Glucophage® Long
Lactic acidosis
Lactic acidosis is a very rare but serious complication (high mortality in the absence of immediate treatment) that can occur due to the accumulation of metformin. Cases of lactic acidosis when taking metformin occurred mainly in patients with diabetes mellitus with severe renal failure.
Other associated risk factors should be taken into account, such as decompensated diabetes mellitus, ketosis, prolonged fasting, alcoholism, severe infectious disease, liver failure, any condition associated with severe hypoxia and concomitant use of drugs that can cause the development of lactic acidosis (see section " Interaction with other drugs"). This may help reduce the incidence of lactic acidosis. The risk of developing lactic acidosis should be taken into account when nonspecific signs appear, such as muscle cramps accompanied by dyspeptic disorders, abdominal pain and severe asthenia.
Lactic acidosis is characterized by severe malaise with general weakness, acidotic shortness of breath, vomiting, abdominal pain, muscle cramps and hypothermia followed by coma.
Diagnostic laboratory parameters are a decrease in blood pH (less than 7.35), plasma lactate concentration over 5 mmol/l, increased anion gap and lactate/pyruvate ratio. If lactic acidosis is suspected, stop taking the drug and consult a doctor immediately.
Surgical operations
The use of metformin should be discontinued 48 hours before elective surgery and can be continued no earlier than 48 hours after, provided that renal function was found to be normal during the examination.
Kidney function
Since metformin is excreted by the kidneys, before starting treatment and regularly thereafter, it is necessary to determine creatinine clearance: at least once a year in patients with normal renal function, every 3-6 months in patients with creatinine clearance 45-59 ml/min and every 3 months in patients with creatinine clearance 30-44 ml/min.
In case of creatinine clearance less than 30 ml/min, the use of the drug is contraindicated.
Particular caution should be exercised in case of possible impairment of renal function in elderly patients, with dehydration (chronic or severe diarrhea, repeated bouts of vomiting), and with the simultaneous use of antihypertensive drugs, diuretics or non-steroidal anti-inflammatory drugs.
Heart failure
Patients with heart failure have a higher risk of developing hypoxia and renal failure.
Patients with chronic heart failure should have cardiac and renal function monitored regularly while taking metformin. Taking metformin in acute heart failure and chronic heart failure with unstable hemodynamic parameters is contraindicated.
Other Precautions
- Patients are advised to continue to follow a diet with even carbohydrate intake throughout the day. Overweight patients are recommended to continue to follow a hypocaloric diet (but not less than 1000 kcal/day). Patients should also exercise regularly.
— Patients should inform their doctor about any treatment they are undergoing and any infectious diseases such as colds, respiratory tract infections or urinary tract infections.
— It is recommended that routine laboratory tests be performed regularly to monitor diabetes mellitus.
— Metformin, when used alone, does not cause hypoglycemia, but it is recommended to exercise caution when using it in combination with insulin or other oral hypoglycemic agents (for example, sulfonylurea derivatives or repaglinide, etc.). Symptoms of hypoglycemia include weakness, headache, dizziness, increased sweating, rapid heartbeat, blurred vision, or difficulty concentrating.
— It is necessary to warn the patient that the inactive components of the drug Glucophage® Long can be excreted unchanged through the intestines, which does not affect the therapeutic activity of the drug.
Pharmacodynamics and pharmacokinetics
Metformin is a biguanide with a hypoglycemic effect that can reduce the concentration of glucose in the blood plasma. However, it does not stimulate the production of insulin , and therefore does not cause hypoglycemia . During treatment, peripheral receptors become more sensitive to insulin, and glucose utilization by cells increases. The synthesis of glucose by the liver is reduced due to inhibition of glycogenolysis and gluconeogenesis. There was a delay in glucose absorption in the gastrointestinal tract.
The active component of the drug stimulates the production of glycogen by acting on glycogen synthase. The transport capacity of any membrane glucose transporters increases.
When treated with metformin, patients maintain body weight or notice a moderate decrease. The substance has a beneficial effect on lipid metabolism: reducing the level of total cholesterol, triglycerides and LDL.
Extended-release tablets are characterized by slow absorption. Therefore, the therapeutic effect lasts for at least 7 hours. The absorption of the drug does not depend on food and does not cause accumulation. Slight binding to plasma proteins is noted. Metabolism occurs without the formation of metabolites. The components are excreted unchanged through the kidneys.
Interaction
The development of lactic acidosis can be caused by a combination of the drug with iodine-containing radiocontrast agents. Therefore, 48 hours before and after radiological examination using iodine-containing radiopaque agents, it is recommended to discontinue Glucophage Long.
Concomitant use with drugs with an indirect hyperglycemic effect - hormonal agents or tetracosactide , as well as β2-adrenergic agonists, danazol, Chlorpromazine and diuretics can affect the concentration of glucose in the blood. Therefore, it is necessary to monitor its indicators, and, if necessary, adjust dosages.
In addition, in the presence of renal failure, diuretics contribute to the development of lactic acidosis . Combination with sulfonylurea derivatives , acarbose , insulin , and salicylates often causes hypoglycemia.
Combinations with amiloride , digoxin , morphine , procainamide , quinidine , quinine , ranitidine , triamterene , trimethoprim and vancomycin , which are secreted in the renal tubules, compete with metformin for tubular transport, which increases its concentration.
Side effects
During drug therapy, the development of lactic acidosis , megaloblastic anemia , and decreased absorption of vitamin B12 is possible.
Disturbances in the functioning of the nervous system and gastrointestinal tract are also possible: changes in taste, nausea, vomiting, pain, diarrhea, loss of appetite. Typically, such symptoms bother you at the beginning of treatment and gradually disappear. To prevent their development, patients are recommended to take metformin together or immediately after meals.
In rare cases, deviations in the activity of the liver and bile and the manifestation of allergic skin reactions .
Instructions for use Glucophage Long (Method and dosage)
The tablets are intended to be taken orally whole with a small volume of liquid. It is recommended to do this daily during dinner.
According to the instructions for use, the choice of dosage of extended-release tablets is carried out individually for a particular patient, taking into account blood glucose concentrations.
Glucophage Long 750 mg and 500 mg can be prescribed as mono- or combination therapy. It is important to strictly adhere to the prescribed dosages and regularly monitor blood sugar levels.
Reviews about Glucophage
Quite often, patients leave reviews about Glucophage Long 750 mg, since this is the dosage prescribed for the treatment of type 2 diabetes in its middle stage. However, most patients note sufficient effectiveness of the drug. There are often reports that when diabetics with high body weight took this medicine, they subsequently noticed a moderate reduction in weight to more acceptable levels.
As for Glucophage XR 500, the medicine in this dosage can be prescribed at the initial stage of treatment. In the future, a gradual increase in the dose is allowed until the most effective dose is selected.
It should be noted that any hypoglycemic drugs can only be prescribed by a specialist. In addition to competent drug treatment, the doctor will recommend changes in diet and exercise, which should be an integral part of the life of people suffering from diabetes. Only this approach will ensure a normal quality of life and not so acutely feel all the unwanted symptoms of this disorder.
Analogs
Level 4 ATX code matches:
Bagomet
Diaformin
Metformin
Formetin
Gliformin
Glucophage
Siofor
The main analogues of this drug:
- Siofor
- Glucophage Long
- Metformin
- Gliformin
- Merifatin
- Formetin
- Diasfor
- Metadiene
- Diaformin
- Rinformin
Price Glucophage Long, where to buy
The price of Glucophage Long 500 mg for 30 pieces per package is about 200 rubles.
- Online pharmacies in RussiaRussia
ZdravCity
- Glucophage Long tablets with prolong release.
750 mg 60 pcs. LLC Nanolek 459 rub. order - Glucophage long tablets prolong. 750 mg 30 pcs. Nanolek LLC
RUB 286 order
- Glucophage long tablets prolong. 500 mg 60 pcs. Merck Sante S.A.S./Nanolek LLC
RUB 323 order
- Glucophage Long tab. with prolong. release 1000 mg No. 60 LLC Nanolek
RUR 626 order
- Glucophage Long tablets prolonged action 500 mg 30 pcs. Nanolek LLC
167 RUR order
