Metformin Sustained Release Tablet (Metformin Hydrochloride)

Adult dose

Administer 500 mg of Metformin Hydrochloride sustained release tablets once daily with the evening meal. Measure blood sugar levels a week later to adjust the dosage, and gradually increase the dosage to improve gastrointestinal side effects. The maximum dosage is 2000 mg per day, which can be achieved by increasing by 500 mg weekly with the evening meal. If blood sugar control is not achieved with the maximum of 2000 mg once daily, consider 1000 mg twice daily.

This medication can rarely cause a serious condition known as lactic acidosis, which can lead to death, so extreme caution is required. Additionally, when used in conjunction with other diabetes medications such as insulin or sulfonylureas, severe hypoglycemia may occur. This medication should not be used in patients with significantly decreased renal function, dehydration, or acute conditions such as severe infections, heart failure, or acute myocardial infarction. Particularly, the medication must be discontinued prior to procedures involving iodinated contrast, and can only be resumed after renal function is confirmed to be normal post-exam. Patients with allergies to any component of this medication, or those with Type 1 diabetes or diabetic ketoacidosis should also avoid its use. If undergoing surgery, this medication should be stopped 48 hours before major surgeries that restrict food or fluid intake, and can be resumed after renal function is restored. Patients with very poor nutritional status, impaired liver function, or excessive alcohol consumption should also exercise caution when using this medication. Renal function should be regularly monitored during treatment, especially in elderly patients or those with reduced renal function. Gastrointestinal symptoms such as nausea, vomiting, diarrhea, etc., are common initially but usually improve over time. However, if severe diarrhea or vomiting persists, there is a risk of dehydration; thus, medication should be temporarily suspended. This medication can cause vitamin B12 deficiency, so regular monitoring of serum vitamin B12 levels is recommended. Excessive acute or chronic alcohol intake should be avoided during treatment, as alcohol can affect lactate metabolism and increase risk. Furthermore, the blood sugar lowering effects may be enhanced or reduced depending on other medications taken concurrently; thus, it is essential to monitor these factors closely and discuss them with healthcare professionals. During pregnancy, this medication may affect fetal development, so fetal progress should be carefully monitored. In breastfeeding cases, consideration should be given to either halting breastfeeding or discontinuing this medication. Its safety in children has not been established and it is not recommended. In the case of overdose, hypoglycemia does not typically occur; however, to prevent drug accumulation, dialysis may be necessary. This medication should be swallowed whole and not chewed or crushed, and the tablet coating may appear in stool, which is normal. Finally, it is crucial to conduct regular blood sugar and renal function tests during treatment to continuously confirm therapeutic efficacy and safety.

Serious side effects

Lactic acidosis, urticaria, severe swelling (edema), severe skin reactions (severe rash, blisters, skin peeling, pain in mucous membranes of mouth/eyes), difficulty breathing, liver complications (jaundice), severe neurological symptoms (severe headache, thunderclap headache, seizures, confusion, visual disturbances, paralysis), severe edema or urinary disturbances

Mild side effects

• Vitamin B12 deficiency
• taste alteration
• nausea
• vomiting
• diarrhea
• abdominal pain
• loss of appetite
• erythema
• itching
• urticaria

This medication should be stored in a tightly sealed container to prevent air and moisture from entering. Additionally, it is recommended to keep the medication at room temperature between 1°C and 30°C to preserve its effectiveness.

Appearance

White, double-convex, rectangular sustained release tablet

Package unit

Bottle - 30 tablets/bottle, Bottle - 300 tablets/bottle