Metformin: instructions for use, analogues, price and reviews

Metformin is a class substance. biguanides, its mechanism of action is manifested due to inhibition of the gluconeogenesis process in the liver, it reduces the absorption of glucose from the intestine, enhances the process of peripheral glucose utilization, increases the degree of tissue sensitivity to action insulin. Does not affect the process of insulin secretion by beta cells of the pancreas, does not provoke manifestations of hypoglycemic reactions. As a result, it stops hyperinsulinemia, which is an important factor contributing to weight gain and the progress of vascular complications in diabetes. Under its influence, body weight stabilizes or decreases.

The tool reduces the content in bloodtriglyceridesand linoproteinslow density. Reduces the rate of fat oxidation, inhibits the production of free fatty acids. Its fibrinolytic effect is noted, inhibiting PAI-1 and t-PA.

The drug suspends the development of proliferation of smooth muscle elements of the vascular wall. Positive effect on the state of the cardiovascular system, prevents the development diabetic angiopathy.

Pharmacokinetics and pharmacodynamics

After Metformin is taken orally, the highest concentration is observed in plasma after 2.5 hours. In people who receive the drug in maximum doses, the highest content of the active component in the plasma was not higher than 4 μg / ml.

Absorption of the active component stops 6 hours after administration. As a result, plasma concentration decreases. If the patient takes the recommended doses of the drug, then after 1-2 days a stable constant concentration of the active substance is observed in the plasma at the border of 1 μg / ml or less.

If the medicine is taken during the meal, then the absorption of the active component decreases. It accumulates mainly in the walls of the digestive tube.

Its half-life is approximately 6.5 hours. The bioavailability level in healthy people is 50-60%. With plasma proteins, its relationship is negligible. About 20-30% of the dose comes out through the kidneys.

Indications for use of Metformin

The following indications for the use of Metformin are determined:

  • type 1 and type 2 diabetes.

The medicine is prescribed as an additional remedy for the main treatment with insulin, as well as other anti-diabetes drugs. Also prescribed as monotherapy.

The use of the drug is recommended if the patient suffers concomitant obeseif the patient needs to control blood glucose, and this cannot be achieved with diets or physical activity.

The tool is also used for polycystic ovary, but this can only be done under the strict supervision of a physician.

Contraindications

The following contraindications for the use of the drug Metformin are determined:

  • patient age up to 15 years,
  • high degree of sensitivity to the active ingredient or other components of the drug,
  • severe kidney disease (dysfunction, failure),
  • diabetic precoma
  • gangrene,
  • diabetic ketoacidosis,
  • dehydration (in case of constant vomiting and diarrhea),
  • diabetic foot syndrome
  • myocardial infarction in acute form
  • dehydration, severe infectious diseases, shock and other conditions that can lead to impaired renal function,
  • adrenal insufficiency
  • liver failure,
  • a diet in which a person consumes no more than 1000 kcal per day,
  • lactic acidosis,
  • chronic alcoholism,
  • diseases in which the patient has tissue hypoxia,
  • fever,
  • intravenous or intraarterial administration of radiopaque drugs in which there is iodine,
  • alcohol poisoning,
  • pregnancy and period breast feeding.

Side effects

Most often, when taking the drug, side effects in the functions are manifested digestive system: nausea diarrheavomiting, abdominal pain, worsening appetiteThe appearance of a metallic taste in the mouth. As a rule, such reactions develop at the first time of taking the drug. In most cases, they disappear on their own with further use of the drug.

If a person has a high sensitivity to the drug, the development of erythema is possible, but this only happens in rare cases. With the development of a rare side effect - moderate erythema - it is necessary to cancel the reception.

With prolonged treatment, some patients experience a worsening of the absorption process. Vitamin B12. As a result, its level in serum decreases bloodthat may lead to violation hematopoiesis and development megaloblastic anemia.

Metformin tablets, instructions for use (method and dosage)

It is necessary to swallow the tablets whole and drink them with plenty of water. They drink the medicine after eating. If it is difficult for a person to swallow a 850 mg tablet, it can be divided into two parts, which are taken immediately, one after the other. Initially, a dose of 1000 mg per day is taken, this dose should be divided into two or three doses to avoid side effects. After 10-15 days, the dose is gradually increased. The maximum allowed intake of 3000 mg of medication per day.

If older people take Metformin, they need to constantly monitor their kidneys. Full therapeutic activity can be obtained after two weeks after the start of treatment.

If necessary, start taking Metformin after taking another hypoglycemic drug for oral administration, you must first stop treatment with such a drug, and then start taking Metformin in the specified dosage.

If the patient combines insulin and Metformin, then in the first few days you should not change the usual dose of insulin. Further, the dose of insulin can gradually be reduced under the supervision of a physician.

Directions Metformin Richter

The doctor sets the dose of the medicine, it depends on the patient’s blood glucose. When taking 0.5 g tablets, the initial dose is 0.5-1 g per day. Further, the dose can be increased if necessary. The highest dose per day is 3 g.

When taking 0.85 g tablets, the initial dose is 0.85 g per day. Further, if necessary, it is increased. The highest dose is 2.55 g per day.

Overdose

In case of an overdose, some side effects may occur, which is why tablets are recommended to be taken only at the specified dose. When taking Metformin in a dosage of 85 g, an overdose case was recorded, as a result of which lactic acidosis developed, in which vomiting, nausea, muscle pain, diarrhea, and abdominal pain were noted. If assistance is not provided in a timely manner, development is possible dizziness, impaired consciousness and coma. The most effective method of eliminating metformin from the body is hemodialysis. Next, symptomatic therapy is prescribed.

Interaction

Metformin and sulfonylurea derivatives should be carefully combined due to the risk of hypoglycemia.

The hypoglycemic effect is reduced when taking systemic and local glucocorticosteroids, glucagon, sympathomimetics, gestagens, adrenaline, hormones thyroid gland, estrogenderivatives of nicotinic acid, thiazide diuretics, phenothiazines.

While taking Cimetidine The elimination of metformin from the body slows down, as a result, the risk of manifestation of lactic acidosis increases.

The hypoglycemic effect is potentiated by β2-adrenoreceptor antagonists, angiotensin-converting factor inhibitors, clofibrate derivatives, monoamine oxidase inhibitors, non-steroidal anti-inflammatory drugs and oxytetracycline, cyclophosphamidederivatives of cyclophosphamide.

When using intraarterial or intravenous contrast drugs with iodine content, which are used for X-ray studies, together with Metformin, the patient may develop renal failure, and also increases the likelihood of lactic acidosis. It is important to suspend the reception before such a procedure, during it and for two days after. Further, the drug can be restored when renal function is repeatedly assessed as normal.

When taking an antipsychotic chlorpropamazine in high doses, serum glucose increases and insulin release is inhibited. As a result, an increase in the dose of insulin may be necessary. But before that, it’s important to control your blood glucose.

To avoid hyperglycemiashould not be combined with Danazol.

With concomitant prolonged use with metformin Vancomycin, Amilorida, Quinine, Morphine, Quinidine, Ranitidine, Cimetidine, Procainamide, Nifedipine, Triamterena plasma concentration of metformin increases by 60%.

Metformin absorption slows down Guar and Cholestyramine, therefore, while taking these drugs, the effectiveness of metformin decreases.

Enhances the effect of internal anticoagulants, which belong to the class of coumarins.

Release form and composition

Enteric coated tablets, Metformin have a round shape, a biconvex surface and white color. The main active ingredient of the drug is metformin hydrochloride, its content in one tablet is 500 mg. Also, its composition includes auxiliary components, which include:

  • Crospovidone.
  • Talc.
  • Magnesium stearate.
  • Corn starch.
  • Methacrylic acid and methyl methacrylate copolymer.
  • Povidone K90.
  • Titanium dioxide.
  • Macrogol 6000.

Metformin tablets are packaged in a blister pack of 10 pieces. A cardboard pack contains 3 blisters (30 tablets) and an annotation for the use of the drug.

Mechanism of action

Metformin or dimethylbiguanide is part of the group of oral antidiabetic drugs, biguadins.

How does Metformin reduce blood glucose? It is worth noting that this expression is not entirely correct, the glucose level does not change, but rather is redistributed and not synthesized. This occurs as a result of several mechanisms. Firstly, Metformin inhibits the formation of glucose in the body. Quite the contrary, it stimulates its decay. This happens because Metformin blocks the formation of energy and oxygen in cells that synthesize glucose, due to which glucose breaks down without the participation of oxygen. Glucose enters the cells from the extracellular space, and the cells receive the necessary amount of glucose, and the excess part is simply destroyed.

Also Metformin, instructions for use, it describes in detail, stimulates the consumption of glycogen stores in the liver without lowering blood glucose levels. It turns out that Metformin simply helps redistribute glucose to where it is needed, blocks the mechanisms of formation of excess glucose and does not lead to a change in glucose levels in the body.

During diabetes, the amount of fatty acids increases, and body weight rises. Metformin blocks the formation of free fatty acids. Also, obesity can occur due to the constantly high level of insulin, thanks to the action of Metformin, insulin levels are reduced. This mechanism is very important for the prevention of complications on the vessels of the body.

Metformin helps increase the sensitivity of the body's cells to insulin, this helps to absorb glucose to organs and tissues that suffer from a lack of glucose during diabetes. When using the drug for more than a year, the patient feels a decrease in appetite and weight.

Metformin dilutes blood, reduces the level of bad fats, inhibits the thickening of the walls of blood vessels. This suggests the importance of Metformin in the prevention of vascular complications of diabetes. Thus, Metformin delays the onset of diabetic angiopathy. So you can judge the level of risk of a diabetic heart attack or stroke in the future by calculating the SCORE index, if cholesterol drops, the risk decreases.

Metformin, instructions for use, this indicates a positive effect on slowing the evolution of diabetes, acting on all pathological aspects of the disease.

After taking the drug, its maximum content in the blood is observed after 2-2.5 hours.

The correct intake of Metformin only before meals, because otherwise it will be worse absorbed from the intestines and will not reach a concentration at which the therapeutic effect occurs.

It is worth recalling that taking antidiabetic drugs makes sense only if the patient continues to adhere to the diet prescribed by the endocrinologist and does not practice a passive lifestyle, does sports, does exercises.

Special instructions

If monotherapy with Metformin is carried out, hypoglycemia is not observed. Therefore, the patient can work with precise mechanisms or drive vehicles. However, with a combination of taking the drug with insulin or with other drugs that are used to treat diabetes, it may occur hypoglycemia, which, in turn, leads to a violation of mental reactions and coordination of movements.

Do not prescribe tablets to people after reaching the age of 60, if they are physically hard working. In this case, lactic acidosis may develop.

Patients who take the drug need to determine the creatinine level in the blood before treatment and then, in the course of treatment, regularly. With a normal rate, this should be done once a year, with an increased initial level of creatinine, such studies should be carried out 2-4 times a year. Similar studies are carried out with similar frequency in older people.

If the patient is overweight, it is important to maintain a balanced diets.

After surgery, you can resume treatment after 2 days.

Experimental application

Recently, Metformin has been increasingly used in the experimental treatment of polycystic ovaries, non-alcoholic fatty liver disease, early puberty and other diseases related to insulin resistance, such as acromegaly, hypercorticism.

There are no exact data and scientific conclusions on the effect of Metformin on the above diseases, however, some doctors claim that after the administration of Metformin, the level of glucose and insulin decreases, but this is not enough to include the drug in the official protocol for treating the disease.

Metformin for polycystic ovary for the treatment of ovulation stimulation remains unofficial, as many studies of its effect on reproductive function have yielded various inaccurate results. Some doctors, using Metformin for polycystic ovary and secondary diabetes, notice an increase in pregnancy in patients taking Metformin, unlike those who do not. However, clomiphene is classically used to stimulate ovulation.

Analogs of Metformin

Metformin analogues are drugs Metformin Hydrochloride, Metformin Richter, Metformin teva, Bagomet, Formethine, Metfogamma, Glyformin, Metospanin, Siofor, Glycometer, Glycon, Vero Metformin, Orabet, Glyminfor, Glucophage, Novoformin. There are also a number of drugs with similar effects (Glibenclamide etc.), but with other active ingredients.

Innovation

MD Anderson Cancer Center conducted a large study that showed the effect of Metformin on pancreatic cancer prevention.The findings of the study showed that a 62% decrease in the risk of developing pancreatic cancer in study participants who took Metformin compared to a group of patients who did not take it. This led to the initiation of new research and the development of a program for the prevention of pancreatic cancer.

Metformin Slimming

Today, it has become popular among people who are overweight and obese without diabetes to take Metformin as a means for losing weight. There is a certain course of treatment with Metformin in order to burn excess weight. Endocrinologists do not advise their patient to take Metformin without diabetes mellitus and a decrease in the sensitivity of cells to insulin. Instructions for use write about it. But often, patients do this without consulting a doctor. This is a very dangerous practice.

Failure to follow the necessary diet with a low glucose content, ignorance of the required dose of the drug, can lead to many side effects, this is, firstly. Secondly, it is proved that Metformin does not affect the blood glucose level in healthy people, which means that only a mechanism to reduce the level of fatty acids will work in this case.

Metformin for weight loss, especially without a doctor’s prescription, is contraindicated.

A doctor can prescribe it only in case of prediabetes or with insulin resistance. But even in this case, diet and exercise are much more effective than the medication that Metformin is. Instructions for use do not describe the use of the drug for weight loss.

Instructions for use, setting the required dose

The drug is taken orally and washed down with water. If the tablet is 850 mg - it may be difficult to swallow, then you can divide the tablet into two parts. If side effects are observed after administration, to facilitate their relief, the daily dose can be divided into 2-3 doses.

The minimum daily dose is 1 gram, the maximum dose per day is 3 grams. Two to three weeks after the appointment of the drug, the dose may be increased. The full activity of the drug and its effect are observed after 10-15 days.

If you need to start taking Metformin instead of another antidiabetic drug, you should stop taking the first drug, and only then start taking Metformin, according to the dose.

The dose of insulin should be reduced if it is prescribed together with metformin. Both drugs potentiate the hypoglycemic properties of each other.

Symptoms and danger of overdose

An overdose of Metformin is extremely rare. In the literature, you can find a description of only one case when taking the drug at a dose of 75g. At the same time, the glucose level did not change, but lactic acidosis developed - a very dangerous condition in which the level of lactate in the blood becomes higher than 5 mmol / l. The first signs may be:

  • dizziness,
  • headache until the onset of migraine,
  • fever
  • interruptions in breathing
  • nausea,
  • vomiting
  • diarrhea,
  • stomach ache,
  • spasms in the muscles of the limbs.

Severe cases may result in the establishment of a coma and the need to connect to a ventilator.

In case of such symptoms, it is necessary to immediately hospitalize the patient and conduct all necessary tests that will show the level of lactate, pyruvate and their ratio in the blood.

For the rapid removal of Metformin from the body, it is rational to use hemodialysis.

Reviews about Metformin

Reviews about Metformin tablets from those patients who have diabetes indicate that the medicine is effective and allows you to control glucose levels. The forums also have reviews of the positive dynamics after treatment with this drug for PCOS. But most often there are reviews and opinions on how drugs Metformin Richter, Metformin teva and others allow you to control body weight.

Many users report that drugs containing metforminreally helped to cope with the extra pounds. But at the same time, side effects associated with gastrointestinal tract functions were very often manifested. In the process of discussing how metformin is used for weight loss, the opinions of doctors are mostly negative. They strongly advise against using it for this purpose, as well as drinking alcohol during the treatment process.

Metformin during pregnancy and lactation

During pregnancy, Metformin is strictly contraindicated. It can and should be taken before pregnancy for women with type 2 diabetes and obesity to increase the risk of conception and weight loss, but the drug should be discontinued when pregnancy occurs. Many doctors still prescribe Metformin during the first trimester, but this is fraught with complications for the fetus.

Subsequently, children whose mothers took Metformin during pregnancy will be at risk of developing obesity and diabetes. Therefore, it is proved that a woman should take Metformin during pregnancy only when absolutely necessary and inability to replace with another drug.

For pregnancy planning, Metformin earned the title “indispensable” among women with diabetes, overweight and polycystic ovary. Obese women are more likely to suffer from infertility. Metformin helps the body distribute glucose and reduces the level of fatty acids, thereby stabilizing the hormonal background and restoring the normal menstrual cycle.

When breastfeeding, it is also worth stopping the use of Metformin.

Metformin for children

In the twenty-first century, type II diabetes in children and adolescents became increasingly common. Moreover, the disease does not bypass children of different nationalities and social groups. Children around the world are prone to obesity and decreased tissue sensitivity to insulin. Recently, many programs have been developed for the non-pharmacological treatment of children with insulin-resistant diabetes, which include a balanced diet and physical activity. However, more and more have to resort to medical treatment. A passive lifestyle and an unhealthy diet rich in sugar and fats led to a sharp rejuvenation of the disease.

Metformin was initially contraindicated in children under 15 years of age. After a recent study by American doctors, in which children and adolescents aged 10-16 years took Metformin for 16 weeks, a significant decrease in the level of free fatty acids in the blood, a decrease in the level of low and very low density lipoproteins, triglycerides, and weight loss. Among the side effects, neither hypoglycemia nor lactic acidosis were observed, rare events in the form of nausea or diarrhea did not affect the results of the study.

The benefits of the use of Metformin in childhood have been proven, starting from 10 years without serious complications, but with good results and in the future to complete control of diabetes and reduce the dose to a minimum with the possibility of its cancellation.

Metformin's price, where to buy

Price Metformin in pharmacies depends on the drug and its packaging.

Price Metformin teva 850 mg averages 100 rubles per pack of 30 pcs.

Buy Metformin Canon 1000 mg (60 pcs.) Can be for 270 rubles.

How much is Metformin, depends on the number of tablets in the package: 50 pcs. You can buy at a price of 210 rubles. It should be taken into account when buying a drug for weight loss that it is sold by prescription.

Metformin and Vitamin B12

Vitamit B12 or cyanocobalomin is a substance necessary for hematopoiesis and the functioning of the nervous system; thanks to it, protein is synthesized in the body.

It is assumed that with prolonged use of Metformin, the drug disrupts the absorption in the ileum of this vitamin, which leads to a gradual decrease in it in the blood. In the fifth year of admission, the level of B12 decreases by 5% for the 13th year - by 9.3%.

It should be noted that a 9% deficiency does not lead to hypovitaminosis and the development of hemolytic anemia, but increases the risk of future development.

Deficiency of B12 results in hemolytic anemia, which means that red blood cells become fragile and quarrel right in the bloodstream. This leads to the development of anemia and jaundice. The skin and mucous membranes acquire a yellowish color, the patient complains of weakness, dry mouth, numbness of the legs and arms, dizziness, loss of appetite, impaired coordination.

In order to determine the level of vitamin B12, you need to do a general blood test to look at the shapes and sizes of red blood cells. With B12 deficiency hemolytic anemia, red blood cells will be larger than normal with the nucleus, anemia will be observed, and unbound bilirubin will be increased in the biochemical analysis of blood.

It is worth making up for the lack of vitamin B12 when taking Metformin. Your doctor may prescribe supplements and vitamin complexes.

A funny and logical coincidence, but the treatment of B12 deficiency is of course also carried out by administering a vitamin, only already intravenously.

Conclusions

Metformin is a well-studied drug used in many fields, created in the middle of the last century, and is still practically indispensable. Its effect on glucose metabolism changes the course of diabetes mellitus, preventing the development of vascular complications, which means it is an excellent prevention of acute myocardial infarction, ischemic and hemorrhagic strokes, diabetic angiopathy, neuropathy and nephropathy, and the development of diabetic foot. With the use of Metformin, the level and lifespan of diabetics has increased. New studies are carried out annually and more and more new possibilities of the drug are revealed, when it had several prescriptions, today it seems to be keeping pace with the whole world.

What is Metformin for?

Taking Metformin tablets is indicated to reduce the concentration of glucose in the blood with non-insulin-dependent type 2 diabetes mellitus in the absence of a therapeutic effect from diet correction. The drug is also used in combination with insulin for severe type 2 diabetes mellitus, especially in individuals with increased body weight.

Dosage and administration

Metformin tablets are taken orally with food or immediately after taking it. Do not chew the tablet and drink plenty of water. To reduce the likelihood of developing adverse reactions from the digestive system, the daily dose is taken, dividing into 2-3 doses. The doctor sets the dose and regimen of the drug individually, depending on the initial concentration of sugar in the blood, as well as therapeutic efficacy. Typically, the starting dose is 500-1000 mg per day (1-2 tablets). After 10-15 days, depending on the level of glucose concentration in the blood, it is possible to increase the dosage of Metformin tablets to 1500-2000 mg per day. The maximum daily dosage should not exceed 3000 mg. In older people, the maximum daily therapeutic dose should not exceed 1000 mg.

Side effects

Taking Metformin tablets can lead to the development of side effects from various organs and systems:

  • Digestive system - “metallic” taste in the mouth, nausea, periodic vomiting, abdominal pain, diarrhea, loss of appetite until its complete absence (anorexia), flatulence (increased gas formation in the intestinal cavity). Such side effects usually develop at the beginning of the course of treatment with the drug and disappear on their own. To reduce the severity of these symptoms as soon as possible, antacids, antispasmodics and atropine-like drugs are prescribed by the attending physician.
  • The endocrine system is hypoglycemia (a decrease in blood sugar concentration below normal).
  • Metabolism - lactic acidosis (increased concentration of lactic acid in the blood), malabsorption of vitamin B12 from the intestines.
  • Blood and red bone marrow - megaloblastic anemia (anemia associated with a violation of the formation and maturation of red blood cells in the red bone marrow due to insufficient intake of vitamin B) can rarely develop12).
  • Allergic reactions - skin rash and itching.

With the development of side effects after taking Metformin tablets, the doctor decides on the drug withdrawal individually, depending on their type and severity.

Doctors reviews about metformin

Rating 3.8 / 5
Efficiency
Price quality
Side effects

It helps some patients to start losing weight quite well, especially if obesity is associated with a large amount of carbohydrate intake. In some cases, it is possible to take the drug for prophylactic purposes.

Not everything is suitable, some patients may have pronounced side effects.

Take only as directed.

Rating 5.0 / 5
Efficiency
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Side effects

The mechanisms of action of Metformin are unique to other classes of oral antihyperglycemic drugs. Metformin lowers blood glucose by decreasing liver glucose production (gluconeogenesis), decreasing intestinal glucose absorption, and increasing insulin sensitivity by increasing peripheral glucose uptake.

In the intestine, Metformin enhances the anaerobic glucose metabolism in enterocytes (intestinal cells), which leads to a decrease in the net absorption of glucose and an increase in the delivery of lactate to the liver.

Rating 5.0 / 5
Efficiency
Price quality
Side effects

This drug has low toxicity, is prescribed in gynecology, endocrinology, gastroenterology, has a wide spectrum of action. Due to its properties, there is an improvement in the quality of life of patients with high weight, with diabetes mellitus, with a metabolic disorder syndrome, and is used in the treatment program for polycystic ovary syndrome against obesity, with infertility. Proven effectiveness in weight loss programs.

Rating 5.0 / 5
Efficiency
Price quality
Side effects

Metformin is an effective treatment for obesity. I use it as part of complex therapy in patients who are overweight. There are side effects such as allergic reactions, gastrointestinal upsets (diarrhea, nausea, bloating), and individual intolerance.

Side effects in the form of diarrhea.

In general, an effective drug for weight loss.

Rating 4.2 / 5
Efficiency
Price quality
Side effects

The drug has found high use in endocrinology. Effectively helps lower blood sugar in combination with other antidiabetic drugs. In the presence of a history of obesity, it effectively helps to reduce visceral fat.

The tablet size is very large. Often causes loose stools.

An individual selection of the dose of the drug is required. It is advisable to break the daily dose into 2 doses.

Rating 5.0 / 5
Efficiency
Price quality
Side effects

The drug "Metformin" is becoming very popular, occupies its own niche among drugs for weight loss. Very well established among gynecologists-endocrinologists. The main thing is to choose the right reception scheme. It is highly effective in the treatment of diabetes.

The tablet form of some manufacturers is very large and inconvenient to swallow.

Consult with an endocrinologist before use.

Rating 4.2 / 5
Efficiency
Price quality
Side effects

"Metformin" demonstrates new facets and increasingly strengthens its position. I use it in urology with success, the use of Metformin is accompanied by a decrease in viscero-abdominal fat deposition. Has some hemodynamic effects. The anticarcinogenic effect of Metformin is of great interest, especially in relation to prostate cancer.

I regularly take it for preventive purposes.

Rating 4.2 / 5
Efficiency
Price quality
Side effects

I like drugs that reduce weight, if they are prescribed wisely, especially true for varicose veins with a comprehensive fight against obesity.

A mindless prescription by many doctors, especially general therapists.

I tried to take it myself - from the side effects there was nausea, a little dizziness, quickly regressed in a day.

Rating 4.2 / 5
Efficiency
Price quality
Side effects

A very effective and worthy drug in relation to the treatment of endocrinological pathology (diabetes mellitus, impaired carbohydrate metabolism).

The likelihood of developing side effects, diarrhea is very high, and individual intolerance is also common.

It can be used as mono-therapy, or in conjunction with other drugs.

Rating 3.8 / 5
Efficiency
Price quality
Side effects

Effective. Subject to safety precautions - safe.

Often patients develop dyspeptic disorders and diarrhea. Weight is reduced to a certain level, and then without dynamics.

A classic drug for the treatment of type 2 diabetes mellitus both in monotherapy and in combination treatment. A positive effect on metabolic processes and with prolonged use contributes to weight loss.

Rating 3.8 / 5
Efficiency
Price quality
Side effects

The drug has proven itself in endocrinology for the treatment of diabetes and weight loss, as a result - lowering blood pressure.

As side effects - disorders in the gastrointestinal tract (decreased appetite, diarrhea).

It is indicated for patients with insulin resistance.

Rating 5.0 / 5
Efficiency
Price quality
Side effects

Over many years of use, the drug "Metformin" has proven to be a very effective tool in the fight against excess weight, this drug is also very effective in type 2 diabetes, especially in its initial stage. A drug with a proven clinical effect in a short time allows you to achieve the effect.

Rating 4.2 / 5
Efficiency
Price quality
Side effects

Good compatibility with other drugs. Highly effective treatment.

Tolerance is poor, the severity of side effects reduces compliance.

In the presence of insulin resistance, an excellent way to overcome it and reduce weight. Side effects (nausea, a sharp decrease in appetite) sometimes lead to self-cancellation by patients.

Rating 5.0 / 5
Efficiency
Price quality
Side effects

For many years, I have been actively prescribing metformin for disorders of carbohydrate metabolism (impaired tolerance to carbohydrates, type 2 diabetes mellitus), especially overweight, with sclerocystosis of the ovaries on the background of insulin resistance. In some countries, it is allowed to be used during pregnancy.

Of the side effects - more often diarrhea (at the beginning of treatment).

The drug from the biguanide group was once banned somewhere until the end of the 90s, but was at that time adept, could be found in pharmacies, well compensated for fasting hyperglycemia. Then metformin appeared and with it a real opportunity to help the diabetic.

Rating 5.0 / 5
Efficiency
Price quality
Side effects

"Metformin" - the drug of choice for type 2 diabetes in the onset of the disease, with low glycated hemoglobin, effectively solves the problems of carbohydrate metabolism disorders, overweight, and obesity. The drug increases the sensitivity of tissues to insulin, thereby improving the condition of the body in diseases accompanied by insulin resistance.

Rating 5.0 / 5
Efficiency
Price quality
Side effects

This is a new drug and at the moment is the most effective of the available analogues. It is applied once in the evening, completely the entire prescribed dose. When using the drug by patients, no side effects were noted.

In my practice I use the modern drug Metformin for the treatment of diabetes.

Rating 4.6 / 5
Efficiency
Price quality
Side effects

The drug effectively increases the sensitivity of receptors to insulin with insulin resistance. This condition accompanies many premenopausal and menopausal women, characteristic of polycystic ovary syndrome. I apply in practice after confirming the diagnosis using laboratory data. The drug also improves lipid profile.

Normalization of carbohydrate metabolism, of course, depends on a whole range of measures. One of the necessary conditions is the correction of micronutrient deficiencies, as well as polyunsaturated fatty acids in the diet.

Rating 4.2 / 5
Efficiency
Price quality
Side effects

Common side effects include loose stools and bloating. The drug is taken in the evening, in order to reduce the severity of side effects, it is recommended to avoid taking carbohydrate products in the evening (especially if the drug is prescribed to reduce weight, against the background of insulin resistance).

This drug is used by endocrinologists to treat the syndrome of insulin resistance, overweight (against the background of insulin resistance), diabetes mellitus. The drug should be prescribed exclusively by a doctor according to indications. In order to reduce weight in the absence of insulin resistance (its presence, again, is determined by the doctor), the drug will not work. Therefore, do not self-medicate, seek help from qualified specialists.

Rating 2.9 / 5
Efficiency
Price quality
Side effects

A drug with proven clinical efficacy, I actively use in the treatment of nutritional obesity, the activity of the drug in inhibiting the aging process, in the treatment of type 2 diabetes mellitus has been identified.

Sometimes there is nausea after taking, you can titrate the dose.

A good drug with proven action for little money.

Patient reviews about metformin

Because of diarrhea, the doctor transferred to Glucophage. There is also an active substance - metformin, but there are no such adverse reactions. Even flatulence was not at the beginning of the reception, and it is convenient to take it - only once a day.

The drug is good, indispensable in its niche - for the treatment of diabetes. A pleasant bonus in the form of a decrease in body weight of more than 1-2 kg, unfortunately, is observed only in one of 10-15 patients.

A reasonably acceptable drug both in price and in affordability in pharmacies in Moscow! I have been taking this drug for six months now, as type 2 diabetes was diagnosed, and it really helps. Real improvements are visible. Sugar has dropped almost to the required rate. After taking the drug and lowering sugar, my health improved. It is worth noting that after taking no side effects were noticed and this is another plus of this medicine! It turns out that this medicine, for me personally, has one plus. Price, availability, effect and lack of side effects. But, do not forget that any drug should be taken strictly as prescribed by the doctor.

So we found that same magic diet pill. A very effective drug that helps to lose weight. The drug was shown on the first channel in Elena Malysheva’s Live Healthy program, where she spoke in detail about this drug. Then I had a desire to get it, the effect is definitely present. If you read the instructions, you can see that the drug is primarily intended for those with diabetes in order to reduce blood sugar. You might think about diabetes and weight loss. It's all about insulin, when a person begins to obesity, it arises from an excess of insulin, the drug, in turn, makes the balance of insulin in the blood, and the person does not get fat. Finally, I got rid of extra pounds.

After 30 years, I began to actively gain weight. Although I strictly followed the rules of proper nutrition, sometimes I could afford something tasty. I passed the tests and in the end it turned out that I had type 2 diabetes. I was worried, but to my happiness, I turned to an experienced specialist who prescribed the necessary drugs for treatment, including Metformin. Metformin not only helped me with excess fat, it also helped lower sugar levels. And also with it, my appetite decreased and my nutrition became more balanced. I did not notice any side effects, since I followed the clear instructions for the use of this drug.

Because of type 2 diabetes, I gained a lot of excess, as much as 17 kg. I tried to lose weight with diets, but it was very difficult for me to control myself, therefore, as prescribed by the doctor, I also started to drink Metformin. But it did not work out because of a side effect. I switched to "Glucophage" 1000 mg. This drug reduces sugar levels, and also contributes to weight loss. Already in the first 3 months she lost 10 kg. She continued to take Glucofage and lost another 7 kg in 2 months. So for six months I put myself in order, and sugar returned to normal. Now I feel great, thanks to Glucofage!

My grandmother has diabetes. They tried a lot of drugs, did little to help, or helped, and then again all over again. Once I saw somewhere an advertisement of Metformin, we decided to consult a doctor. And finally, sugar began to decline, my grandmother began to feel better, and even lost weight.

He suffered from excess weight for a very long time (approximately 25 kg deviations from the norm). I could not lose weight for a long time, I tried a lot of different tools and techniques. I decided to go to the city hospital, where I learned from the doctor about the Metformin preparation. This drug helped me lose weight by 10 kg in 3.5 months and I continue to take it further without changing the dose. The price does not bite and is sold in many pharmacies in my city. I advise everyone who suffers from such an ailment.

For several weeks, eating various fast food, I recovered. My determination to lose weight has increased very much, I was advised the drug "Metformin". Of course, I, like everyone else, did not believe in the effectiveness of this tool. But rather, he really could surprise me, all because Metformin completely kills the feeling of hunger. I took it three times a day and lost a lot of excess weight. Surprisingly, there were no problems during use in vain. I was also surprised by its cost, because it is much cheaper than similar products. “Metformin” very well helped in solving my problem, because I started to reset already in the first week.

The drug is just excellent, I read about it a different number of reviews, both good and bad, but decided that I would try to use it on myself and believe the effectiveness. I liked the effect. After a course of taking the drug, I was quite able to notice tangible changes. My weight began to decrease gradually, I won’t say that I lost 20 kg, but the stable 4 per month were gone, this is a good indicator for me. The cost of the drug is within the range of availability, everything completely suits me.

My mom has type 2 diabetes. She took Metformin for 7 years, from 2008 to 2015. She got it for free, as prescribed by a doctor. Then she went to a private clinic, double-checked, so to speak. After passing the tests, the doctor in the strictest form banned taking this drug! In general, Metformin left 40% of the kidneys for mama! So think about how you pay for losing weight and lowering blood sugar.

I heard about Metformin from my mother’s friend a year ago. According to her stories, if you take Metformin before meals twice a day, do not eat sweets and generally cut back on carbohydrates, then the weight will go away faster. I don’t eat sweets at all, but if I kept on a diet, then a miracle didn’t happen. I read about it on the Internet and decided to take a chance, because a month later, going to sea. In the end, I drank these pills for 3-4 days. And it took me 3 kg. I was very happy about this. She even began to advise her friends. Of course, his side effects are not the most pleasant, his stomach was very painful after eating. That is why I did not continue to drink them. I was very happy with the result. In the winter I drank before the New Year holidays, also a couple of kilos left in a few days. Now I started drinking them again. I'm getting ready for vacation again. The result has not yet been tested. In general, if you take it for a short time, infrequently and in conjunction with a diet, then the result will not be long in coming!

I have type 2 diabetes, I have been taking Medformin for almost a year, my weight has not decreased, unfortunately. After the evening reception of Medformin, the zhor began. Now I take a second pill before bedtime, everything has become normal. In the morning, sugar from 6 to 7.2 holds. They also prescribed the drug "Jardins" 25mg., Dear: 2.900 per month.

Hello! This drug really helped me with obesity. Blood sugar was greatly increased and Metformin successfully normalizes it. The weight goes away gradually, took it for six months as prescribed by the doctor. It’s good that the price is reasonable and the medicine helps!

Acquired this tool, hoping that with its help I will be able to lose weight at least a little. The nutritionist made an advertisement for this remedy. Naturally, I did not lose 1 kg. Every day I go in for sports for an hour, eating only vegetables and fruits, while using these pills, for a month I could not throw off even 0.5 kg. I don’t even know who to blame and what to think about. Perhaps, prescribing this remedy to me, the nutritionist did not take into account any nuances. Maybe it helped someone, but not for me. In general, as a result, a waste of money and futile hopes.

I have type 2 diabetes. I have been taking Metformin in combination with insulin injections for about a year. This drug lowers blood sugar well, recently I had a serious interruption in the supply of insulin. Two weeks had to take one "Metformin" and he pleased me with his quality work. And I also have a liver disease, in this regard, I learned the doctor’s opinion on how Metformin affects my diseased liver. He pleased me, saying that everything is in order, do not be discouraged - it does not have a pronounced effect. In general, I personally am pleased with the drug. But people are all different and everyone’s body is different so look, think, consult with doctors.

I took Metformin as prescribed by the endocrinologist. The main goal was to lose those extra pounds. My sugar was normal, though it fluctuated on the upper border. Moreover, the glucose tolerance test did not reveal any abnormalities, glycated hemoglobin did not exceed normal values. Since the beginning of taking Metformin and a low-carb diet, I have already lost ten kilograms. At the same time, the condition of the skin on the face has also significantly improved, the number of blackheads has decreased, the skin is not as greasy as before. In addition, sugar decreased slightly.

I have type 2 diabetes. He took glibenclamide for a long time, and more recently he switched to metformin. I agree that the medicine is easily tolerated, affordable. Blood sugar has decreased to normal, the condition has improved.

I have diabetes, thank God, no. However, from childhood I tend to be overweight. As soon as I didn’t fight, I’m still round. My best friend is also my attending physician. Also chubby. She once said that we will now drink Metformin to lose weight. There is no reason to distrust her; they began to drink a tablet a day. A month later, I quit, it didn’t work for me, I was sick and my head was spinning. But a friend survived, drank it for about six months, and her weight steadily decreased by droplets. As a result, it decreased by 9 kg. Diabetes is also not sick. In no case, I do not advise anyone, although the doctor herself used this method, I just share the experience of using metformin.

At the next physical examination, they revealed elevated blood sugar (against the background of extreme stress). The doctor recognized type 2 diabetes. Prescribed drug - metformin. I have been taking it for six months now. Against the background of the diet and the action of the drug, sugar decreased to the norm. The medicine is easily tolerated, available in pharmacies and at a price. True, metformin has a slight laxative effect. And taking the drug helped me lower my blood pressure and “lose” 11 kg of excess weight. I continue treatment without increasing the dose of the drug.

Metformin helped me overcome insulin resistance. She was short and did not affect my weight. But because of her, there were problems with the ovaries. With the use of metformin, the reproductive system returned to normal, I was able to get pregnant.

The composition and form of the drug

The tablets, coated with a white film coating, are oblong, biconvex, with a notch on one side, in a cross section - a homogeneous white or almost white mass.

1 tab
metformin hydrochloride850 mg

Excipients: povidone (collidone 90F) - 34 mg, magnesium stearate - 8.5 mg.

The composition of the film membrane: hypromellose - 6.8 mg.

10 pieces. - blister packs (3) - packs of cardboard.
10 pieces. - blister packagings (6) - packs of cardboard.
30 pcs - cans of polyethylene (1) - packs of cardboard.
60 pcs. - cans of polyethylene (1) - packs of cardboard.

Short description

Diabetes mellitus is one of the most serious problems of modern medicine. He is raised to this rank by the high cost of treatment, frequent and severe (up to disability) complications, and high mortality. So, among patients suffering from type 2 diabetes, mortality is 2-3 times higher than that in the general population. The oral hypoglycemic drug metformin is designed to fight just the same with this ailment, "sweet" in sound, but by no means a fact of it. Today, this drug cannot be called a kind of innovative breakthrough: it has been introduced into endocrinological practice since the late 50s. last century. Currently, metformin is, without exaggeration, the most commonly prescribed tablet sugar-lowering drug. The mechanism of its action is almost completely laid out on the shelves, and this also plays a plus for him. Metformin inhibits the process of gluconeogenesis (glucose synthesis) in the liver, reduces the absorption of glucose in the small intestine, increases the ability of peripheral tissues to utilize glucose, and increases the receptor sensitivity of tissues to insulin. Most importantly, the drug does not affect the production of its own insulin by the pancreas and does not cause hypoglycemic reactions characteristic of some sugar-lowering drugs (the extreme degree of which may be hypoglycemic coma).

Other pharmacological effects of the drug include a decrease in the concentration of triglycerides and “bad” lipoproteins (LDL) in the blood, stabilization (and in some cases even a decrease) in the patient’s own weight, and fibrinolytic (antithrombic) action.

The dose of metformin is determined by the doctor in each case and depends on the initial level of glucose in the blood. According to general recommendations, the drug begins to be taken with 500-1000 mg (which is equivalent to 1-2 tablets). After 10-14 days, it is allowed to increase the dose, based on the current indicators of its concentration in the blood. The maintenance dose of metformin ranges from 1500-2000 mg, the maximum is 3000 mg. Elderly patients are a special case. First of all, it should be noted that in people in their seventies, who, despite their years, continue to engage in heavy physical labor, metformin can cause lactic acidosis. In this regard, taking the drug in such patients is contraindicated. In other cases, the elderly should take no more than 1000 mg of metformin per day. Tablets are recommended to be taken with food or immediately after it with a glass of water. The daily dose is usually divided into 2-3 doses.

Pharmacology

Oral hypoglycemic agent from the group of biguanides (dimethylbiguanide). The mechanism of action of metformin is associated with its ability to suppress gluconeogenesis, as well as the formation of free fatty acids and the oxidation of fats. Increases the sensitivity of peripheral receptors to insulin and the utilization of glucose by cells. Metformin does not affect the amount of insulin in the blood, but changes its pharmacodynamics by reducing the ratio of bound insulin to free and increasing the ratio of insulin to proinsulin.

Metformin stimulates glycogen synthesis by acting on glycogen synthetase. Increases the transport capacity of all types of membrane glucose transporters. Delays intestinal absorption of glucose.

Reduces the level of triglycerides, LDL, VLDL. Metformin improves the fibrinolytic properties of blood by suppressing a tissue-type plasminogen activator inhibitor.

While taking metformin, the patient's body weight either remains stable or decreases moderately.

Drug interaction

With simultaneous use with sulfonylurea derivatives, acarbose, insulin, salicylates, MAO inhibitors, oxytetracycline, ACE inhibitors, with clofibrate, cyclophosphamide, the hypoglycemic effect of metformin may be enhanced.

With simultaneous use with GCS, hormonal contraceptives for oral administration, danazol, epinephrine, glucagon, thyroid hormones, phenothiazine derivatives, thiazide diuretics, nicotinic acid derivatives, a decrease in the hypoglycemic effect of metformin is possible.

In patients receiving metformin, the use of iodine-containing contrast agents for diagnostic tests (including intravenous urography, intravenous cholangiography, angiography, CT) increases the risk of acute renal dysfunction and lactic acidosis. These combinations are contraindicated.

Beta 2 -adrenomimetics in the form of injections increase the concentration of glucose in the blood due to the stimulation of β 2 -adrenoreceptors. In this case, it is necessary to control the concentration of glucose in the blood. If necessary, it is recommended to prescribe insulin.

Concomitant use of cimetidine may increase the risk of lactic acidosis.

The simultaneous use of "loop" diuretics can lead to the development of lactic acidosis due to possible functional renal failure.

Concurrent administration with ethanol increases the risk of lactic acidosis.

Nifedipine increases the absorption and C max of metformin.

Cationic drugs (amiloride, digoxin, morphine, procainamide, quinidine, quinine, ranitidine, triamteren, trimethoprim and vancomycin) secreted in the renal tubules compete with metformin for tubular transport systems and can increase its C max.

Pregnancy and lactation

Adequate and strictly controlled studies of the safety of metformin during pregnancy have not been conducted. Use during pregnancy is possible in cases of emergency, when the expected benefit of therapy for the mother outweighs the possible risk to the fetus. Metformin crosses the placental barrier.

Metformin in small amounts is excreted in breast milk, while the concentration of metformin in breast milk can be 1/3 of the concentration in the mother’s plasma. Side effects in newborns during breastfeeding while taking metformin were not observed. However, due to the limited amount of data, the use during breastfeeding is not recommended. The decision to stop breastfeeding should be made taking into account the benefits of breastfeeding and the potential risk of side effects in the baby.

Preclinical studies have shown that metformin does not have teratogenic effects in doses that are 2-3 times higher than the therapeutic doses used in humans. Metformin does not have a mutagenic potential, does not affect fertility.

Dosage

It is taken orally, during or after a meal.

The dose and frequency of administration depends on the dosage form used.

With monotherapy, the initial single dose for adults is 500 mg, depending on the dosage form used, the frequency of administration is 1-3 times / day. It is possible to use 850 mg 1-2 times / day. If necessary, the dose is gradually increased with an interval of 1 week. up to 2-3 g / day.

With monotherapy for children aged 10 years and older, the initial dose is 500 mg or 850 1 time / day or 500 mg 2 times / day. If necessary, with an interval of at least 1 week., The dose can be increased to a maximum of 2 g / day in 2-3 doses.

After 10-15 days, the dose must be adjusted based on the results of determination of glucose in the blood.

In combination therapy with insulin, the initial dose of metformin is 500-850 mg 2-3 times / day. The dose of insulin is selected based on the results of determination of glucose in the blood.

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