children and adolescents under 18 years of age.

Also, Metformin should not be taken in case of alcoholism or acute alcohol poisoning. In general, you should stop drinking alcohol and ethanol-containing medications if you are taking Metformin. The fact is that the combination of ethanol and metformin, even in small doses, provokes the rapid development of lactocytosis, even death.

It is dangerous to take Metformin with constant low-calorie and “starvation” diets.

It should not be taken by persons over 60 years of age if they are engaged in heavy physical labor, in order to avoid the development of lactic acidosis.

During treatment, patients need to monitor renal function, monitor the level of plasma lactate and serum creatinine.

Side effects of the drug

Metformin provokes a number of side effects. Therefore, during therapy, it is necessary to carefully monitor the condition of your body and, if complaints arise, immediately consult a doctor, especially if you are taking the drug not according to the indications and prescription of a doctor, but on your own.

First of all, the drug causes disruptions in the gastrointestinal tract. In this case, such unpleasant manifestations as:

nausea;
severe vomiting;
persistent diarrhea;
flatulence;
loss of appetite;
the appearance of a metallic taste in the mouth;
the appearance of abdominal pain.

The patient may also complain of breathing problems, tachycardia, rashes and peeling of the skin, often with itching.

A rare but dangerous side effect is lactic acidosis. With lactic acidosis, lactic acid enters the blood, the first symptoms of the disease are weakness, drowsiness, increased fatigue, increasing nausea, and vomiting.

With long-term use of the drug, liver function disorders are possible.

If you notice at least one of these manifestations, you should immediately contact your doctor and tell him that you are taking Metformin tablets. The benefits and harm to the body in this case may be unequal; perhaps you should not take the drug and need to find another option for treatment or weight loss.

Summary

Metformin is the most effective tablet for type 2 diabetes. Metformin also helps to reduce weight, but it is worth remembering that this drug is not a panacea; it will not replace a low-carbohydrate diet and physical activity. Therapy with Metformin should be accompanied by monitoring blood glucose levels and giving up bad habits, including food habits. If you want to lose weight with its help, do not give up the gym, eat right and do not forget that first of all this is a serious medicine, it is intended to fight diabetes, so you need to take it carefully and only after consulting a doctor.

Drugs from the biguanide group have long been used in the treatment of type 2 diabetes mellitus. However, such drugs have many side effects. Does this mean that metformin is harmful to health, since it is the main active ingredient in such medications?

Today, new properties of this substance are being discovered and its use is expanding quite significantly, using the medicine not only in complex therapy for diabetes mellitus.

The drug Metformin has long been used to treat type 2 diabetes mellitus in conjunction with diet therapy prescribed by a doctor. It allows not only to normalize blood glucose levels, but also helps to reduce excess weight, which is especially important for people with this diagnosis.

To date, other features of the drug have also been identified. It has been scientifically established that a person can take Metformin to achieve the following goals:

Helps protect the brain from aging, which allows it to be used for preventive purposes against Alzheimer's disease.
Has a beneficial effect on the condition of blood vessels and arteries. Thus, with the help of Metformin, the development of vascular atherosclerosis, heart failure, hypertension, and vascular calcification can be prevented.
Reduces the likelihood of cancer.
Actively affects the improvement of potency in men, which was impaired as a result of various senile diseases.
Neutralizes the development of osteoporosis in diabetics. Women especially often suffer from brittle bones after menopause, as there is a significant decrease in hormones - estrogens.
Has a beneficial effect on the performance of the thyroid gland.
Shows a protective function in relation to the respiratory organs.

Even though the drug has so many benefits, it cannot be said that it is healthy and can cure many diseases. Like other medications, Metformin can be used only as prescribed by the attending physician, taking into account the possibility of all its side effects and contraindications.

Pharmacological properties of the drug

Metformin is a medication from the biguanide class, which is actively used in the treatment of type 2 diabetes mellitus.

The main active ingredient of the drug is Metroformin hydrochloride; silicon dioxide, povidone, magnesium stearate, and macrogol are used as auxiliary components.

The medicine is actively used to lower blood sugar levels. At the same time, the decrease in indicators occurs not only after the main meal, but also allows you to reduce the basic level. The main active component of the tablets allows you to regulate the production of insulin by the pancreas, which has a beneficial effect on the body and does not provoke the development of hypoglycemia. In addition, positive effects include:

neutralization of hyperinsulinemia;
promotes weight loss;
reduces the risk of developing cardiovascular diseases;
has a beneficial effect on lipid metabolism in the body;
reduces the process of fat oxidation;
reduces elevated levels of bad cholesterol;
reduces the risk of diabetic angiopathy;
reduces triglyceride levels.

The medicine is taken orally, after which its maximum activity begins to appear after two to three hours. Approximately six hours after taking the drug, the plasma concentration of metformin decreases, as absorption of the active component ends.

When undergoing a course of treatment with this drug, after a few days you can observe its constant presence in the blood in small quantities.

Instructions for use of the medicine

The drug Metformin is available in tablet form in various dosages. The medicine can be purchased in city pharmacies in the following doses:

500 mg of active substance in one tablet;
850 mg of active ingredient;
1000 mg metformin.

Depending on the dosage, the rules for taking the drug will depend. It should be noted that only the attending physician can recommend the use of this drug, including as a replacement for a previously taken medication. A course of treatment is prescribed in dosages that are based on the general clinical picture of the disease and the individual characteristics of the patient’s body. The main indicator that you need to pay attention to when choosing a dose is the level of glucose in the blood and the weight category of the patient.

The minimum dose at which treatment begins is 500 mg of the drug with a possible subsequent increase. In this case, a single dosage also cannot exceed the above figure. For better tolerability of the drug, as well as in the case of high prescribed doses, the number of doses can be divided into two or three during the day. In this way, it will be possible to prevent the development of negative effects. The maximum possible dose of the drug should not exceed 3000 mg of the active substance.

In some cases, for example, taking a medicine for preventive purposes, the dosage should be reduced by two to three times.

The maximum effect from taking the drug is achieved after a two-week period of therapy has expired.

If, due to certain circumstances, a medication was missed, there is no need to compensate by increasing the next dose.

When taking the drug, it is necessary to take into account the normal course of metabolic processes and good health.

It should be taken into account that there is a high risk of developing lactic acidosis.

Negative effects of taking the drug

Therapy and treatment with Metformin should occur under the close supervision of a physician. It is unacceptable to take the medication in doses exceeding the doctor’s recommendations, or together with other medications chosen by the patient.

Taking Metformin incorrectly can cause numerous side effects and reveal the harmful properties of the drug for the human body.

The main negative manifestations of the drug include the following:

problems with the digestive tract, which may be accompanied by flatulence, abdominal pain or diarrhea;
An unpleasant metallic taste may appear in the mouth after eating;
nausea and vomiting;
lack of certain groups of vitamins, especially B12, therefore it is recommended to additionally take special medicinal complexes that can normalize the level of all substances necessary for the body;
manifestation of allergic reactions to one or more components of the drug;
the appearance of hypoglycemia;
development of lactic acidosis;
megaloblastic.

And although Metformin is included in the group of safe medications, you should carefully familiarize yourself with all possible negative manifestations. This drug can be dangerous if you do not follow the necessary rules for taking it.

One of the most common negative consequences from the use of the drug is lactic acidosis. This condition is accompanied by symptoms such as increased drowsiness, muscle soreness, decreased body temperature and blood pressure, and difficulty breathing. When such a syndrome develops, the patient requires urgent hospitalization.

Lactic acidosis is one of the side effects that occurs as a result of a severe overdose of the drug.

In what cases is taking a medication prohibited?

The drug Metformin has a significant list of contraindications for its use.

Therefore, before starting a course of treatment, you must carefully read the instructions. If any negative effects occur, you should contact your doctor and discuss further steps regarding taking the medication.

It is prohibited to use the drug if the following factors and diseases are present:

for the treatment of type 1 diabetes mellitus, insulin-dependent patients;
development of ketoacidosis, coma or precoma of the diabetic type;
serious pathological processes in the kidneys or liver, as well as in the presence of their failure;
some diseases of the respiratory tract, as well as in case of difficulty breathing;
diseases of the cardiovascular system, heart failure or myocardial infarction;
development of diseases caused by various infections;
recent surgeries and injuries;
before and after some diagnostic studies are carried out, these include radiography or radioisotropic diagnostics, since a contrast agent containing iodine is used.
lactic acidosis;
intolerance or hypersensitivity to one or more components of the drug;
in the presence of dehydration;
chronic alcoholism or regular abuse of alcoholic beverages.

Pregnant girls and women during lactation are prohibited from taking Metformin, as various problems may arise with the normal development of the fetus. If there is an urgent need to take medication, a woman should stop breastfeeding.

In addition, children under the age of fifteen are at risk.