Glupa Tablet 500mg (Metformin Hydrochloride)

Adult dose

Dosage should be determined based on individual drug effectiveness and tolerance, ensuring it does not exceed the recommended maximum daily dose. This medication should be initiated at a low dose to reduce gastrointestinal adverse reactions and to identify the minimum effective dose required for appropriate blood sugar control, with administration of 500mg with meals, 2-3 times a day. Doses can be gradually increased by 500mg weekly, and for doses up to 2000mg, it is typically divided and taken twice daily in the morning and evening. For doses exceeding 2000mg, it should be divided and taken three times a day with meals, with a maximum daily dose of 2550mg. At the start of treatment and during dosage adjustments, fasting blood sugar should be measured to assess therapeutic response and confirm the minimum effective dose. Blood HbA1c levels should be checked approximately every three months. The treatment goal with this medication is to normalize fasting blood sugar and blood HbA1c concentrations or bring them to near-normal levels when used alone or in conjunction with sulfonylureas or insulin at the minimum effective dose. In general, if a patient who previously managed to control blood sugar levels solely through diet experiences temporary dysglycemia, sufficient effectiveness can be obtained with short-term administration of this medication. For children and adolescents in growth spurts, this medication can be used for those aged 10 years and older. The typical starting dose is 500 milligrams once daily, taken during or after a meal. Blood sugar levels should be measured after one week to adjust the dosage accordingly. Gastrointestinal side effects can improve with gradual dose increase. The maximum daily dose is 2000mg, which should be divided into 2-3 doses. In patients with kidney impairment, this medication can be used under dosage adjustments without other associated symptoms that may increase the risk of lactic acidosis, specifically for those with stage 3a moderate renal impairment (creatinine clearance [CrCl] 45≤~<60ml/min or glomerular filtration rate [GFR] 45≤~<60mL/min/1.73㎡). - The starting dose is 500mg or 850mg once daily. The maximum daily dose is 1000mg, divided into two doses. Kidney function should be closely monitored every 3-6 months. If creatinine clearance or glomerular filtration rate drops below 45ml/min or 45ml/min/1.73㎡, this medication should be immediately discontinued.

Child dose

This medication can be used for children aged 10 years and older or adolescents in growth spurts. The typical starting dose is 500 milligrams once daily and should be taken during or after a meal. After one week, blood sugar levels should be checked to adjust the dosage accordingly.

This medication can cause severe lactic acidosis or hypoglycemia, so caution is advised. Patients with moderate or severe renal impairment, dehydration, serious infections, cardiovascular issues, etc., should not take this medication. Patients with acute heart failure or those scheduled to undergo examinations using iodinated radiocontrast agents should also avoid this medication. Patients who have had allergic reactions to this medication or biguanide drugs, type 1 diabetes patients, and those with diabetic ketoacidosis should not be treated with this medication. Patients with severe infections or serious trauma should discontinue this medication until they can orally ingest and their kidney function returns to normal. Patients scheduled for surgery should stop taking this medication 48 hours prior to the procedure and can resume only after confirming normal renal function. Caution is necessary for individuals with poor nutritional status, liver dysfunction, lung dysfunction, or excessive alcohol consumption. Irregular meals or intense exercise, as well as interactions with other medications, can increase the risk of lactic acidosis and hypoglycemia, so should be administered carefully. Lactic acidosis is rare but can be fatal; therefore, if symptoms such as fatigue, muscle pain, shortness of breath, or abdominal pain occur, immediate medical attention should be sought. Gastrointestinal disturbances are common at the start of treatment, and taking the medication with food or gradually increasing the dose can help reduce these symptoms. This medication is primarily excreted by the kidneys, so regular kidney function tests are required, and it should be discontinued if kidney function declines. Alcohol intake can affect the metabolism of lactic acid from this medication and may increase the risk of lactic acidosis, so it is advisable to avoid it. Vitamin B12 deficiency may occur; thus, regular blood tests are recommended. Limited reports exist regarding fetal effects during pregnancy; however, if there is a risk of placental insufficiency or preeclampsia, it should be avoided. If breastfeeding, careful consideration should be given as this medication can be excreted in breast milk regarding whether to continue breastfeeding or to discontinue medication. For the elderly, since kidney function decline is common, treatment should start with lower doses while monitoring kidney function regularly. In cases of overdose, blood dialysis can remove this medication; therefore, if overdose is suspected, immediate medical attention should be sought. This medication does not cause weight gain and may even cause weight loss in some patients. Keep out of reach of children and do not transfer to other containers.

Serious side effects

Lactic acidosis (although very rare, it can be fatal), severe allergic reactions (requiring medication discontinuation due to rash, etc.), hypoglycemia, acute kidney function deterioration, liver abnormalities, severe edema or urinary anomalies, breathing problems (such as shortness of breath), serious neurological symptoms (such as severe headache, consciousness confusion)

Mild side effects

Gastrointestinal symptoms (diarrhea, nausea, vomiting, abdominal distension, loss of appetite, dyspepsia, constipation, abdominal pain), unpleasant or metallic taste, rash, anemia, leukopenia, thrombocytopenia, vitamin B12 deficiency, liver function anomalies, severe delayed hypoglycemia

This medication should be stored in a tightly closed container to protect it from air and moisture, and it is safe to store it at room temperature between 1°C and 30°C. It is advisable to avoid direct sunlight and not to place it in areas that are too hot or cold.

Appearance

White elongated film-coated tablet

Package unit

For domestic use: 500 tablets/bottle, 100 tablets/bottle, 60 tablets/bottle; for export: 500 tablets/bottle, 60 tablets/bottle, 60 tablets (10 tablets/PTPX6)