What is Glucophage SR?
Glucophage SR (metformin) is a tableted hypoglycemic drug of the biguanide class for oral administration. This drug is used in the treatment of type 2 diabetes, especially in people who are overweight and obese, while maintaining normal kidney function.
How does it work?
The most important action of metformin is the suppression of glucose production by the liver. The drug activates the secretion of liver enzyme AMPK, which is responsible for the metabolism of glucose and fat. This activation leads to the effect of suppressing glucose production in the liver. That is, excess glucose due to metformin is not formed. In addition, the drug increases sensitivity to insulin and increases peripheral glucose uptake (with insulin, glucose is delivered to all cells of the body and becomes a source of energy), increases fatty acid oxidation, and decreases glucose absorption in the gastrointestinal tract. Metformin delays glucose absorption in the gastrointestinal tract, which allows you to maintain lower levels of glucose in the blood after a meal, as well as to increase the sensitivity of target cells to your own insulin. This property of metformin allows its use in pre-diabetes.
How should I use Glucophage SR?
The dose of the drug is set by the doctor individually, depending on the level of glucose in the blood.
The initial dose is 0.5-1 g/day. After 10-15 days, a further gradual increase in dose is possible depending on the level of glucose in the blood. The maintenance dose of the drug is usually 1.5-2 g/day. The maximum dose is 3 g/day.
Tablets should be taken whole during or immediately after a meal, washed down with a small amount of liquid (a glass of water). To reduce the side effects of the gastrointestinal tract, the daily dose should be divided into 2-3 doses.
Due to the increased risk of lactate acidosis, the dose should be reduced in case of severe metabolic disorders.
What are the contraindications of this medicine?
Do not use Glucophage SR in the presence of any of the following conditions:
- cardiac and respiratory failure, the acute phase of myocardial infarction, acute cerebrovascular accident, dehydration, chronic alcoholism and other conditions that may contribute to the development of lactate acidosis;
- lactic acidosis (including in history);
- diabetic ketoacidosis, diabetic precoma, coma;
- hypersensitivity to metformin
- pregnancy and breastfeeding period;
- serious surgical interventions and injuries when insulin therapy is indicated;
- pronounced renal dysfunction;
- abnormal liver function;
- acute alcohol poisoning;
- observance of a low-calorie diet (less than 1000 kcal/day).
Use of the drug is contraindicated for at least 2 days before and within 2 days after radioisotope and X-ray studies with the introduction of iodine-containing contrast agent.
It is not recommended to use these tablets for people over 60 years old who perform heavy physical work, which is associated with an increased risk of lactate acidosis.
What are the side effects of Glucophage SR?
The medicine can cause the following side effects:
- taste disturbance;
- nausea, vomiting, diarrhea, abdominal pain, lack of appetite;
- impaired liver function;
- allergic skin reactions (erythema, pruritus, urticaria);
- lactic acidosis.
If you have any unusual or severe side effects after taking these tablets, consult your doctor as soon as possible.
What may interact with this medicine?
Do not take Glucophage SR if you are currently using any of the following medications and substances:
- sulfonylurea derivatives;
- phenothiazine derivatives;
- nicotinic acid derivatives;
- nonsteroidal anti-inflammatory drugs;
- MAO inhibitors;
- ACE inhibitors;
- clofibrate derivatives;
- oral contraceptives;
- thyroid hormones;
- “loop” diuretics;
- anticoagulants (coumarin derivatives);
What should I watch for while using this medicine?
Taking Glucophage XR during pregnancy is possible if the expected therapeutic effect exceeds the risk to the fetus.
The medicine should be discontinued in the breastfeeding period.
Symptoms of an overdose include a dry tongue, mucous membranes, skin, muscle pain, chest pain, dyspeptic symptoms, increased breathing, apathy, insomnia/drowsiness, cardiovascular insufficiency, vomiting, abdominal pain, neurological disorders, noisy breathing, collapse development, DIC-syndrome. Treatment: symptomatic therapy, hemodialysis. During treatment, it is necessary to monitor renal function.
During treatment, it’s necessary to determine the content of lactate in the plasma at least 2 times a year. In addition, it’s necessary to control serum creatinine level 2 times a year (especially in patients of advanced age).
The drug should not be used if the level of creatinine in the blood is higher than 135 µmol/L in men and 110 µmol/L in women.
The use of the drug in combination with sulfonylurea derivatives is possible. In this case, careful control of the blood glucose level is required.
Stop taking the pills 48 h before and within 48 h after radiopaque (urography, angiography).
If you have a bronchopulmonary infection or an infection of the urinary organs, you should immediately inform your doctor.
During treatment, you should refrain from taking alcohol and drugs containing ethanol.
The use of Glucophage SR in monotherapy does not affect the ability to drive and work with mechanisms.
Store the drug at a temperature away from heat and moisture. Shelf life is indicated on the packaging. Do not take pills after the expiration date.