Following oral administration, metformin is absorbed from the gastrointestinal tract. The bioavailability after ingestion of standard. The maximum plasma concentration is reached after 2 h. After ingestion. Almost does not bind to plasma proteins. It accumulates in the salivary glands, muscles, liver and kidneys. Provided unchanged by the kidneys. When renal function is dianabol side effects for men possible accumulation of the drug.
Indications Diabetes mellitus type 2, with no tendency to ketoacidosis (especially in patients who are obese) when poor diet.
- Hypersensitivity to the drug;
- diabetic ketoacidosis, diabetic precoma, coma;
- pronounced renal dysfunction;
- cardiac and respiratory failure, acute phase of myocardial infarction, acute cerebrovascular accident, dehydration, chronic alcoholism, and other conditions that may contribute to the development of lactic acidosis;
- lactic acidosis and instructions to him in history;
- Pregnancy and breast-feeding;
- major surgery or injury, when shown holding insulin;
- liver dysfunction, acute alcohol poisoning;
- use for at least 2 days prior to and within 2 days after the radioisotope or radiological examinations with iodide introduction. contrast agent;
- compliance with a hypocaloric diet (less than 1000 calories / day).
Do not use the drug in patients older than 60 years, performing heavy physical work, which is associated with an increased risk of developing lactic acidosis.
Dosing and Administration Determined individually, taking into account the level of glucose in the blood. The initial dose is typically 500-1000 mg (1-2 tablets) per day may further gradual increase in the dose depending on the effect of therapy. Supportive daily dose of 1000-2000 mg (2-4 tablets) per day. The maximum daily dose – 3 g (6 tablets) appointment bradley martin steroids of higher doses does not contribute to the effect of the treatment.
The course of drug treatment is long. As a result of high-risk development of lactic acidosis, the dose should be reduced in severe metabolic disorders.
Side effect On the part of the gastrointestinal tract : nausea, vomiting, abdominal pain, diarrhea, lack of appetite, “metallic” taste in the mouth. In these cases, usually not required discontinuation of treatment and symptoms are independently without changing dose. The frequency and severity of side effects from the gastrointestinal tract may be reduced by gradually increasing the dose of metformin. In rare cases – abnormalities liver function tests or hepatitis, transient after discontinuation of the drug. Allergic reactions :. Rash dianabol side effects for men From the Endocrine : hypoglycemia (especially when used in inadequate doses).On the part of metabolism : rarely – lactic acidosis (requires termination treatment), long-term treatment – vitamin deficiencies Bi2 (malabsorption). From the hematopoietic system : in some cases – megaloblastic anemia.
Overdose If overdose may develop lactic acidosis fatal. The reason for the development of lactic acidosis may also be the accumulation of the drug due to renal dysfunction. Early symptoms of lactic acidosis include nausea, vomiting, diarrhea, drop in body temperature, abdominal pain, pain in the muscles, in the future may be marked shortness of breath, dizziness, impaired consciousness and coma development. In case of lactic acidosis symptoms, drug treatment you need to stop immediately, the patient hospitalized immediately and determine the concentration of lactate, to confirm the diagnosis. The most effective measure for the excretion of lactate and metformin is hemodialysis. Spend as symptomatic treatment. In combination therapy dbol with with a sulfonylurea may develop hypoglycaemia.
Interaction with other medicinal products In an application with sulfonylureas, acarbose, insulin, nonsteroidal anti-inflammatory agents, monoamine oxidase inhibitors, oxytetracycline, angiotensin converting enzyme inhibitors, clofibrate derivatives, cyclophosphamide, ß-blockers may increase the hypoglycemic effect of metformin. While the use of corticosteroids, oral contraceptives, epinephrine, sympathomimetics, glucagon, thyroid hormones, thiazide and “loop” diuretics, phenothiazine derivatives, derivatives of nicotinic acid may reduce the hypoglycemic action of metformin. Cimetidine slows the elimination of metformin, thus increasing the risk of lactic acidosis. Metformin may weaken the effect of indirect anticoagulants (coumarin derivatives). At simultaneous reception of alcohol may develop lactic acidosis. Nifedipine increases absorption,dianabol side effects for men , slows down. Incompatible with ethanol (lactic acidosis). Cationic drugs (amiloride, digoxin, morphine, procainamide, quinidine, quinine, ranitidine, triamterene, vancomycin), secreted in tubule, competing for kanaltsievye transport systems and long-term therapy may increase.
Cautions During treatment necessary dianabol side effects to monitor renal function. At least 2 times a year, as well as the appearance of myalgia should be determination of lactate in plasma. Possible use of the drug Metfogamma ® 850 in combination with sulfonylureas or insulin. In this case, you need a particularly careful control of blood glucose levels.
Effects on ability to drive vehicles and operate machinery Using the drug in monotherapy does not affect the ability to drive vehicles and operate machinery. With the combination of metformin with other hypoglycemic agents (sulfonylureas, insulin, etc.) may develop hypoglycemic conditions under which deteriorating ability to road management and occupation of other potentially hazardous activities that require increased attention and rapid psychomotor reactions.