Metformin hydrochloride

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[met-FOR-min] Pregnancy Category: B

Apo-Metformin M, Gen-Metformin M, Glucophage, Novo-Metformin M, Nu-Metformin M [Rx] Classification: Oral antidiabetic

Action/Kinetics: Decreases hepatic glucose production, decreases intestinal absorption of glucose, and increases peripheral uptake and utilization of glucose. Food decreases and slightly delays the absorption of metformin. Negligibly bound to plasma protein; steady-state plasma levels (less than 1 mcg/mL) are reached within 24-48 hr. Excreted unchanged in the urine; no biliary excretion. tvi, plasma elimination: 6.2 hr. The plasma and blood half-lives are prolonged in decreased renal function.

Uses: Alone as an adjunct to diet to lower blood glucose in clients having non-insulin-dependent diabetes mellitus whose blood glucose cannot be managed satisfactorily via diet alone. Also, metformin may be used concomitantly with a sulfonylu-rea when diet and metformin or a sulfonylurea alone do not result in adequate control of blood glucose. Contraindications: Renal disease or dysfunction (serum creatinine levels greater than 1.5 mg/dL in males and greater than 1.4 mg/dL in females) or abnormal CCR due to cardiovascular collapse, acute MI, or septicemia. In clients undergoing radio-logic studies using iodinated contrast media, because use of such products may cause alteration of renal function, leading to acute renal failure and lactic acidosis. Acute or chronic metabolic acidosis, including diabetic ketoacidosis, with or without coma. Lactation.

Special Concerns: Cardiovascular collapse, acute CHF, acute MI, and other conditions characterized by hypoxia have been associated with lactic acidosis, which may also be caused by metformin. Use of oral hypoglycemic agents may increase the risk of cardiovascular mortality. Although hypoglycemia does not usually occur with metformin, it may result with deficient caloric intake, with strenuous exercise not supplemented by increased intake of calories, or when metformin is taken with sulfonylureas or alcohol. Because of age-related decreases in renal function, use with caution as age increases. Safety and efficacy have not been determined in children. Side Effects: Metabolic: Lactic acidosis (fatal in approximately 50% of cases). Oral: Unpleasant or metallic taste. GI: Diarrhea, N&V, abdominal bloating, flatulence, anorexia. He-matologic: Asymptomatic subnormal serum vitamin B12 levels. Drug Interactions: None reported that would interact with dental therapy or oral health. How Supplied: Tablet: 500 mg, 850 mg


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