Metformin-Astrafarm 850 mg is a fundamental pharmacological intervention for the management of Type 2 Diabetes Mellitus (T2DM). Belonging to the biguanide class, it serves as a first-line therapy, particularly for patients with excess body weight whose glycemic levels are not adequately controlled by lifestyle modifications alone. By improving insulin sensitivity and reducing hepatic glucose production, Metformin-Astrafarm helps mitigate the long-term macrovascular and microvascular complications associated with chronic hyperglycemia, offering a reliable profile for both monotherapy and combination regimens with insulin or other oral hypoglycemic agents.
Each tablet of Metformin-Astrafarm contains:
Active Substance: Metformin hydrochloride — 850 mg.
Excipients: Povidone, magnesium stearate.
Tablet Coating: Hydroxypropylmethylcellulose 2910, 5sPz, PEG 6000, and titanium dioxide.
Metformin operates through three primary anti-hyperglycemic mechanisms:
Reduction of Hepatic Glucose Production: It inhibits gluconeogenesis and glycogenolysis in the liver.
Increased Insulin Sensitivity: In skeletal muscle, it improves glucose uptake and utilization by enhancing the efficiency of insulin receptors.
Delay of Intestinal Absorption: It slows the absorption of glucose within the gastrointestinal tract.
Unlike sulfonylureas, metformin does not stimulate insulin secretion, which significantly reduces the risk of hypoglycemia in monotherapy. It also exerts a positive effect on lipid metabolism, often leading to a reduction in total cholesterol, LDL, and triglycerides.
Type 2 Diabetes Mellitus: Specifically in adults and children aged 10 and older when diet and exercise fail.
First-line Therapy: Preferred for overweight patients to reduce diabetes-related complications.
Combination Therapy: Used alongside insulin or other oral antidiabetics for synergistic glycemic control.
Hypersensitivity to metformin or any excipients.
Renal Impairment: Severe kidney failure (GFR < 45 ml/min/1.73 m²).
Acute Conditions: Dehydration, severe infections, or shock.
Tissue Hypoxia: Decompensated heart failure, respiratory failure, or recent myocardial infarction.
Metabolic Acidosis: Diabetic ketoacidosis or precoma.
Hepatic Insufficiency: Liver failure or chronic alcoholism/acute alcohol intoxication.
For Adults:
Initial Dose: 500 mg or 850 mg, administered 2–3 times daily.
Titration: Adjust the dose after 10–15 days based on blood glucose monitoring.
Maximum Dose: 3000 mg per day, divided into three doses.
For Children (10 years and older):
Initial Dose: 500 mg or 850 mg once daily.
Maximum Dose: 2000 mg per day, divided into 2–3 doses.
Timing: Always take tablets during or after meals to minimize gastrointestinal discomfort.
Gradual Increase: Slowly increasing the dosage over several weeks significantly improves gastric tolerance.
Gastrointestinal (Very Common): Nausea, vomiting, diarrhea, abdominal pain, and loss of appetite. These usually resolve spontaneously.
Metabolic: Very rarely, Lactic Acidosis (requires immediate medical attention). Long-term use may lead to decreased Vitamin B12 absorption.
Nervous System: Taste disturbances (metallic taste).
Hepatobiliary: Isolated reports of liver function test abnormalities or hepatitis.
Lactic Acidosis: A rare but serious metabolic complication. Risk increases with renal impairment, sepsis, or excessive alcohol intake.
Surgery: Discontinue metformin 48 hours before elective surgery involving general, spinal, or epidural anesthesia.
Pregnancy: It is generally recommended to switch to insulin during pregnancy to maintain strict glycemic control.
Driving: Does not affect reaction speeds unless used in combination with agents that cause hypoglycemia (e.g., insulin).
Store in the original package to protect from light.
Maintain a temperature not exceeding 25°C.
Keep out of reach of children.
Shelf life: 5 years.
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