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Everything you should know about Metformin online
Metformin is one of the first drugs in the treatment of type 2 diabetes mellitus, first synthesized in 1922 and started to be used in clinical practice since the late 50’s of the last century. It is prescribed to people with Type 2 diabetes mellitus without a tendency to ketoacidosis (especially in obese patients) with ineffectiveness of diet therapy. Metformin is one of the widely used antidiabetic drugs. In 2006, the International Diabetes Federation adopted new recommendations for the treatment of diabetes in which Metformin was offered as a first-line drug in combination with a lifestyle change.
Pharmacologic action of Metformin
Metformin inhibits gluconeogenesis in the liver, reduces the absorption of glucose from the intestine, enhances peripheral utilization of glucose, and also increases the sensitivity of tissues to insulin. In this case, it has no effect on the secretion of insulin by beta cells of the pancreas, does not cause hypoglycemic reactions. Metformin reduces the level of triglycerides and low density lipoproteins in the blood. It stabilizes or reduces body weight. It has a fibrinolytic effect by suppressing the inhibitor of the tissue of the plasminogen activator type.
Pharmacokinetics Metformin online
After ingestion, Metformin is absorbed from the digestive tract. Bioavailability after taking a standard dose is 50-60%. Cmax in blood plasma is achieved 2.5 hours after ingestion. Virtually it does not bind to plasma proteins. It accumulates in the salivary glands, muscles, liver and kidneys. It is allocated in an unchanged form by kidneys. In case of violations of kidney function, cumulation of the drug is possible.
How to use Metformin?
Metformin tablets are taken strictly after you have eaten being washed with plenty of water. The first and the initial dose is 1000 mg per day. Within 1-2 weeks the dose gradually increases, the value of it is adjusted under the control of laboratory data on the level of glucose in the blood.
The maximum allowable dose is 3000 mg per day. The daily dose can be used at one time but at the beginning of therapy in the period of adaptation it is recommended to divide it into 2-3 doses, which helps reduce the side effect of the drug on the gastrointestinal tract. The highest concentration of the drug in the blood plasma is observed after 2.5 hours after administration after 6 hours it begins to decrease. After 1-2 days of regular intake of a constant concentration of the drug in the blood, according to reviews, Metformin begins to have a noticeable effect two weeks after the start of admission. With the combined use of Metformin and insulin, medical supervision is necessary, at high doses of insulin – in a hospital.
Side effects Metformin
- On the part of the digestive system: nausea, vomiting, metallic taste in the mouth, lack of appetite, diarrhea, flatulence, abdominal pain.
- From the side of metabolism: rarely – lactate-acidosis (requires discontinuation of treatment); with prolonged treatment – hypovitaminosis B12 (impaired absorption).
- From the hemopoietic system: in some cases – megaloblastic anemia.
- From the endocrine system: hypoglycemia (when used in inadequate doses).
- Allergic reactions: skin rash.
Contraindications to the use of the drug
- diabetic ketoacidosis, diabetic precoma, coma;
- severe renal dysfunction;
- cardiac and respiratory failure, acute phase of myocardial infarction, acute disturbance of cerebral circulation, dehydration, chronic alcoholism and other conditions that may contribute to the development of lactic acidosis;
- pregnancy and the period of breastfeeding;
- serious surgical interventions and injuries, when insulin therapy is indicated;
- impaired liver function;
- acute alcohol poisoning;
- lactate acidosis (including in the anamnesis);
- compliance with the hypocaloric diet (less than 1000 kcal / day);
- Hypersensitivity to the drug.
It is contraindicated to use the drug for at least 2 days before and within 2 days after carrying out radioisotope and radiographic studies with the introduction of iodide-containing contrast medium.
It is not recommended to use the drug for people over 60 who perform heavy physical work, which is associated with an increased risk of developing lactic acidosis.
When Metformin monotherapy is unavailable, there is no risk of developing hypoglycemia, as a part of complex diabetes therapy such risk is not excluded, which the patient should be warned of. It is forbidden to take this medication together with intravascular X-ray contrast substances containing iodine. Any combined use of Metformin and another medicinal substance requires the supervision of a physician. During the surgical procedure, the drug is canceled for 2-3 days after the operation. Metformin’s instruction prescribes compliance with the diet throughout the treatment period, which avoids the sharp peaks and drops in blood glucose causing deterioration in health condition.
Why choose Metformin?
Metformin online is an effective antidiabetic drug and, if necessary, can be successfully used with other antidiabetic drugs: sulfonylureas, meglitinides, glitazones, inhibitors of alpha-glucosidase. Favorably influencing the classical risk factors, as well as through insulin-dependent and independent mechanisms, Metformin significantly reduces cardiovascular diseases and mortality.
Metformin is well tolerated and safe. The risk of developing lactic acidosis is not higher compared with other antidiabetic drugs.
According to the recommendations of the International Diabetes Federation and the American Diabetes Association, Metformin is the first choice drug in type 2 diabetes patients. In a study of the Diabetes Prevention Program, Metformin reduced the risk of developing diabetes in people with early impairment of carbohydrate metabolism. According to the British Prospective Study on Diabetes Mellitus, among all antidiabetic drugs, Metformin is unique in reducing morbidity and mortality.