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What is Glucophage?

Glucophage (metformin) is a hypoglycemic drug available in the form of long-acting tablets that are used to treat high blood sugar levels. The drug is prescribed for type II diabetes mellitus (especially in the case of concomitant obesity) when diet therapy is ineffective. It’s also prescribed to patients in the pre-diabetes state. It can be used both in monotherapy and in complex treatment with insulin, other antidiabetic drugs to reduce blood glucose levels.

How does it work?

The drug inhibits gluconeogenesis and glycogenolysis, increases insulin sensitivity, decrease glucose absorption in the gastrointestinal tract. Accordingly, the production of glucose in the liver is reduced, the absorption and utilization of glucose in muscles are stimulated, reducing the total glucose concentration in the blood plasma. In addition to hypoglycemic properties, it improves the metabolism of fats (lipids), helps to reduce the level of triglycerides, cholesterol, dipoproteins with low density.

How should I use this drug?

Glucophage is administered orally (by mouth) during or after a meal.

The initial dose is 500-850 mg 2-3 times a day.

After 10–15 days, the dose is adjusted according to the results of the glycemic profile.

The maximum recommended dose is 3000 mg per day, divided into 3 doses.

The initial dose for children older than 10 years is 500–850 mg once a day, the maximum dose is 2000 mg/day, divided into 2–3 doses.

What are the contraindications of this medicine?

Do not use Glucophage if you have any of the following conditions:

  • hypersensitivity to metformin or to any excipient;
  • diabetic ketoacidosis, diabetic precoma, coma;
  • renal failure or impaired renal function (CC less than 45 ml/min);
  • acute conditions occurring at risk of developing renal dysfunction: dehydration (with diarrhea, vomiting), serious infectious diseases, shock;
  • clinical manifestations of acute or chronic diseases that can lead to the development of tissue hypoxia (including acute heart failure, chronic heart failure with unstable hemodynamic parameters, respiratory failure, acute myocardial infarction);
  • extensive surgery and trauma (when insulin therapy is indicated);
  • liver failure, abnormal liver function;
  • chronic alcoholism, acute alcohol poisoning;
  • pregnancy;
  • lactic acidosis (including in history);
  • use within a period of less than 48 hours before and within 48 hours after conducting radioisotope or x-ray studies with the introduction of an iodine-containing contrast agent;
  • a low-calorie diet.

The drug should be used with caution:

  • in patients over 60 years of age who perform heavy physical work (which is associated with an increased risk of developing lactic acidosis);
  • in patients with renal insufficiency (CK 45-59 ml/min);
  • during breastfeeding.

What are the side effects of Glucophage?

The most common side effects occur during the initial period of treatment and pass spontaneously in most cases:

  • Central nervous system: a violation of taste;
  • Digestive system: nausea, vomiting, abdominal pain, lack of appetite;
  • Allergic reactions: erythema, pruritus, rash;
  • Metabolism: lactic acidosis (requires discontinuation of the drug); with long-term use – vitamin B12 hypovitaminosis (impaired absorption);
  • Hepato-biliary system: violation of liver function indicators, hepatitis.

These effects are quickly reversible with discontinuation of the drug and are usually clinically insignificant. Reducing the level of vitamin B12 should be taken into account in patients with megaloblastic anemia.

What may interact with this medicine?

Not recommended combinations:

  • danazol;
  • alcohol and ethanol-containing drugs;
  • iodine radiopaque agents.

Combinations requiring special care:

  • glucocorticoids (for systemic and local use);
  • neuroleptics;
  • “loop” diuretics;
  • beta2 sympathomimetic injections;
  • ACE inhibitors and other antihypertensive drugs;
  • sulfonylurea derivatives, insulin, acarbose, salicylates

What should I watch for while using this medicine?

An overdose of metformin can cause lactic acidosis. Symptoms of overdose may include severe drowsiness, severe nausea/vomiting/diarrhea, rapid breathing, slow/irregular heartbeat, passing out, trouble breathing.

If you are planning a pregnancy or get pregnant when on the pills, pregnancy, the drug should be canceled. You need to notify the doctor in case of pregnancy. Insulin therapy may be indicated. Mother and child should be monitored.

It is not known whether metformin is excreted in breast milk. If necessary, the use of the drug during lactation should be stopped.

Since metformin is excreted in the urine, serum creatinine levels should be determined regularly before starting treatment with the medication.

Particular caution should be exercised in violation of kidney function, for example, in the initial period of therapy with antihypertensive drugs, diuretics, NSAIDs.

The patient should be informed about the need to seek medical attention if symptoms of a bronchopulmonary infection or an infection of the urinary organs appear.

You should refrain from drinking alcohol when taking this drug.

In children over 10 years old, Glucophage can be used both in monotherapy and in combination with insulin.

Monotherapy with this drug does not cause hypoglycemia and therefore does not affect the ability to drive and work with mechanisms. However, patients should be wary of the risk of hypoglycemia when using metformin in combination with other hypoglycemic agents (including sulfonylurea derivatives, insulin, repaglinide).