Dainab Tablet (Metformin Hydrochloride)

Adult dose

The administration dose should be determined based on the individual drug effect and tolerance, and should not exceed the recommended maximum daily dose. This medication should be started at a low dose to reduce gastrointestinal adverse reactions and determine the minimal dose necessary for effective blood sugar control, administered 500 mg with meals, twice or three times a day. Dosage increases should be made gradually by 500 mg weekly, with common dosing being twice daily in the morning and evening when administering a total of 2000 mg. For doses exceeding 2000 mg, it should be taken three times daily with meals and can be administered up to a maximum of 2550 mg daily. Blood sugar must be measured on an empty stomach to assess the therapeutic response and determine the minimal effective dose during the initiation and adjustment of this medication. The glycosylated hemoglobin concentration in blood should be measured approximately every 3 months. The therapeutic goal of this medication is to reduce fasting blood sugar and glycosylated hemoglobin levels to normal or near-normal levels when administered as monotherapy or in combination with sulfonylureas or insulin at minimal effective doses. In general, if a patient whose blood sugar has been controlled only with dietary therapy experiences temporary blood sugar control issues, sufficient efficacy can be achieved by administering this medication for a short period. Pediatric and adolescent patients: This medication may be used for children over 10 years or adolescents in growth. The usual starting dose is 500 mg once daily, taken during or after meals. Blood sugar levels should be measured after one week to adjust the dosage. Gastrointestinal side effects can improve with gradual dose increases. The maximum daily dose is 2000 mg, which should be administered in two to three divided doses. For patients with kidney impairment: This medication may be used in patients with moderate renal impairment (stage 3a, creatinine clearance [CrCl] 45 ≤ ~ < 60 ml/min or glomerular filtration rate [GFR] 45 ≤ ~ < 60 ml/min/1.73㎡), provided that there are no other symptoms that might increase the risk of lactic acidosis. - The starting dose is 500 mg or 850 mg daily. The maximum daily dose is 1000 mg, divided into two doses. Kidney function should be closely monitored every 3-6 months. If the creatinine clearance or glomerular filtration rate falls below 45 ml/min or 45 ml/min/1.73㎡, the administration of this medication must be immediately discontinued.

Child dose

The usual starting dose for children over 10 years old or adolescents in growth is 500 milligrams once daily, taken during or after meals. Blood sugar levels should be measured after one week to adjust the dosage.

This medication can cause severe lactic acidosis or hypoglycemia, so caution is required. It should particularly not be administered to patients with moderate to severe kidney dysfunction, or acute conditions such as dehydration, severe infections, or acute myocardial infarction. Patients with acute and unstable heart failure, those undergoing examinations with radiographic iodine contrast agents, and patients with hypersensitivity to this medication or other biguanides should also avoid use. It should not be used in patients with type 1 diabetes or metabolic acidosis, and patients with severe infections or traumatic systemic disorders, as well as those before and after surgery should temporarily discontinue use. Caution is also necessary for patients with malnutrition, liver dysfunction, pulmonary dysfunction, and excessive alcohol consumption. During the administration of this medication, kidney function should be regularly monitored to prevent drug accumulation. Gastrointestinal symptoms may commonly occur during initial treatment, but they are usually temporary and can be alleviated by taking the medication with meals or gradually increasing the dosage. Symptoms of lactic acidosis include fatigue, muscle pain, shortness of breath, and abdominal pain, so if these symptoms occur, the patient should immediately inform their physician. Alcohol consumption should be avoided during the use of this medication, and if combined with other hypoglycemic agents, the risk of hypoglycemia may increase, thus careful monitoring of blood sugar is required. The decision to administer during pregnancy should take into account the potential effects on the fetus and placental function, and during breastfeeding, the decision regarding whether to continue breastfeeding or discontinue the medication should be made carefully as this medication is secreted into breast milk. Elderly or pediatric patients should have their kidney function and growth status monitored closely and the dosage adjusted accordingly. In case of overdose, the drug can be removed via hemodialysis, so if overdose is suspected, immediate consultation with medical personnel is necessary. This medication does not cause weight gain, making it favorable for weight management, and long-term use can help with blood sugar control and the prevention of diabetic complications. Store out of reach of children and do not transfer to another container for safety.

Serious side effects

Lactic acidosis (which can be fatal), severe allergic reactions (such as rash), dehydration, deterioration of kidney function, renal failure, increased blood pressure, cardiovascular collapse (shock), acute myocardial infarction, sepsis, hypoglycemia, liver dysfunction (potential for jaundice due to liver damage), hypotension, resistant bradycardia arrhythmia, symptoms related to lactic acidosis (hyperventilation, muscle pain, fatigue, altered consciousness), severe edema, blood disorders (severe anemia, dramatic decrease in white blood cells and platelets)

Mild side effects

Gastrointestinal symptoms (diarrhea, nausea, vomiting, abdominal distension, loss of appetite, dyspepsia, constipation, abdominal pain), metallic taste, rash, anemia, leukopenia, thrombocytopenia, vitamin B12 deficiency, liver dysfunction, hypoglycemia, hypoglycemic symptoms, nonspecific gastrointestinal symptoms, fatigue, muscle pain, weakness, abdominal pain

This medication should be stored in a tightly sealed container to prevent air exposure, at room temperature between 1 to 30 degrees Celsius. This storage method helps maintain the medication's effectiveness and prevents degradation.

Appearance

White round film-coated tablet

Package unit

30 tablets/bottle, 500 tablets/bottle