Generic Azulfidine

1. Denomination

Glucophage

2. Active Substance

Metformin

3. Indications for Use.

Sugar diabetes of type 2 in adults (in the cases when diet therapy is inefficient), especially in obesity cases. Sugar diabetes of type 1 as an addition to insulin therapy.

4. Action

Metformin decreases absorption of carbohydrates, deflates the concentration of glucose, increases the tolerance to glucose, decreases the body mass.

5. Posology and Administration

A dose is to be picked individually. Metformin should be taken orally, immediately after meal; non-insulin patients should take 1 g (2 tablets) 2 times a day in the first 3 days or 500 mg each 3 times a day, and in future - from the 4-th to the 14-th day 1 g each 3 times a day; after 15 days a dosage may be reduced with respect to glucose content in blood and urine. A supporting daily dose is 1-2 g. Retard tablets (850 mg) are to be taken 1 each in the morning and in the evening. The maximal daily dose is 3 g.
Simultaneous use of insulin with the drug demands great care and should be done at hospital.

6. Counterindications

Childhood (efficiency and safety of the use in children is not determined) and elderly age (over 65 years) age. Hypersensitivity, kidneys disease – evidenced compromised liver function, heart and respiratory failure, acute phase of myocardial infarction, infectious diseases, major surgeries and traumas, chronic alcoholism, pregnancy, breastfeeding.

7. Should Be Taken with Precautions, if…

During the treatment kidneys function and blood composition control is needed. During Metformin therapy hard physical work is not recommended.
Combined use of the drug with insulin is recommended to carry out at hospital.

8. Interface with Other Medications

Interface with other medications may give adverse side effects. In this respect it is recommended to inform your doctor which medications you take or have taken at the last period of time. On the matter of drug combination it is necessary to take advice of your attending doctor.

9. Overdosing

Metabolic disorder.

10. Side Effects

Nausea, vomiting, “metallic” off-flavor, loss of appetite, pain in the stomach, weakness, pain in muscles, respiratory disorders, drowsiness, deflation of arterial tension, skin rash. In cases of emergence of side effects the dose should be reduced or temporary withdrawn

11. Pregnancy and Lactation

Metformin should be administered in the period of pregnancy. During the treatment breastfeeding should be stopped.

12. Driving

In the period of Metformin therapy it is necessary to refrain from potentially hazardous activities which require alertness and rapidity of psychomotor actions.

DIABETES AND EXERCISE: SECONDARY PREVENTION OF TYPE 2 DIABETES MELLITUS
A large, randomized clinical trial in the U.S. involving 3234 pre-diabetic individuals (i.e., had elevated fasting and postprandial plasma glucose concentrations) showed that the incidence of diabetes was 58% lower in the lifestyle-intervention group and 31 % lower in the metformin group, compared to the placebo group. The goals of the lifestyle-modification program were at least a 7% weight loss and at least 150 min of physical activity/week. The mean age of the participants was 51 years, and the mean BMI was 34 kg/m2; 68% were women, and 45% were members of minority groups. The average weight loss was 0.1, 2.1, and 5.6 kg in the placebo, metformin, and lifestyle-intervention groups, respectively. Thus, lifestyle modification was twice as effective as the drug in preventing type 2 diabetes in patients with abnormal glucose tolerance.
In another study of 522 overweight Finnish men and women aged 55 years with average BMIs of 31 kg/m2 and impaired glucose tolerance, twice as many cases of clinical type 2 diabetes were found in the control group (who did not receive any lifestyle counseling) compared to the lifestyle intervention group (who received individualized counseling aimed at reducing body weight and total intake of fat, especially saturated fat, and increasing intake of fiber and physical activity).
Overweight/obese women who are in the lowest quartile of physical activity have a 40% higher risk of type 2 diabetes than overweight/ obese women who are in the top two quartiles of physical activity. Note that overweight/obese women in the second lowest quartile of physical activity have a 20% reduction in the risk of having type 2 diabetes; these differences are clinically significant. Overweight patients have a much higher prevalence of type 2 diabetes than individuals with BMI Only moderate amounts of physical activity are necessary to produce health benefits. Physical activity is a valuable health measure for overweight patients. Obviously, the ideal is to prevent BMI > 25 kg/m2 from ever occurring, but increasing physical activity levels regardless of body weight has tremendous health implications by significantly reducing the relative risk of type 2 diabetes.
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DIABETES

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