If, after some time, you think that the effect of Metformin is too strong or too weak, talk to your doctor or pharmacist. If you take more Metformin than you should If you have taken more Metformin than you should have, you may experience lactic acidosis. Symptoms of lactic acidosis are vomiting, bellyache abdominal pain with muscle cramps, a general feeling of not being well with severe tiredness, and difficulty in breathing.
If this happens to you, you may need immediate hospital treatment, as lactic acidosis may lead to coma. Contact a doctor or the nearest hospital straight away. In case of dehydration severe diarrhoea or vomiting, fever or reduced fluid intake , metformin should be temporarily discontinued and contact with a health care professional is recommended. Medicinal products that can acutely impair renal function such as antihypertensives, diuretics and NSAIDs should be initiated with caution in metformin-treated patients.
Other risk factors for lactic acidosis are excessive alcohol intake, hepatic insufficiency, inadequately controlled diabetes, ketosis, prolonged fasting and any conditions associated with hypoxia, as well as concomitant use of medicinal products that may cause lactic acidosis see sections 4.
Renal function GFR should be assessed before treatment initiation and regularly thereafter, see section 4. Cardiac function Patients with heart failure are more at risk of hypoxia and renal insufficiency. In patients with stable chronic heart failure, metformin may be used with a regular monitoring of cardiac and renal function.
For patients with acute and unstable heart failure, metformin is contraindicated see section 4. Administration of iodinated contrast agents Intravascular administration of iodinated contrast agents may lead to contrast induced nephropathy, resulting in metformin accumulation and an increased risk of lactic acidosis. Taking Metformin with food and drink Do not drink alcohol when you take this medicine.
Alcohol may increase the risk of lactic acidosis, especially if you have liver problems or if you are undernourished. This also applies to medicines that contain alcohol. Top of page cut-off to middle of registration mark: This means that it will not affect your ability to drive or use machines.
Mean metformin absorption from the prolonged release formulation is almost not altered by meal composition. No accumulation is observed after repeated administration of up to mg of metformin as prolonged release tablets. Distribution Plasma protein binding is negligible.
Metformin partitions into erythrocytes. The blood peak is lower than the plasma peak and appears at approximately the same time. The red blood cells most likely represent a secondary compartment of distribution. The mean Vd ranged between L. Metabolism Metformin is excreted unchanged in the urine. No metabolites have been identified in humans. For oral dosage form extended-release tablets: At first, milligrams mg once a day taken with the evening meal.
Your doctor may increase your dose if needed until your blood sugar is controlled. However, the dose is usually not more than mg per day. At first, mg once daily with the evening meal. At first, mg once a day taken with the evening meal. Then, your doctor may increase your dose if needed until your blood sugar is controlled.
Metformin with a sulfonylurea: Your doctor will determine the dose of each medicine. At first, mg once a day. Then, your doctor may increase your dose by mg every week if needed until your blood sugar is controlled. Children—Use and dose must be determined by your doctor.
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