Dangerous Drug: Metformin Hydrochloride(met fore’ min)
Apo-Metformin (CAN), CO Metformin Coated (CAN), Fortamet, Gen-Metformin (CAN), Glucophage, Glucophage XRDNC, GlumetzaDNC, Metformin HCl ERDNC, Nu-Metformin (CAN), PMS-Metformin (CAN), ratio-Metformin (CAN), Riomet
PREGNANCY CATEGORY B
Drug Classes
Antidiabetic
Biguanide
Therapeutic Actions
Exact mechanism is not understood; possibly increases peripheral utilization of glucose, decreases hepatic glucose production, and alters intestinal absorption of glucose.
Indications
Adjunct to diet to lower blood glucose with type 2 diabetes mellitus in patients 10 yr and older; ER in patients 17 yr and older; 18 yr and older for Glumetza
As part of combination therapy with a sulfonylurea or insulin when either drug alone cannot control glucose levels in patients with type 2 diabetes mellitus
Unlabeled uses: Treatment of anovulation in women with polycystic ovary syndrome; treatment of antipsychotic drug-induced weight gain
Contraindications and Cautions
Contraindicated with allergy to metformin; heart failure; diabetes complicated by fever, severe infections, severe trauma, major surgery, ketosis, acidosis, coma (use insulin); type 1 diabetes, serious hepatic impairment,
serious renal impairment, uremia, thyroid or endocrine impairment, glycosuria, hyperglycemia associated with primary renal disease; labor and delivery (if metformin is used during pregnancy, discontinue drug at least 1 mo before delivery); lactation (safety not established).
Use cautiously with the elderly.
Available Forms
Tablets—500, 850, 1,000 mg; ER tabletsDNC—500, 750, 1,000 mg; oral solution—500 mg/5 mL
Dosages
Adults
500 mg bid or 850 mg once daily PO with a meal. May increase 500 mg/wk or 850 mg/2 wk to maximum of 2,550 mg/day in divided doses. Dosage should be adjusted based on response and blood glucose level. ER tablet: Initially, 1,000 mg/day PO with evening meal; may be increased by 500 mg/wk to a maximum of 2,000 mg once daily (2,500 mg Fortamet). If higher doses are required, use immediate-release tablets. Doses above 2,000 mg/day may be better tolerated if divided and given tid with meals.
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