Siofor: how to take, what to replace, contraindications

What is Siofor?

Siofor is an oral hypoglycemic (lowering blood glucose concentration) drug intended for the treatment of type II diabetes mellitus (non-insulin-dependent) by controlling blood sugar levels.

It is used in complex treatment along with diet, as well as special exercises for people with type 2 diabetes and obesity.

The active ingredient of this medication is metformin. Its pharmacological effect works by inhibiting the production of glucose (gluconeogenesis) in the liver. It reduces the absorption of glucose in the intestine. It also dulls the feeling of hunger and promotes weight loss.

Siofor is sometimes used with insulin or other medications, but not to treat type 1 diabetes.

Is Siofor prescribed if there is no diabetes?

The drug Siofor has proven itself as an effective means for weight loss. Therefore, many people who are overweight take this medicine for weight loss. As a rule, this happens without medical advice. You can buy Siofor without a prescription.

Metformin is a substance that allows you to lose weight without harming your health. There is a practice of using it for the treatment of childhood obesity (for patients over 10 years of age).

Today, research is already being conducted on the fact that Siofor allows you to prolong life. Moreover, this is true for both overweight and thin people. However, to date, these studies have not yet been completed.

What you need to know before you start taking Siofor

First of all, you should not take this medicine if you have an individual intolerance to the active and auxiliary substances of the drug Siofor.

Siofor should not be taken if you have:

• severe kidney disease;
• metabolic acidosis (high blood acid or acid-base imbalance) - this can increase the risk of infections and heart problems, and can also worsen kidney problems.

If you need to have an X-ray or any type of computed tomography (CT) scan that uses dye injected into veins, you may need to temporarily stop taking Siofor 2 days before and after such procedures.

If while taking Siofor you have any severe infection, chronic alcoholism, or if you are 65 years of age or older, then there is a risk of lactic acidosis - this is a dangerous accumulation of lactic acid in the blood.

With long-term use of Siofor, there is a deterioration in the absorption of vitamin B12 (cyanocobalamin), this is especially important for people suffering from anemia.

Controlling diabetes is important during pregnancy, and high blood sugar can cause complications for both mother and baby.

Siofor may stimulate ovulation in premenopausal women (the initial period of decreased ovarian function) and may increase the risk of unintended pregnancy.

Siofor: instructions for use

Siofor is produced by the German company Berlin-Chemie AG/Menarini Group. The main active ingredient is metformin. The price of Siofor is not overpriced, so the medicine is available for purchase even to low-income citizens of Russia. However, there are analogues of Siofor on sale, which are even lower in cost.

Analogues of the drug Siofor, which are produced in Russia:

• The company Akrikhin produces a drug called Gliformin.
• The Metformin-Richter company produces a drug called Gedeon Richter-RUS.
• The Pharmstandard-Leksredstva company will market a drug called Fermetin.
• The company Kanonpharma Production produces a drug called Metformin Canon.

Siofor has been used to treat patients with diabetes for many years. This allows us to realistically judge the high effectiveness of the drug. In addition to being prescribed to diabetics, Siofor is taken by obese people.

In addition to inexpensive analogues of domestic production, drugs from foreign companies can be found on the pharmacological market.

These include:

• The French company Merk produces a drug called Glucophage.
• The German company Worwag Pharma produces a drug called Metfogamma.
• The Bulgarian company Sopharma offers diabetics the drug Sophamet.
• The Israeli company Teva produces the drug Metformin-Teva.
• The Slovak company Zentiva produces the drug Metformin Zentiva.

Contraindications to the use of the drug Siofor

If you have a history of one or more of the following health conditions, Siofor suitable

• kidney disease;
• liver diseases;
• heart problems such as congestive heart failure;
• ketonuria (increased levels of ketones in urine);
• ketoacidosis (high levels of ketones in the blood).

You should not take Siofor if you are pregnant or if you are breastfeeding.

Siofor is prohibited for use in children under 10 years of age. At the age of 10 to 12 years, the drug should be taken with caution under the strict guidance of a doctor.

The influence of Siofor on internal organs and hormonal levels

If the patient has fatty liver hepatosis, then taking Siofor will help get rid of this disorder. This is only possible if the person follows a low-carbohydrate diet. If the patient has hepatitis, then you should definitely consult with a specialist regarding the possibility of taking the medicine.

Siofor helps normalize blood sugar levels and helps prevent the development of kidney failure. However, if a person already has kidney disease, then taking metformin is contraindicated for him. Therefore, before starting treatment you need to undergo appropriate tests.

Siofor is a drug that allows you to lose weight. If a person is healthy, then this medicine is not able to cause any problems with the kidneys and liver.

When women take Siofor to treat polycystic ovary syndrome, their hormonal levels improve.

Directions for use and dosage of Siofor

Siofor is available in dosages of 0.5 g (500 mg), 0.85 g (850 mg) and 1 g (1000 mg).

Usual Adult Dose for Type 2 Diabetes:

Initial dose: 500 mg orally 2 times a day or 850 mg orally 1 time a day, or half a tablet (1/2) at a dosage of 1000 mg, divided into two doses per day.

If necessary, increase the dose, but always gradually - this will help avoid side effects from the gastrointestinal tract.

Depending on the level of glycemia (blood glucose) as prescribed by the doctor, the dose may be:

• at a dose of 0.5 g - 3-4 tablets per day;
• at a dose of 0.85 g - 2-3 tablets. in a day;
• at a dose of 1 g - up to 2 tablets per day.

The maximum daily dose should not exceed 3 g per day, divided into three doses per day.

At the age of 12 to 18 years, the maximum daily dose of Siofor should not exceed 2 g per day, divided into 2-3 doses.

For complex treatment of type 1 diabetes mellitus:

To improve blood sugar control, Siofor can be combined with insulin. In this case, the dosage and use regimen is the same as in the treatment of non-insulin-dependent diabetes (type 2).

Siofor: all the features of treatment

Taking Siofor depending on food

The drug is taken either with meals or immediately after meals. If you take the pill in advance, this increases the risk of side effects from the digestive system. For example, a person may experience diarrhea, increased flatulence, etc.

If the patient suffers from a decrease in glucose levels in the morning, then doctors recommend taking Siofor in the evening before going to bed. Moreover, preference should be given to a drug based on metformin with a prolonged action, for example, the drug Glucophage Long.

How long should treatment last?

If a woman suffers from polycystic ovary syndrome, then she will need to take the drug until she manages to get rid of the problem. After pregnancy occurs, treatment is stopped.

If Siofor is prescribed for the treatment of type 2 diabetes mellitus, then it should be long-term. Therapy often lasts throughout life. If you refuse treatment, the person will begin to gain weight, and the disease will progress.

There is no need to worry about prolonged use of the drug. This will not harm your health, but, on the contrary, will help preserve it. Moreover, for patients with diabetes, treatment is a vital necessity.

To avoid B12-deficiency anemia, which can develop due to prolonged treatment with Siofor, doctors recommend drinking vitamin B12 once or twice a year. In this case, you cannot refuse the main treatment.

Is it possible to take the drug at intervals of one day?

If you take Siofor every other day, you will not be able to achieve a lasting decrease in blood sugar. You will also not be able to lose extra pounds. Therefore, you need to strictly follow your doctor’s recommendations and take the drug according to the instructions, that is, daily.

The initial dose of the drug should be from 50 to 850 mg per day. It will take time to bring it to the maximum allowable.

Siofor and alcohol

When treated with Siofor, you can drink alcohol, but in small quantities. However, we are talking specifically about small doses of alcohol. If you neglect this recommendation, then the likelihood of developing severe side effects, in particular lactic acidosis, increases. This condition is life-threatening. Therefore, it is strictly prohibited to abuse alcoholic beverages.

At the same time, treatment with Siofor does not force a person to give up alcohol forever. If there are no other contraindications to its use, then it is allowed to occasionally drink a small portion of alcoholic beverages. At the same time, there is no dependence on the time of taking the drug in relation to drinking alcohol, that is, it is permissible to drink alcohol almost immediately after taking the next dose.

Maximum daily dose of Siofor

As mentioned above, starting treatment with high daily doses is prohibited. When the body adapts, the patient will need to take one tablet three times a day, during main meals. A single dose is 850 mg.

If a person takes a long-acting drug, then the maximum daily dose of metformin is reduced to 2000 mg. You should take the drug before bedtime, once a day. This will prevent a morning spike in blood sugar.

Often people take Siofor on their own to slow down the aging of the body. In this case, there is no need to take the maximum daily dose of the drug. It is enough to limit yourself to 500-1700 mg per day. There is currently no updated information about taking Siofor against aging.

Hypothyroidism and Siofor: features of administration

Hypothyroidism is not a contraindication for taking Siofor. The drug allows you to lose weight, but it is not able to solve the problem of hormone deficiency in the body.

Hypothyroidism is treated by an endocrinologist. It is he who must select hormonal therapy, which is based on the diagnostic data of a particular patient.

Also, people with hypothyroidism need to follow a diet, removing from their menu foods that can cause deterioration in well-being. Treatment can be supplemented by taking vitamin and mineral complexes.

Preventive use of Siafor

Prevention of type 2 diabetes involves following a low-carbohydrate diet. Not a single drug, including the most expensive, can prevent the development of this disease if a person eats junk food.

Following the principles of a healthy diet and maintaining a healthy lifestyle is the most effective prevention of not only diabetes, but also high blood pressure, atherosclerosis and other pathologies.

What should you not do while taking Siofor?

Excessive alcohol consumption should while taking Siofora, since alcohol-containing drinks increase the decrease in blood sugar, as a result of which the risk of developing lactic acidosis (a complication of diabetes mellitus, accompanied by the accumulation of lactate in the blood due to lack of insulin) may increase.

It is worth remembering that although Siofor is used in complex treatment for type 1 diabetes, it is strictly not recommended to take it independently as an auxiliary therapy without a doctor’s prescription.

Taking Siofor affects the functioning of the liver. Is it true?

In fact, Siofor is not prescribed to patients with liver cirrhosis and other serious diseases of the hepatobiliary system. In general, diabetes mellitus, which is complicated by liver pathologies, is very difficult to treat.

At the same time, Siofor can be used to treat patients with fatty liver hepatosis. In parallel, the patient will need to adhere to a low-carbohydrate diet.

Regarding the question regarding the effect of Siofor on the liver, fried and smoked foods and alcoholic beverages cause much more harm to the organ. If you switch to proper nutrition, which is devoid of harmful food additives, then the liver will definitely respond with health.

What are the side effects of Siofor?

Common side effects of Siofor may include:

• hypoglycemia (low blood sugar);
• disturbance of taste sensations;
• digestive disorders (nausea, vomiting, metallic taste, diarrhea).

Some people taking this medication are at risk of developing lactic acidosis, which can be fatal. contact an ambulance as soon as possible if you have one or more symptoms of this condition:

• unusual muscle pain;
• feeling cold;
• labored breathing;
• dizziness;
• feeling very tired;
• sharp pain in the abdomen;
• vomit;
• slow or irregular heartbeat.

What drug can replace Siofor?

Finding a replacement for the drug Siofor is quite problematic, because its main active ingredient (metformin) can be called unique. Sometimes taking Siofor does not reduce blood sugar levels to the desired levels. Most likely, this indicates that the patient has advanced diabetes, or type 2 diabetes has turned into type 1 diabetes. In this case, no glucose-lowering drugs will help the patient. Insulin injections will be required. The pancreas has completely used up all its reserves and is no longer able to produce insulin. A person begins to lose weight sharply and develops complications of diabetes. If insulin therapy is not started in time, the patient will die.

Sometimes patients want to replace Siofor not because it does not help, but because the drug causes negative reactions from the body, for example, diarrhea. In this case, you can try switching to Glucophage Long. Smoothly increasing the dose will help get rid of digestive problems. In general, observations show that severe diarrhea develops in patients who did not comply with this rule and immediately began taking the maximum daily dose of the drug.

Symptoms and consequences of an overdose of Siofor

an overdose of this drug may occur These conditions are accompanied by symptoms such as:

• gastrointestinal problems (severe abdominal pain, nausea, vomiting, diarrhea);
• confusion, severe weakness;
• decrease in body temperature;
• bradycardia (decreased heart rate);
• decrease in blood pressure.

If you notice at least one of the symptoms presented above, you need to immediately go to an ambulance followed by hospitalization for timely medical care, which involves hemodialysis (blood purification) to remove excess lactic acid from the body.

Interaction of Siofor with other drugs and substances

Many medications can interact with Siofor, making it less effective or increasing the risk of lactic acidosis.

List of drugs that may interact with Siofor:

• X-ray contrast agents - increase the cumulation (accumulation) of Siofor and increase the risk of lactic acidosis;
• danazol (synthetic male hormone - androgen) - can lead to hyperglycemia (high blood sugar);
• nifedipine (a drug that lowers blood pressure), cimetidine (anti-ulcer) - slow down the elimination of Siofor from the body;
• other hypoglycemic agents - the effect of hypoglycemia is enhanced;
• indirect anticoagulants - Siofor weakens their effect;
• furosemide (diuretic) - Siofor reduces its concentration in the blood plasma.

Note!

The combined use of Siofor and alcohol increases the risk of developing a complication of diabetes, called lactic acidosis. This condition can be fatal.

This list of joint interactions with Siofor is not complete; for more detailed information, you should consult a medical specialist.

Siofor® 500 (Siofor® 500)

Treatment with Siofor® 500 should be accompanied by diet correction and increased physical activity (in the absence of contraindications).

Lactic acidosis

Lactic acidosis is a rare but serious complication, most often occurring in the setting of acute deterioration of renal function, cardiopulmonary disease, or sepsis. Accumulation of metformin against the background of acute deterioration of renal function increases the risk of lactic acidosis.

If dehydration occurs (severe diarrhea or vomiting, fever or decreased fluid intake), you should temporarily stop treatment with metformin and consult a doctor.

Treatment of patients taking metformin with drugs that can acutely worsen renal function (such as antihypertensive drugs, diuretics or NSAIDs) should be initiated with caution.

Other associated risk factors for lactic acidosis should be considered, such as decompensated diabetes mellitus, ketosis, prolonged fasting, excessive alcohol consumption, liver failure, severe infectious disease and any other condition associated with severe hypoxia, as well as concomitant use with drugs that may lead to lactic acidosis (see sections “Contraindications” and “Interaction with other drugs”). This may help reduce the incidence of lactic acidosis.

Patients and/or caregivers should be informed of the risk of lactic acidosis.

Lactic acidosis is characterized by severe malaise with general weakness, acidotic shortness of breath, abdominal pain, muscle cramps, severe asthenia and hypothermia followed by coma. If suspicious symptoms occur, the patient should stop taking metformin and seek immediate medical attention.

Diagnostic laboratory parameters are a decrease in blood pH (less than 7.35), lactate content in the blood plasma over 5 mmol/l, increased anion gap and lactate/pyruvate ratio.

Doctors should warn patients about the risk of developing and symptoms of lactic acidosis.

Administration of iodinated contrast agents

Intravascular administration of iodinated contrast agents can lead to nephropathy and accumulation of metformin, which increases the risk of developing lactic acidosis. The use of metformin should be stopped 48 hours before such a procedure and resumed no earlier than 48 hours after it, provided that the examination did not reveal renal dysfunction (see section “Interaction with other drugs”).

Surgical operations

The use of metformin should be discontinued 48 hours before surgery under general, spinal or epidural anesthesia and can be continued no earlier than 48 hours after surgery, provided that the examination did not reveal impaired renal function.

Kidney function

Since metformin is excreted by the kidneys, before starting treatment and regularly thereafter, it is necessary to determine QC:

• at least once a year in patients with normal renal function;
• every 3-6 months in patients with CC 45-59 ml/min and every 3 months with CC 30-44 ml/min.

When CC is less than 30 ml/min, the use of the drug is contraindicated. Treatment with metformin should be suspended in the presence of conditions that may affect renal function.

Particular caution should be exercised in case of possible impairment of renal function in elderly patients (due to the asymptomatic nature), with simultaneous use of antihypertensive drugs, diuretics or NSAIDs.

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 heart failure with unstable hemodynamic parameters is contraindicated.

Children and teenagers

The diagnosis of type 2 diabetes mellitus must be confirmed before starting treatment with metformin.

In clinical studies lasting 1 year, metformin was shown to have no effect on growth and puberty. However, due to the lack of long-term data, careful monitoring of the subsequent effects of metformin on these parameters in children, especially during puberty, is recommended. Clinical experience with metformin in children aged 10 to 12 years is limited, so the most careful monitoring is necessary in children in this age group.

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; Inform your doctor if you are undergoing any treatment or any infectious diseases such as colds, respiratory or urinary tract infections.

— It is recommended to regularly carry out standard laboratory tests to control diabetes mellitus.

— Metformin in monotherapy does not cause hypoglycemia, however, it is recommended to exercise caution when using it in combination with insulin or other hypoglycemic agents (for example, sulfonylurea derivatives, repaglinide, etc.).

The use of the drug in patients with prediabetes is recommended in the presence of additional risk factors for the development of overt type 2 diabetes mellitus, which include: age less than 60 years, body mass index (BMI) > 30 kg/m2, history of gestational diabetes mellitus, family history of diabetes mellitus in first-degree relatives, increased concentration of triglycerides, decreased concentration of HDL cholesterol, arterial hypertension.

Metformin did not affect fertility in male or female rats when administered at doses three times the maximum recommended daily dose for humans.