"Siofor 500" is a hypoglycemic drug for oral administration. It provides an antidiabetic effect, which is achieved by inhibiting the absorption of glucose from the digestive tract. In addition, it contributes to an increase in the sensitive activity of tissues to the action of insulin and inhibits glucogenesis.
Also, the medication has a lipid-lowering and fibrinolytic effect.
Indications for use of "Siofora 500"
This drug has a rather narrow therapeutic use, namely - it is used in the treatment of diabetes mellitus of the second type in the absence of the effect of dietary tactics and physical activity. This is especially true for patients who are overweight. "Siofor 500" for weight loss is also prescribed.
This drug can be used both separately and in therapeutic combination with insulin. Adult patients can be prescribed with other types of hypoglycemic drugs. What does the instructions for use of Siofora 500 tell us?
The composition of the drug and release form
The dosage form is presented in the form of coated tablets. They are white in color and biconvex.
10 pieces are produced in blister strip packaging. One cardboard package contains 3, 6 or 12 contour packs of 10 pieces.
1 tablet "Siofora 500" contains:
- metformin hydrochloride - 0.5 g;
- excipients in the form of povidone, hypromellose, magnesium stearate;
- the tablet shell is represented by titanium dioxide, hypromellose and macrogol 6000.
Pharmacodynamics
"Siofor 500" with metformin is an antihyperglycemic drug that is part of the biguanide group. The active substance has the ability to lower the basal and postprandial glucose concentration in the blood (plasma). The drug does not cause hypoglycemia, because does not affect insulin-secreting function.
The principle of action of the active substance of the drug is the inhibition of gluconeogenesis and glycogenolysis, which accordingly entails a decrease in glucose synthesis by the liver. Also, the drug increases muscle sensitivity to insulin, which ultimately improves peripheral glucose metabolism and reduces intestinal glucose absorption.
Metamorphine also has a favorable activity in terms of lipid processes, in particular, it reduces the level of triglycerides and cholesterol.
Pharmacokinetics
Metmorphine is absorbed in the digestive tract and reaches its maximum plasma concentration in an average of two hours. When taking the maximum dose, the level is 0.004 mg per 1 ml. Eating leads to a deterioration or slowdown in the absorption of the drug from the digestive tract. The bioavailability of the drug is 50-60% on average (in a healthy part of patients). Metmorphine has the ability to accumulate in the liver, kidneys, salivary glands and muscle tissue. It also has permeability to red blood cells.
The elimination half-life is 6-7 hours on average. Through the kidneys, the withdrawal of the drug occurs unchanged.
In case of impaired renal function, the half-life increases and there is an increase in the level of the active substance of the drug in blood plasma. This confirms the instructions for use for Siofor 500.
Contraindications
The drug is not prescribed for:
- diabetic precoma;
- diabetic ketoacidosis;
- acute diseases and serious conditions in which there is a high probability of impaired renal function, including during dehydration;
- chronic and acute forms of renal pathologies that can cause tissue hypoxia (examples are the development of shock conditions, heart and respiratory failure, post-infarction conditions);
- lactic acidosis;
- acute and chronic liver failure;
- during pregnancy and while breastfeeding;
- following a low-calorie diet;
- chronic alcoholism;
- acute alcohol poisoning;
- intravascular administration of a contrast drug with iodine content;
- under 10 years old;
- individual intolerance to the components of the drug.
Particular care must be taken when using the drug in the children's age group of 10-12 years, as well as for treating patients with an increased daily calorie intake, for example, people engaged in heavy physical labor.
Dosage and route of administration
Tablets "Siofor 500" are intended for oral administration. It is recommended to take them with food or immediately after it. The course dose of the drug, the duration of the course of treatment, as well as the course regimen are determined by the attending physician individually.
Adults
The following treatment regimens are used:
- Monotherapy. The maximum daily dose is three grams per day. These are 6 tablets. They are divided into three methods. In order to avoid negative manifestations from the digestive system, they begin with an initial dose of 1 tablet 1-2 times a day for the first 10-15 days. After this period, the dose should be increased - 3-4 tablets per day.
- With combination therapy in combination with insulin. As in the previous case, the maximum daily dose is 3 grams per day - this is 6 tablets. They are divided into three methods. Also start with 1 tablet 1-2 times a day. Then, with a gradual increase in the daily dose with a weekly interval, the daily dose is adjusted to 3-4 tablets per day. The insulin dosage is calculated based on indicators of glucose in the blood.
If the patient took another antidiabetic drug before prescribing "Siofor 500", it is canceled and transferred to the initial stage of the regimen, as indicated above.
For elderly patients, the appointment of the drug should be carried out only on the basis of creatinine in plasma. Regular monitoring of kidney function is also required.
Children over 10 years old
In the case of monotherapy with the drug, treatment begins with 1 tablet per day - 1 time. Taking into account indicators of blood glucose levels, after 10-15 days from the start of therapy, you can increase the dose. The maximum daily dose is 4 tablets, which are taken 2-3 times a day.
What side effects does Siofor 500 have?
Side effects
Frequent side effects include reactions from the gastrointestinal tract (dyspeptic disorders, the appearance of a metallic taste in the mouth, nausea, vomiting, loss of appetite, epigastric pain, diarrhea)
Undesirable reactions such as loss of taste sensitivity, skin manifestations in the form of itching, urticaria, and redness are also found.
There is also a chance of an increase in the enzymatic activity of the liver
The appearance of lactic acidosis also belongs to the category of probable side effects.
Overdose
According to observations, doses up to 85 grams per day of Siofora 500 in diabetes do not cause cases of hypoglycemia.
Significant overdose can cause lactic acidosis, the symptoms of which are severe headache, general weakness and drowsiness, manifestations of the respiratory system, dyspeptic disorders, fever, lower heart rate and blood pressure. Muscle pain, disorders of consciousness up to a complete loss also appear. If one or a combination of symptoms of an overdose occurs, immediate withdrawal of the drug and the provision of urgent medical care is necessary. One of the most effective assistance measures for removing high doses of the drug’s active substance and lactate is hemodialysis.
Drug interaction
If it is necessary to intravascularly introduce an iodine-containing contrasting drug, it is necessary to cancel the administration of Siofor two days before the X-ray examination. The resumption of the drug is also recommended no earlier than 2 days after the procedure.
If it is necessary to provide hypoglycemic therapy during this period, it is possible to use other drugs, for example, insulin.
Concomitant use of Siofor 500 with alcohol-containing products and preparations is not recommended.
There is a high likelihood of developing lactic acidosis after severe intoxication and intoxication, while taking alcohol, with liver failure, starvation or significantly limited calorie intake.
special instructions
It is worth noting such a thing as lactic acidosis. This is a serious condition, which is a consequence of intoxication with lactic acid (its accumulation in the blood). The cumulative effect of metmorphine can cause this pathology, although such cases are rare. The usual similar is observed if the patient with diabetes has severe renal failure. Accordingly, before prescribing a drug, it is necessary to analyze possible additional negative risk factors in the form of decompensated diabetes, ketoacidosis, chronic alcoholism, liver failure, as well as hypoxic conditions of patients.
At the very beginning of therapy, the appearance of negative effects from the gastrointestinal tract is quite possible. That is why it is recommended to gradually increase the course dosage. Usually, the aforementioned side effects go away on their own and do not require special therapy.
In cases of long courses of taking the drug in patients with megaloblastic anemia, a B12 deficiency in the blood is observed.
Also, before starting treatment with Siofor 500 (including for weight loss), it is necessary to assess the state of functioning of the kidneys and liver.
The desired therapeutic result of taking this drug is achieved by combining it with diet therapy, physical education. If the patient is overweight, a mandatory adjustment of the daily caloric intake is necessary in the direction of decrease. It is also important to conduct regular laboratory monitoring of indicators.
Metmorphine does not adversely affect the development and growth of pediatric patients. Monitoring of indicators of physical formation and development of adolescents was carried out during the year. A longer intake of the drug requires careful attention to controlling the development of physical indicators and the development of adolescents, since nothing is known about the relationship between the physical development of children and long-term use of the drug.
Of course, it depends on how you take the Siofor 500. We will consider reviews below.
Pregnancy and lactation
The drug is not recommended for use during pregnancy. Women with diabetes mellitus of the second type, in case of pregnancy, must inform the doctor about her and her planning. During pregnancy, the drug is canceled and replaced with insulin. The use of insulin during the gestation period reduces the risk of the effect of hyperglycemia on the growth and condition of the fetus.
Clinical trials of breast milk for metmorphine have not been conducted. But, based on the results of clinical trials in animals, which showed permeability to metphmorphine, the drug is contraindicated during breastfeeding.
During breastfeeding, the attending physician considers options: while taking "Siofora 500", it is shown either to stop breastfeeding, or to discontinue the drug in the absence of a threat to the health of the mother.
Analogs
In the pharmacy market, analogues of the drug are widely represented. These are such products as Bagomet, Diaformin, Gliformin, Metformin, Metfogamma, Glyukofazh, Formmetin.
Reviews
According to reviews on this drug, it has an active ability to lower blood glucose levels and maintain it at an optimal level. It also helps to normalize appetite with the recommended limited intake of carbohydrates.
Patient reviews are mostly positive in terms of tolerability of the drug Siofor 500.
There is a practice of taking the drug for weight loss. Since it has the ability to normalize carbohydrate metabolism, it has been actively used for weight loss. Here reviews are found both negative and positive. Unfortunately, the therapeutic effect of Siofora 500 is not designed to promote healthy weight loss, since the drug was developed for completely different purposes: the treatment of diabetes. Metforfin is not at all designed for its use by people without an appropriate pathology.
Accordingly, the side effects of weight loss by taking it are the result of inappropriate use of the drug. Among these undesirable consequences of improper use of the drug, despite progress in losing weight, there are unpleasant symptoms from the digestive system, similar to those of food poisoning, liver dysfunction, and the development of a gag reflex to pronounced food aromas. Prolonged uncontrolled administration of the drug may lead to the development of acute pancreatitis.
What is the price of Siofor 500? About this below.
Pros and Cons for Weight Loss
Many people start taking metformin drugs to reduce body weight. At the same time, no one is in a hurry to get an appropriate recommendation from an endocrinologist.
In the case of the use of drugs for weight loss, regular monitoring of blood sugar is required. A strict diet, intense physical activity lead to the development of hypoglycemia. This is the main disadvantage of this tool. There should also be a restriction in the diet of the amount of simple carbohydrates. A varied and nutritious diet is required: starvation is strictly prohibited.
Caution should always be taken. Appetite is suppressed and weight loss occurs only during the period of admission. Refusing pills, you can again gain weight.
The advantages of the drug are as follows:
- suppresses appetite;
- stimulates the metabolism;
- provides prevention of type 2 diabetes.
There will be no side effects if the dosage is increased gradually.
Price "Siofora 500"
The cost of the drug depends on the region and the pricing policy of the pharmacy chain. A package of 60 tablets on average costs about 350-450 p.