Glavis 1000 mg (Metformin Hydrochloride)

Adult dosage

The dosage should be determined based on individual drug effectiveness and tolerance, and should not exceed the recommended maximum daily dosage. Start with a low dose, taken 500 mg two to three times a day with meals. The dosage may be gradually increased by 500 mg weekly, with a maximum of 2550 mg. Up to 2000 mg is typically divided into doses taken twice daily in the morning and evening; for doses exceeding 2000 mg, split the total into three doses taken with meals, not to exceed 2550 mg per day. Upon initiation and dosage adjustment, fasting blood glucose should be monitored to assess therapeutic response and identify the minimum effective dose. HbA1c levels should be measured approximately every three months. The treatment goal is to achieve normal or near-normal levels of fasting glucose and HbA1c concentrations, whether administered as monotherapy or in combination with sulfonylureas or insulin, using the minimum effective dose. Generally, patients who were previously able to control blood glucose levels with diet alone may find sufficient effectiveness with short-term treatment using this medication when blood glucose levels are transiently uncontrolled.

Children's dosage

Children aged over 10 years and adolescents in growth should take 500 mg once daily during or just after meals. Blood glucose levels should be measured after one week to adjust the dosage, as gastrointestinal side effects may improve with gradual dosage increase.

This medication can cause severe lactic acidosis or hypoglycemia, so caution is required. It should not be administered to patients with moderate to severe renal impairment, acute heart failure, severe infections, or dehydration. If undergoing tests using iodine-based contrast agents, the administration of this medication must be suspended before and after the examination and can only be resumed once kidney function has returned to normal. It is also not to be used in cases of hypersensitivity to this drug, type 1 diabetes patients, or patients with acute or chronic metabolic acidosis. In cases of severe infections or severe traumatic systemic disorders, or during surgery, treatment should be temporarily suspended and resumed once the condition stabilizes. Patients with hepatic dysfunction or pulmonary dysfunction, or those consuming excessive alcohol, should take caution. This medication may cause a rare but fatal side effect known as lactic acidosis; therefore, if symptoms such as fatigue, muscle pain, respiratory distress, or abdominal pain occur, immediate consultation with a physician is necessary. Gastrointestinal disturbances are common but mostly temporary, and can be alleviated by taking it with meals or gradually increasing the dosage. Kidney function should be regularly monitored to prevent drug accumulation, particularly in elderly patients or those with reduced kidney function. Alcohol increases the risk of side effects from this medication, so alcohol consumption should be avoided while taking it. When used in conjunction with other medications, blood glucose control may be affected by interactions; therefore, consultation with a physician or pharmacist is recommended. During pregnancy, it should be used cautiously to ensure fetal health, and should be avoided in cases of placental insufficiency or risk of intrauterine growth retardation. If breastfeeding, since this medication is excreted in breast milk, the decision to continue breastfeeding should be discussed with healthcare providers. For children and elderly patients, dosage adjustment and monitoring of kidney function are important, and in cases of overdose, hemodialysis may be required. Finally, store this medication in a safe place out of reach of children and avoid transferring it to other containers.

Serious side effects

• Lactic acidosis
• severe edema
• elevated blood pressure
• hypoglycemia.

Mild side effects

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

This medication should be stored in a tightly sealed container to protect it from air and moisture. The storage temperature should ideally be maintained between 1°C and 30°C.

Appearance

White rectangular film-coated tablet

Package unit

30 tablets/bottle, 100 tablets/bottle