Metpol M Tablet (Metformin Hydrochloride)

Adult dose

Dosage should be determined based on individual drug effects and tolerability, and should not exceed the recommended maximum daily dose. This medicine should start with a low dose to reduce gastrointestinal side effects and confirm the minimum dosage needed for adequate blood sugar control, to be administered 500 mg with meals 2 to 3 times a day. The dosage can be gradually increased by 500 mg weekly up to 20

Child dose

Can be used for children over 10 years old or adolescents. The usual starting dosage is 500 mg once daily, administered with or after meals. Blood sugar levels should be measured one week later to adjust the dosage.

This medicine can cause severe lactic acidosis or hypoglycemia, which could potentially lead to death, and thus should be used with utmost caution. It should not be administered to patients with moderate to severe renal impairment or acute conditions affecting kidney function, such as dehydration, severe infections, or acute myocardial infarction. It is also safe not to use this medicine in patients with acute heart failure or unstable cardiac conditions. Before and after exams using iodinated contrast agents, administration of this medicine must be discontinued and can only be resumed after renal function has returned to normal. Patients with a history of allergic reactions to this medicine or biguanides should avoid taking it. This medicine is not suitable for patients with type 1 diabetes or metabolic acidosis, including diabetic ketoacidosis and lactic acidosis. Patients with severe infections or significant traumatic systemic disorders must suspend intake until oral intake is feasible and renal function has normalized. In cases of surgery, especially when food and fluid intake is limited, the medicine should be discontinued 48 hours prior to the surgery and can be resumed only after confirming normal renal function post-surgery. Patients in poor nutritional status or frailty, and those with pituitary or adrenal dysfunction must be monitored closely. Patients with hepatic impairment, pulmonary infarction, or severe pulmonary dysfunction, those who consume excessive alcohol, or those with dehydration, diarrhea, or vomiting, should avoid this medicine. It is safest not to use this medicine during pregnancy if there is a risk of placental insufficiency, preeclampsia, or intrauterine growth retardation. Patients with irregular eating habits, insufficient meal intake, or who engage in intense physical activity, and those with potential drug interactions should be administered this medicine cautiously. While using this medicine, if symptoms of lactic acidosis such as fatigue, muscle pain, difficulty breathing, or abdominal pain occur, report immediately to healthcare personnel, and discontinue medication. Gastrointestinal side effects (diarrhea, nausea, vomiting) may commonly occur but are usually transient and can be alleviated by taking the medicine with food or gradually increasing the dosage. This medicine can accumulate based on renal function, so renal function tests should be done before administration and regularly thereafter. If there is a rapid decline in renal function, immediate discontinuation is necessary. Alcohol can impact the metabolism of this medicine increasing the risk of lactic acidosis; therefore, excessive drinking should be avoided while taking this medicine. Vitamin B12 deficiency may occur, so serum vitamin B12 levels should be monitored regularly. The risk of hypoglycemia is low when taken alone, but it can occur when combined with other hypoglycemic agents or insulin or in cases of insufficient meal intake, requiring vigilance. Elderly patients are at high risk of decreased renal function, necessitating dosage adjustments and regular renal function assessments. Pregnant women should use this medicine only when necessary for blood sugar management before and during pregnancy, with close monitoring of fetal growth. When breastfeeding, as this medicine can be excreted in breast milk, careful consideration must be given to whether to continue breastfeeding or to discontinue the medication. In cases of overdose, there is a risk of lactic acidosis, so in suspected cases, immediate treatment at a healthcare facility is required, and blood dialysis may be helpful. This medicine does not cause weight gain, making it advantageous for diabetic patients who need to manage their weight, and it can be taken safely through consistent blood sugar and renal function tests.

Serious side effects

Lactic acidosis (fatigue, muscle pain, difficulty breathing, weakness, abdominal pain, low body temperature, hypotension, resistant bradyarrhythmias included), severe allergic reactions (hives, rash), renal failure due to worsening renal function, hypoglycemia (including severe delayed hypoglycemia)

Mild side effects

Gastrointestinal symptoms (diarrhea, nausea, vomiting, abdominal distention, loss of appetite, dyspepsia, constipation, abdominal pain), metallic taste, rash, anemia, leukopenia, thrombocytopenia, vitamin B12 deficiency, liver function abnormalities, hypoglycemia

This medicine should be stored in an airtight container to prevent exposure to air or moisture, and it is advisable to keep it at room temperature between 1 to 30 degrees Celsius. Storing it this way helps maintain its effectiveness and prevent degradation.

Appearance

White round film-coated tablet

Package unit

500 tablets/bottle