METFOR 500/MG FC TAB 50/FC TAB

Indications

Approved Uses

Type 2 diabetes mellitus: as an adjunct to diet and exercise, used as monotherapy or in combination with other antidiabetic agents (including insulin) when appropriate.

Dosage & Administration

Initial Dose

500mg twice daily or 850mg once daily, taken with meals.

Maintenance Dose

1500-2000 mg/day in 2-3 divided doses

How to Take

Swallow the film‑coated tablet whole with water; take with or immediately after meals (divide doses with meals if taken more than once daily) to reduce gastrointestinal adverse effects.

Safety & Warnings

Contraindications

Contraindicated in: eGFR <30 mL/min/1.73 m²; acute or chronic metabolic acidosis (including DKA); hypersensitivity to metformin.

Drug Interactions

Drug Interactions

Key interactions: iodinated contrast media (temporarily withhold in at-risk patients); alcohol (↑ lactic acidosis risk); carbonic anhydrase inhibitors e.g., topiramate (↑ metabolic/lactic acidosis risk); cationic drugs that reduce renal tubular secretion/clearance (e.g., cimetidine, ranolazine) (↑ metformin levels); insulin/secretagogues (↑ hypoglycemia risk); drugs that can impair renal function or raise glucose (e.g., diuretics, corticosteroids).

Food Interaction

Take with food

Special Populations

Elderly

Start at lower dose, titrate slowly, monitor renal function regularly; dose selection should be conservative due to potential decrease in renal function; contraindicated if eGFR <30 mL/min/1.73m²

Kidney Impairment

eGFR ≥60: no adjustment, monitor at least annually; eGFR 45-59: continue, monitor every 3-6 months; eGFR 30-44: do not initiate-if already on, consider dose reduction and close monitoring (every ~3 months) and reassess benefit/risk; eGFR <30: contraindicated.

Liver Impairment

Avoid use in patients with hepatic impairment/clinical or laboratory evidence of hepatic disease (no dose-adjustment strategy recommended).

Storage & Patient Advice

Monitoring Requirements

Monitor renal function (eGFR) before initiation and at least annually (more often if eGFR <60 or in the elderly/at risk); monitor glycemic control (HbA1c about every 3 months until stable then every 3-6 months, plus SMBG as appropriate); check vitamin B12 periodically during long‑term therapy (especially if anemia/neuropathy).

Pharmacology

Mechanism of Action

Decreases hepatic glucose production (gluconeogenesis), decreases intestinal glucose absorption, and improves insulin sensitivity by increasing peripheral glucose uptake/utilization (AMPK activation is a key proposed mediator).

Half-Life

Plasma elimination half‑life is about 6 hours (commonly reported range ~4-8.7 hours); the apparent half‑life in whole blood is longer (~17 hours) due to erythrocyte distribution.

Bioavailability

50-60% (under fasting conditions)

Metabolism

Metformin is not metabolized (including not hepatically metabolized) and is excreted unchanged in the urine via renal tubular secretion.

Excretion

Eliminated by the kidneys largely as unchanged drug (via tubular secretion and glomerular filtration).

Product Information

Diabetes Type

Type 2

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