Metformin 500 mg Tablets (Metformin Hydrochloride)

Adult dose

In adults, the dosage should be determined based on individual drug effectiveness and tolerance, without exceeding the recommended maximum daily dose. It should begin at a low dose and be taken 2 to 3 times a day, with 500 mg with meals. The dosage should be gradually increased by 500 mg weekly, and when taking up to 2000 mg, it is typically administered twice a day, in the morning and evening. If exceeding 2000 mg, it should be divided into three doses with meals, and a maximum of 2550 mg per day can be given. To determine treatment response and establish a minimum effective dose, fasting blood sugar should be measured at the start and at dosage adjustments. Hemoglobin A1c should be measured approximately every three months. The therapeutic goal of this medication is to reduce fasting blood sugar and hemoglobin A1c levels to normal or close to normal with either monotherapy or in combination with sulfonylureas or insulin, using the minimum effective dose. Generally, when patients who were previously able to control their blood sugar with diet alone temporarily cannot manage their blood sugar, short-term administration of this medication can produce sufficient effects. In pediatric patients and adolescents in growth, this medication may be used in those over 10 years. The standard starting dose is 500 mg once a day, administered during or after meals. After one week, blood sugar levels should be measured to adjust the dosage. Gastrointestinal side effects may improve with gradual dose increases. The maximum daily dose is 2000 mg, divided into 2 to 3 doses.

Child dose

Children over 10 years and adolescents should take 500 mg once a day with or after meals. After one week, the dosage should be adjusted according to blood sugar levels, with a maximum daily dose of 2000 mg.

This medication potentially carries a risk of severe lactic acidosis or hypoglycemia, thus caution is needed. It should not be used in patients with moderate to severe kidney impairment, dehydration, serious infections, or cardiovascular issues. Acute heart failure or patients undergoing specific imaging tests using iodinated contrast should also avoid this medication and must discontinue use for a certain period before and after the test. It is not to be given to individuals with hypersensitivity to this drug, patients with type 1 diabetes, or metabolic acidosis. Temporary discontinuation of this medication is necessary in cases of severe infection, trauma, or surrounding surgery, and it should only be restarted after kidney function is normalized. Caution is also required for patients with malnutrition, liver dysfunction, lung dysfunction, or excessive alcohol consumption when using this medication. This medication can cause lactic acidosis, a rare but fatal side effect, so if symptoms such as malaise, muscle pain, difficulty breathing, or abdominal pain occur, medical assistance should be sought immediately. Gastrointestinal side effects such as diarrhea, nausea, and vomiting may occur, but these symptoms are typically temporary. Since this medication is excreted via the kidneys, kidney function should be regularly monitored to manage the risk of drug accumulation, especially in elderly patients or those with decreased kidney function. There may be interactions with other medications, thus it is important to consult with healthcare professionals regarding concurrent medications. During pregnancy, it should be used when necessary with consideration of the effects on the fetus, and it must not be used if there is a risk of placental insufficiency or pre-eclampsia. While breastfeeding, as this medication is secreted in breast milk, careful consideration must be given regarding breastfeeding and drug treatments. Special attention is needed for children and the elderly, and dosage adjustments and monitoring of kidney function are crucial. In the case of overdose, blood dialysis may be required, and medical assistance should be sought immediately. Alcohol consumption should be avoided while on this medication, and blood sugar levels should be regularly monitored. Patients and their families should be adequately informed regarding the side effects and precautions associated with this medication so that any unusual symptoms can prompt immediate visits to healthcare facilities.

Serious side effects

Lactic acidosis (malaise, muscle pain, difficulty breathing, weakness, abdominal pain, low body temperature, hypotension, resistant bradyarrhythmias included), severe allergic reactions (e.g., rash), severe edema or urinary abnormalities (significant reduction in urine output, severe systemic swelling), liver issues (jaundice in skin or eyes, extreme lethargy throughout the body), hypoglycemia (severe delayed type), serious neurological symptoms (sudden and very severe headaches, thunderclap headache, seizures, loss of consciousness)

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, symptoms of hypoglycemia (rarely severe)

This medication should be stored in a tightly sealed container to prevent air from entering, and it is best kept at room temperature between 1 and 30 degrees Celsius. Storing it this way maintains the effectiveness of the medication and prevents deterioration.

Appearance

White round film-coated tablet

Package unit

500 tablets per bottle