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Glucophage (Metformin)

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Glucophage

Glucophage is a first-choice medicine indicated for the management of high blood sugar levels in patients with type 2 diabetes mellitus (non-insulin-dependent diabetes) along with an exercise and diet regimen. The medication may be used in the treatment of elevated insulin levels observed in women with polycystic ovary syndrome (PCOS). The drug is also helpful in the management of type 1 diabetes mellitus (insulin-dependent diabetes) where the symptoms are poorly controlled with insulin alone. Glucophage tablets are beneficial for use in patients over 10 years of age. Read more

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What Glucophage is and what it is used for

Glucophage is an anti-diabetic medication used for the treatment of type 2 diabetes mellitus (non-insulin-dependent diabetes) in patients who struggle with managing their blood sugar at a normal level with a diet and exercise alone. The administration of Glucophage tablets is also beneficial in the treatment of insulin resistance found in women with polycystic ovary syndrome (PCOS) and may be added to insulin therapy in managing adverse symptoms of type 1 diabetes mellitus (insulin-dependent diabetes).

The active substance present in the formulation is Metformin that belongs to a group of medicines called biguanide antihyperglycemic agents which act by reducing the level of sugar in the blood. The medicine helps decreases the amount of hepatic glucose production, improve glucose uptake from the gastrointestinal tract and its further utilization by target tissues which also diminishes insulin resistance. The administration of Glucophage in overweight patients provides with a moderate weight loss and reduce the risk of diabetes-related complications. It has also shown a positive effect in precluding the permanent organs damage, preventing certain cancer cells from growing and spreading (cancer of lungs and respiratory system, liver, breast), lowering the level of triglycerides and low-density lipoproteins (LDL) in the blood as well as exerting less pressure on the cardiovascular system, thereby decreasing the likelihood of adverse effects in diabetics.

Indications

Treatment of type 2 diabetes mellitus in diabetic patients, particularly overweight, whose glycemic control cannot be reached by following a diet and exercise alone.

Glucophage may also be administered in patients with type 1 diabetes mellitus (insulin-dependent diabetes) when their glycemic control cannot be reached with an insulin therapy only, in women with polycystic ovary syndrome (PCOS) as well as an off-label drug for treating gestational diabetes mellitus.

MOA (mechanism of action)

Metformin is an insulin sensitizer of the biguanide family which has a hypoglycemic effect and works by reducing both basal and postprandial blood sugar concentrations. Metformin does not stimulate insulin secretion from the pancreatic beta cells and, therefore, does not lead to hypoglycemia, inherent for sulfonylureas. The blood-sugar-lowering effect of the active substance is executed in the inhibition of gluconeogenesis which is reached by the activation of AMP-activated protein kinase (AMPK) that promotes a decrease in the production of glucose by the liver. Metformin increases the sensitivity of muscle tissues to the insulin that improves glucose uptake on the periphery and its utilization as well as reduces its absorption by the intestines. It also has the ability to antagonize the action of glucagon, thus reducing fasting glucose levels and glycated hemoglobin concentrations in the bloodstream. In treating PCOS, Metformin promotes ovulation and ensures regular menstrual cycle by decreasing insulin levels and suppressing ovarian gluconeogenesis, thus lowering ovarian androgen production.

How to take Glucophage

The administration of Glucophage is individual and should be initiated depending on the results of blood and urine glucose evaluations of each patient. The medication is for oral use only and should be swallowed whole with half a glassful of water during or after meals intake. To avoid the occurrence of digestion-related side effects (such as nausea, vomiting, etc.), it is advised not to skip meals while on Glucophage tablets.

Adults (18 years of age and older):

  • The accurate dose should be recommended by your doctor.
  • After 10-15 days, your dose should be adjusted according to your blood sugar levels.
  • The maximum dose is 3000 mg per day, taken in 3 divided doses.
  • If you are transferring from another oral medicine used to treat diabetes to Metformin, the other medicine must be stopped before starting treatment with Metformin.
  • Glucophage may be taken in combination with insulin. Your dose of insulin will be adjusted according to your blood sugar levels.

Patients with kidney problems:

  • The accurate dose should be recommended by your doctor.
  • The maximum dose is 1000 mg per day, taken as 2 divided doses.
  • Your kidney function should be monitored every 3-6 months.

Use in children:

  • Glucophage can be used as the only treatment or in combination with insulin, for children aged from 10 years and above.
  • The accurate dose should be recommended by your doctor.
  • After 10-15 days, your dose should be adjusted according to your blood sugar levels.
  • The maximum recommended dose is 2000 mg per day, taken as 2 or 3 divided doses.

During the treatment with Metformin tablets, patients should adhere to a dietary and exercise program as well as carry out regular blood and urine sugar tests in order to maintain the optimal dosage and estimate the treatment effectiveness for every diabetic. The medicine is meant for a long-term administration and should not be discontinued without a doctor’s recommendation, as this may cause a rapid increase in blood sugar.

If you have taken more Glucophage than you should

If you accidentally take too many tablets, contact your doctor or nearest hospital emergency department immediately for advice. An overdose of this medicine may lead to a build-up of lactic acid in the blood (lactic acidosis).

If you forget to take your Glucophage

Take it as soon as you remember, unless it is nearly time for your next dose. If you miss a dose, do not take a double dose to make up for a forgotten dose.

If you stop taking Glucophage

It is important that you keep taking this medicine for as long as your doctor has told you to. If you have any further questions on the use of this medicine, ask your doctor or pharmacist.

How to store Glucophage

Keep this medicine out of the sight and reach of children. Store at room temperature between 20°C to 25°C (68°F to 77°F) away from excess moisture and heat. Throw away after the expiration date.

Side effects

The most common side effects associated with Glucophage are:

  • lactic acidosis (too much lactic acid in the blood)
  • upset stomach
  • nausea
  • vomiting
  • diarrhea
  • loss of appetite
  • abnormal liver functioning
  • Vitamin B12 deficiency
  • heartburn
  • headache
  • tiredness
  • dizziness
  • feeling cold
  • muscle cramps
  • breathing problems
  • slow or irregular heartbeat
  • jaundice (yellowing of the eyes/skin)
  • skin rash (including redness, itching, hives)

If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed above.

What you need to know before you take Glucophage

Do not take this medication if:

  • You are allergic to Metformin or any of the other ingredients of this medicine.
  • You suffer from kidney or liver problems.
  • You suffer from or have a history of serious diabetic complications such as loss of consciousness caused by either very high or very low blood sugar levels (diabetic coma), a lack of insulin which leads to high blood sugar levels, ketones in the urine and certain acids in the blood (ketoacidosis).
  • You suffer from conditions which may cause a lack of oxygen supply to your body tissue (hypoxia) such as sudden heart failure (even if the condition is under control), insufficient oxygen passes from your lungs to your blood (respiratory failure), you have recently had a heart attack or have severe problems with your circulation such as shock.
  • You regularly drink a lot of alcohol.
  • You have a severe infection.
  • You suffer from a loss or lack of water in the body (dehydration).
  • You have severe disease of the blood vessels.
Warnings and precautions

Talk to your doctor before taking Glucophage if:

  • You are at risk of a build-up of lactic acid in the blood (lactic acidosis). Metformin may cause a very rare, but serious complication called lactic acidosis, particularly if your kidneys are not working properly. The risk of developing lactic acidosis is also increased with uncontrolled diabetes, prolonged fasting, excessive alcohol intake, dehydration, liver problems and any conditions where an area of the body is deprived of oxygen (such as heart failure or sudden heart attack). Symptoms of lactic acidosis can include being sick (vomiting), stomach pain, muscle cramps, a general feeling of not being well, severe tiredness, difficulty in breathing, reduced body temperature, and heartbeat. If you experience any of these symptoms, you should seek medical advice immediately as lactic acidosis may lead to coma.
  • You are to undergo diagnostic tests (using iodinated contrast media). You may need to stop taking this medicine.
  • You continuously use Glucophage. It may reduce your vitamin B12 level and should be annually monitored by your doctor. You suffer from kidney problems, particularly if you are elderly.
  • You suffer from stable chronic heart failure.
  • You are due to have surgery as you must stop taking your Metformin 48 hours before having an anesthetic.
  • This medicine is intended for a child.
  • You are taking insulin or other oral antidiabetic medicines e.g. sulfonylureas or meglitinides as there is a risk of low blood sugar levels (hypoglycemia).
Other medicines and Glucophage

Other medicines which may interact with or be affected by Glucophage:

  • Cimetidine, for stomach ulcers and indigestion
  • Medicines to prevent clotting of the blood, such as warfarin (anticoagulants)
  • Medicines for high blood pressure, such as captopril (ACE inhibitors)
  • Medicines for depression, such as moclobemide (MAO inhibitors)
  • Diazoxide, for high blood pressure (antihypertensives)
  • Medicines for lowering high blood pressure, such as propranolol (beta-blockers)
  • Medicines for inflammatory and allergic conditions, such as beclomethasone (glucocorticoids)
  • Medicines used to treat life-threatening allergies (anaphylaxis) such as epinephrine (sympathomimetics)
  • Oral contraceptives
  • Medicines for fluid retention, such as bumetanide (diuretics)
  • Medicines for high cholesterol, such as ezetimibe (clofibrates)
  • Other medicines for diabetes such as glibenclamide (sulfonylureas) or insulin (antidiabetics)
Pregnancy and breastfeeding

If you are pregnant or breastfeeding, think you may be pregnant or are planning to have a baby, ask your doctor for advice before taking this medicine.

If you are pregnant, it is recommended that your diabetes is treated with insulin instead of Metformin.

If you are breastfeeding, the use of this medicine is not recommended as Metformin passes into breast milk.

Q: What is this medication for?

A: Glucophage is a medicine used to treat type 2 diabetes mellitus. This medication lowers your blood sugar levels by improving the way your body handles insulin. It is usually indicated for diabetics when diet and exercise alone have not been enough to control your blood sugar levels.

Q: How to take this medicine?

A: Glucophage tablets are for oral use only and should be taken with half a glass of water during or after a meal. Do not chew, break or crush the medicine. One must exercise regularly and follow a proper diet, without skipping meals, to get the maximum benefit from the treatment.

Q: Is Glucophage safe during pregnancy or when breastfeeding?

A: The medication may be used as an off-label drug for the treatment of pregnant women with gestational diabetes. The medicine should not be initiated without prior medical consultation.

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Testimonials

Ralf
  2019-07-23

war am anfang misstrauisch und hat auch etwas länger gedauert. ist aber alles doch noch angekommen. guter zustand, gute ware

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