Nexpolmin Sustained Release Tablet (Metformin Hydrochloride)

Adult dose

The general initial dose is 500 mg of sustained release Metformin Hydrochloride taken once daily with the evening meal. The blood sugar levels should be checked one week later to adjust the dose. The dose should be gradually increased by 500 mg weekly, with a maximum dose of 2000 mg per day. It can be taken once daily with the evening meal, up to a maximum of 2000 mg per day. If blood sugar control is not achieved with the maximum daily dose of 2000 mg, consideration should be given to 1000 mg taken twice daily, both with meals. For patients already being treated with regular Metformin, the initial dose of this preparation is the same as the daily dose of regular Metformin they were taking. Switching to this preparation is not recommended for patients taking more than 2000 mg of regular Metformin per day. Upon initiating treatment and adjusting the dose, fasting blood sugar should be measured to assess the treatment response and the minimum effective dose should be confirmed. Blood glucose levels should be checked approximately every three months. The treatment goal with this medication is to achieve normal or close-to-normal fasting blood sugar and glycated hemoglobin levels when used alone or in combination with sulfonylureas or insulin at the minimum effective dose.

This medication can rarely cause severe lactic acidosis, which can be a life-threatening condition. Caution is required when used in conjunction with other diabetes medications as hypoglycemia may occur. This medication should not be used in patients with moderate to severe renal impairment or in conditions such as dehydration or serious infections. Patients with acute heart failure or certain cardiovascular diseases, and those scheduled for tests using contrast agents should also avoid this medication. Patients with allergy to the active ingredient or in diabetic coma should not use this medication. Caution should be exercised in cases of severe infections or trauma, around the time of surgery, nutritional deficiencies, or liver dysfunction. Patients with irregular blood sugar control or those engaging in vigorous exercise, as well as those taking interacting medications, should also be cautious. When taking this medication, side effects such as vitamin B12 deficiency, gastrointestinal disturbances, skin rashes may occur, and if any unusual symptoms arise, they should be reported. Notably, gastrointestinal symptoms are common during initial treatment, and taking with meals or gradually increasing the dose may help. Renal function should be regularly monitored, and if abnormalities are found, the medication dose should be adjusted or discontinued. Alcohol can increase the risk of side effects from this medication, so excessive drinking should be avoided. During pregnancy, it should only be administered after consulting the healthcare provider as it may affect the fetus, and it is not recommended during breastfeeding. Pediatric use has not been established, so it is advisable not to use in children. Elderly patients often have decreased renal function, so doses should be adjusted, and renal function should be monitored regularly. In cases of overdose, the drug can accumulate in the body and lead to severe side effects, so immediate medical attention is necessary. This medication should not be chewed or crushed, but swallowed whole, and the tablet shell may appear in the stool, which is normal. There may be interactions with other medications, so if you are taking other drugs, you must inform your healthcare provider, particularly when combined with drugs that affect renal function. Regular monitoring of blood glucose and glycated hemoglobin should be performed, and if there are changes in symptoms during treatment, immediate consultation with healthcare professionals is advised. Maintaining a healthy diet and regular exercise during the period of taking this medication is important.

Serious side effects

Lactic acidosis, hives, severe swelling (edema), deaths related to lactic acidosis, severe allergic reactions, severe edema accompanied by increased blood pressure, symptoms due to hypoglycemia

Mild side effects

• Vitamin B12 deficiency
• taste disturbance
• nausea
• vomiting
• diarrhea
• abdominal pain
• loss of appetite
• erythema
• itching
• hives

This medication should be stored in a tightly closed container to protect it from air and moisture. It is important to maintain a storage temperature between 1 and 30 degrees Celsius at room temperature.

Appearance

White rectangular tablet

Package unit

30 tablets/bottle, 300 tablets/bottle