Note 4.7 étoiles, basé sur 345 commentaires.
Usual Adult Dose for Diabetes Type 2
Medical uses[ edit ] Metformin is used to lower the blood sugar in those with type 2 diabetes; it Metformin Vente also used as a second line agent for infertility in those with polycystic ovary syndrome.
These guidelines supersede earlier reviews. For example, a review found tentative evidence that people treated with sulfonylureas had a higher risk of severe low blood sugar events RR 5. Not enough data were available at that time to determine the relative risk of death or of death from heart disease. Metformin treatment decreases the risk of developing type 2 diabetes mellitus in women with PCOS who exhibited impaired glucose tolerance IGT at baseline.
Warnings are also given regarding the use of metformin in less severe renal impairment, people aged 65 years Metformin Vente or greater, hypoxic states e. Metformin Vente is recommended to be temporarily discontinued before any procedure involving use of iodinated contrast agents, such as a contrast-enhanced CT scan or angiogram due to the increased risk of lactic acidosis resulting from impaired renal function;   metformin can be resumed after Metformin Vente days after contrast administration, if renal function is adequate and stable.
Adverse effects[ edit ] The most common adverse effect of metformin is gastrointestinal irritation, including diarrheaMetformin Vente, cramps, Metformin Vente, vomiting, and increased flatulence ; metformin is more commonly associated with gastrointestinal side effects than most other antidiabetic medications, Metformin Vente.
The discomfort can often be avoided by beginning Metformin Vente a low dose 1. In Metformin Vente individuals, this slight excess is cleared by other mechanisms including uptake by unimpaired kidneysand no significant elevation in blood levels of lactate occurs. Because metformin decreases liver uptake of lactate, any condition that may precipitate lactic acidosis is a contraindication. Extracorporeal treatments are recommended in severe overdoses.
Chromatographic techniques are commonly employed. Anticholinergic drugs reduce gastric motility, Metformin Vente, prolonging the time drugs spend in the gastrointestinal tract.
This impairment may lead to more metformin being absorbed than without the presence Metformin Vente an anticholinergic drug, thereby increasing the concentration of metformin in the plasma and increasing the risk for adverse effects. Metformin Vente potential mechanisms of action have been proposed: Increased peripheral use of glucose may be due to improved insulin binding to insulin receptors.
Some metabolic actions of metformin do appear to occur by AMPK-independent mechanisms. Chemistry[ edit ] Metformin hydrochloride 1,1-dimethylbiguanide hydrochloride is freely-soluble in water, slightly soluble in ethanol, but almost insoluble in acetone, ether, or chloroform. The pKa of metformin is Steady state is usually reached in one or two days.
The metformin pKa values make metformin a stronger base than most other basic medications with less than 0. These chemical parameters indicate low lipophilicity and, consequently, Metformin Vente, rapid passive diffusion of metformin Metformin Vente cell membranes is unlikely. As a result of its low lipid solubility it requires the transporter SLC22A1 in order for it to enter cells. More lipophilic derivatives of metformin are presently under investigation with the aim of producing prodrugs with superior oral absorption than metformin.
It is cleared from the body by tubular secretion and excreted unchanged in the urine; metformin is undetectable in blood plasma within 24 hours of a single oral dose. Inmetformin, unlike some other similar compounds, was found not to decrease blood pressure and heart rate in animals. Garcia  used metformin he named it Fluamine to treat influenza; he noted the medication “lowered the blood sugar to minimum physiological limit” Metformin Vente was not toxic, Metformin Vente.
Garcia believed metformin to have bacteriostaticMetformin Vente, antiviralantimalarialantipyretic and analgesic actions. Instead he observed antiviral effects in humans. Sterne was the first to try Metformin Vente on humans for the treatment of diabetes; he coined the name “Glucophage” glucose eater for the medication and published his results in It was sold in the UK by Metformin Vente small Aron subsidiary called Rona.
Metformin was approved in Canada in but did not receive approval by the U. Liquid metformin is sold under the name Riomet in Metformin Vente. All of these are available as generic medications in the U. Metformin SR slow release or XR extended release was introduced in It is available in, and mg strengths, mainly to counteract common gastrointestinal side effects, Metformin Vente, as well as to increase compliance by reducing pill burden.
No difference in effectiveness exists between the two Metformin Vente. Combination with other medications[ edit ] When used for type 2 diabetes, Metformin Vente, metformin is often prescribed in combination with other medications. Several are available as fixed-dose combinationsto reduce pill burden and simplify administration. In September the European Medicines Agency EMA recommended that the medication be suspended from the European market because the benefits of rosiglitazone no longer outweighed the risks.
In Europe, Metformin Vente, Canada, and elsewhere metformin combined with linagliptin is marketed under the trade name Jentadueto. Metformin is available combined with the sulfonylureas glipizide Metaglip and glibenclamide US: