Metformin 500 mg Helvepharm
Metformin 500 mg Helvepharm Extended-Release Tablets are oral antihyperglycemic drugs used in the management of type 2 diabetes.
• Treatment of type 2 diabetes mellitus in adults, particularly in overweight patients, when dietary management and exercise alone does not result in adequate glycaemic control.
• Metformin may be used as initial treatment or in sulfonylurea failures either alone or in combination with a sulfonylurea and other oral agents.
• Adjuvant therapy in insulin dependent diabetes especially if overweight.
Dose and method of administration
Life threatening lactic acidosis can occur due to accumulation of metformin. Risk factors include renal impairment, old age and doses of metformin above 2 g per day (see Special warnings and precautions for use). It is important that the tablets are taken in divided doses with meals.
Monotherapy and combination with other oral antidiabetic agents in adults with normal renal function
Initially 500 mg should be taken once or twice a day and, if necessary, increased over a few weeks up to a maximum of 1 g three times per day. The dose should be titrated with gradual dose increments until the desired effect is obtained. 500 mg three times a day is often sufficient to obtain diabetic control. Control may be attained within a few days but occasionally requires up to two weeks. Once control has been obtained, the dosage should be reviewed and reduced to the lowest maintenance level consistent with good diabetic control. The maximum dose of 3g daily should only be used in patients with good renal function (ie creatinine clearance greater than 120ml/min).
Metformin is contraindicated in the following conditions:
• Juvenile diabetes mellitus that is uncomplicated and well regulated on insulin
• Diabetes mellitus regulated by diet alone
• During or immediately following surgery where insulin is essential
• Hypersensitivity to metformin hydrochloride and other biguanides, or to any of the excipients
• Diabetic ketoacidosis, diabetic precoma
• Renal failure (creatinine clearance < 15 mL/minute), patients with unstable renal function
• Acute conditions with the potential to alter renal function such as dehydration, severe infection,shock, intravascular administration of iodinated contrast agents (see Warnings and
• Acute conditions which may cause tissue hypoxia such as cardiac failure, recent myocardial infarction, respiratory failure, pulmonary embolism, acute significant blood loss, sepsis, gangrene, pancreatitis.