What is Glucophage and when is it used?

Glucophage is a registered trade name owned by Merck. The product is based on Metformin, a blood sugar-lowering agent that is also available under other trade names on the market. You can buy Glucophage at a low price if you opt not for the product made by Merck but by the maker of a generic drug.

Metformin diminishes the blood sugar but doesn’t cause its drop below the norm. Contrary to sulfonylurea, it does not promote insulin production and does not induce a hypoglycemic effect in healthy individuals. The medication lowers both the fasting sugar level and the sugar level after eating in the blood plasma.

Metformin works in 3 ways:

- Causes a diminished sugar formation in the liver due to suppression of gluconeogenesis and glycogenolysis;

- Betters the capture and use of peripheral glucose in the muscles by potentiating insulin sensitivity;

- Inhibits the uptake of glucose in the intestines.

Metformin also has a positive impact on fats metabolism: it lowers total cholesterol, low-density lipoproteins, and triglycerides. Increases the susceptibility of receptors located in the muscles and fat tissue to insulin and the use of glucose by cells.

Indications for use

Type 2 diabetes (non-insulin-dependent) with diet therapy ineffectiveness, especially in obese patients:

- As a single-drug therapy or complex therapy in conjunction with other oral hypoglycemic medicines or with insulin for the treatment of adults;

- As a single-drug therapy or complex with insulin for the treatment of children over the age of 10 years.

- Reducing diabetes complications in adult individuals with type 2 diabetes and overweight who used metformin as a first-line drug with diet therapy ineffectiveness.

Prohibitions for Glucophage use

Even if you have the indications for the medication use, you should not buy generic Glucophage in:

- Intolerance of the main or auxiliary ingredients of the drug;

- Diabetic ketoacidosis, diabetic coma;

- Kidney function failure (cc<60 ml / min.);

- Acute diseases/conditions with a risk of kidney function violation such, dehydration, infectious diseases, shock, stroke, and others.

- Liver dysfunction,

- Alcoholism.

Glucophage dosage

When you buy Metformin, it is better to consult your physician first. Here we provide the general recommendations for the medication use. Single-drug therapy or complex therapy in conjunction with other antidiabetic agents.

Adults

Typically, thestarting dosage is 500 mg or 850 mg two to three times per day with or after meals. After two weeks of the course, the dose must be adjusted according to the serum sugar level. Gradual elevation of the dosage reduces adverse reactions from the part of the digestive tract. The highest advised dosage is 3000 mg per day split into three intakes. If you want to start using Metformin while undergoing the treatment with another medication, it is necessary to stop taking another anti-diabetic agent.

Use with insulin: Typically, the initial dosage is 500 mg or 850 mg two to three times per day, while the dose of insulin is chosen based on the blood sugar.

Dosages for kids

The medication is prescribed for children over the age of ten years. Typically, the initial dose is 500 mg or 850 mg of metformin 1 time per day with or after meals. After two weeks of treatment, the dose must be adjusted according to the serum sugar level. The highest advised dosage is 2000 mg per day split into three intakes.

Dosage adjustments

In elderly patients, violated kidney function is possible, thus, the dosage metformin must be selected based on kidney function tests, which must be carried out regularly.

Glucophage adverse effects

- From the digestive tract: nausea, vomiting, diarrhea, bellyache, loss of appetite, metallic taste in the mouth, flatulence, liver function disorders. Most often, these side effects occur at the start of course and, as a rule, disappear without any treatment. To avoid the occurrence of side effects from the gastrointestinal tract, it is advised to slowly raise the dosage and use the medication two to three times a day with or after meals. - From the blood part: Isolated cases of megaloblastic anemia.

- On the part of the skin: rarely skin rashes, itching, urticaria.

- Metabolism: Very rarely, lactic acidosis.

- In long-term use of the medication, absorption of vitamin B12 may decrease, which is accompanied by a drop in its level in blood serum. It is observed with the appointment of metformin in individuals with megaloblastic anemia.

Glucophage interactions

Combinations that are not advised:

- Alcohol raises the danger of lactic acidosis, especially in cases of fasting or a low-calorie diet and in liver dysfunction. When treating with metformin, alcohol and medicines that contain it must be avoided.

- Iodine-containing substances can induce lactic acidosis especially in kidney failure. The use of metformin must be stopped before radiological studies that imply iodine substances use and not be resumed earlier than 48 hours after radiological studies using radiopaque substances.

- The use of danazol with Metformin is not advised as it can cause hyperglycemic effect. If such therapy is necessary, the lowering of the used metformin dosage is required.

Combinations to be used with caution:

- GCS of systemic and local action, beta 2 sympathomimetics, and diuretics have a hyperglycemic effect. It is required to constantly monitor the level of sugar in the blood, particularly at the start of the course. Throughout and after the termination of such joint therapy, the dosage of Metformin must be adjusted.

- When combined with ACE inhibitors, increased hypoglycemic action is possible.

- Chlorpromazine, in high doses, increases glycemia, lowering the production of insulin. In the use of antipsychotics and after stopping taking the latter, the dosage of Metformin must be adjusted.

Glucophage precautions

When you buy Metformin and start using it, you must know that there are some dangers related to its use and how to avoid them:

- Lactic acidosis is an infrequent but serious complication that can occur as a result of the pile-up of metformin. The risk factors include badly-controlled diabetes, ketosis, extended fasting, overconsumption of alcohol, liver failure, or any condition related to hypoxia. Lactic acidosis is characterized by muscle cramps, acidic shortness of breath, pain in the abdomen and reduced body temperature, further development of coma is possible. If you suspect lactic acidosis, you must stop using the medication and immediately inform your doctor as hospitalization can be required.

- Renal failure. Since the medication is washed out by the kidneys, before and during course, serum creatinine levels must be checked, especially in individuals with violated kidney function and in seniors. Caution must be also exercised in cases when kidney function may be impaired, for instance, at the start of the course of antihypertensive drugs, diuretics, and NSAIDs.

- Iodine-containing radiopaque agents. When conducting radiological studies using radiopaque agents, it is necessary to stop the use of metformin 48 hours before the study and not resume earlier than 48 hours after the radiological examination and evaluation of kidney function.

- It is required to stop the use of metformin 48 hours before the planned surgery and not resume earlier than 48 hours after the operation and evaluation of kidney function.

- According to clinical tests involving kids, the impact of metformin on growth in children was not revealed. However, there is no data on the impact of the medication on growth with prolonged use, thus, it is necessary to use the pills with special care for children during puberty, especially at the age of 10 to 12 years.

- Patients need to follow a diet and monitor laboratory parameters. With the combined use of metformin with insulin or sulfonylurea derivatives, an increase in hypoglycemic effect is possible.

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