Metformin is a vital remedy for people with diabetes. Metformin Richter, the indications for use of which is suitable for most patients with diabetes, helps to lower blood sugar and maintains a proper level of carbohydrate metabolism, thereby improving the quality of life, as evidenced by the numerous positive reviews of patients.
Pharmacodynamics and pharmacokinetics
"Metformin" inhibits the process of gluconeogenesis in the liver and becomes an obstacle for glucose from the intestine to enter this organ. In this case, an increase in the peripheral breakdown of glucose occurs and the sensitivity of the liver tissues to insulin increases. These processes are not accompanied by hypoglycemic reactions; the drug does not affect the natural production of insulin by the beta cells of the pancreas, unlike some analogues of the Metformin drug.
Indications for use for weight loss appeared due to the ability of the drug to stabilize or completely significantly reduce the patient’s body weight.
After taking Metformin, active substances begin to flow from the gastrointestinal tract, and the effective effect of the drug begins after 2-2.5 hours. A feature of the drug is its almost complete non-binding to plasma protein.
"Metformin" is able to accumulate in the kidneys and liver, salivary glands, and muscle tissues. It is excreted almost completely by the kidneys after 9-12 hours after administration. If the patient’s kidney function is impaired, the drug may accumulate in the body for a long time.
Indications and contraindications
Indications for the use of Metformin are:
- Type 2 diabetes mellitus, passing without a tendency to ketoacidosis, which is very important for overweight diabetics.
- In combination with insulin in type 2 diabetes, severely obese, followed by secondary insulin resistance.
Despite the high effectiveness of the drug, there are contraindications to the use of Metformin:
- Ketoacidosis in diabetes, predomatous state or coma.
- Violations of the normal functioning of the kidneys.
- Acute diseases leading to the appearance of kidney dysfunction - infections, dehydration with severe diarrhea or vomiting, fever, diseases of the respiratory system, hypoxia.
- Acute and chronic diseases leading to tissue hypoxia - cardiac or respiratory failure, acute myocardial infarction.
- Postponed surgical interventions, after which insulin therapy is prescribed.
- Liver dysfunctions.
- Acute ethanol poisoning, chronic alcoholism.
- Pregnancy.
- Lactation.
- Individual intolerance.
Drug dosage
The dosage of "Metformin" is determined based on the content of glucose in the blood and is prescribed by the doctor personally for each patient. Typically, the starting dosage ranges from 0.5 to 1 g / day. (1-2 tablets), and then, based on the glucose level, after 10-15 days of administration, a step-by-step increase in dosage is possible.
The maintenance dose of Metformin is 1.5-2.0 g / day. (3-4 tablets), and the maximum dosage is 3.0 g / day. either 6 tablets. For patients in advanced age, the highest dose is not more than 1.0 g / day. (2 tablets).
Indications for the use of "Metformin" and patient reviews suggest that the drug should be taken during meals or immediately after it, washed down with plain water. The daily dose is recommended to be divided into 2-3 doses during the day.
Overdose Actions
An overdose can lead to the development of fatal lactic acidosis.
Lactic acidosis is characterized by the following symptoms:
- Dizziness, accompanied by nausea and vomiting.
- Diarrhea.
- A sharp decrease in body temperature.
- Increased breathing.
- Sharp pains in the muscles, abdomen.
- Loss of consciousness and the onset of coma.
If at least mild signs of lactic acidosis appear, you should immediately stop taking Metformin and take measures to hospitalize the patient.
The most effective therapeutic measure for lactic acidosis is hemodialysis, and the treatment of certain symptoms is also effective.
Interaction with other medicines
The drug "Metformin", the indications for use of which exclude the simultaneous administration of the drug with other drugs, can not be used together with dinazole due to the hyperglycemic effect of the latter. If you need to undergo treatment with dinazole, you need to adjust the dose of Metformin, which should be carried out by the doctor.
Reception of "Metformin" must be completely stopped or the dosage adjusted in combination with the following drugs:
- Chlorpromazine.
- Antipsychotic drugs.
- Oral contraceptives, thyroid hormones, thiazide and loop diuretics.
- "Epinephrine."
- "Cimetidine."
Also, when using Metformin, it is necessary to completely stop taking alcohol, otherwise, judging by the reviews of patients, the therapeutic effect is significantly reduced.
"Metformin": reviews when used for weight loss
The therapeutic effect is not limited to the area of use of the Metformin preparation. Indications for use, reviews indicate such abilities as:
- Decreased blood sugar.
- Reducing the natural production of insulin, leading to a decrease in appetite.
- Blocking the formation of carbohydrate fuel in the liver.
- Decreased absorption of carbohydrates that are ingested with food.
To use "Metformin" for weight loss, it should be understood that its main function is to create such conditions under which the deposition of fat, and not muscle tissue, occurs. Therefore, for effective and harmless to the body weight loss, according to many reviews of the drug, both patients and doctors, favorable conditions should be created:
- Refuse sweet and starchy foods, as well as instant products (noodles, cereals, mashed potatoes).
- Reduce calorie intake.
- Actively and regularly exercise.
When using Metformin for weight loss, the dosage should be 500 mg / day, and should be taken before lunch and dinner. Reviews of the patient’s drug indicate its sufficient effectiveness in losing weight, but the use of Metformin for these purposes is unacceptable without consulting a physician and nutritionist.
Side effects
Despite the wide indications for use, Metformin can also cause the manifestation of some unpleasant symptoms from the gastrointestinal tract, which are the result of side effects of the drug:
- Vomiting and nausea.
- Weak appetite or its complete absence.
- Flatulence, diarrhea, abdominal pain.
Quite often, such symptoms appear at the very beginning of treatment and, according to patients, disappear on their own.
Side effects from other systems are much more serious:
- Hypovitaminosis B12 and lactic acidosis.
- Megaloblastic anemia.
- Hypoglycemia.
- Skin rash as an allergic reaction.
Special instructions for use and patient reviews
Like any other drug, which has its contraindications and indications for use, Metformin requires careful attention to dosage and time of administration.
In particular, during administration, it is necessary to constantly monitor renal function, for which at least twice a year, as well as with the manifestation of myalgia, it is necessary to determine the plasma lactate content. In addition, serum creatinine should be monitored every six months, especially in older patients.
When taking Metformin in combination with sulfonylurea derivatives, it is important to constantly monitor blood glucose levels.
If there are diseases of the genitourinary system or bronchopulmonary infections, you should immediately inform your doctor about this.
Taking the drug does not affect the ability to drive a car and does not interfere with the work with mechanisms.
The combination of "Metformin" with other hypoglycemic drugs can lead to the development of hypoglycemic conditions characterized by memory impairment, in which it is forbidden to drive a car and engage in other activities that are potentially dangerous and require increased attention and reaction.
During treatment, it is strictly forbidden to take alcohol and medicines containing ethanol.
According to reviews of the drug "Metformin", despite the frightening many provocations of side effects, they are still observed extremely rarely or to a small extent. And, which is especially noted by lovers of sweets, while taking the medicine, it is quite possible to afford a piece of cake or candy, albeit infrequently.
Also, in the reviews of diabetic patients, there is an increased likelihood of becoming pregnant while taking Metformin, which helps not only to get rid of the disease, but also to find family happiness.