Uses dose prolonged release tablet contains mg metformin hydrochloride corresponding to mg metformin base. White capsule-shaped, biconvex tablet, debossed on one side with '' and on the other side with 'Merck'.
White to off-white capsule-shaped, biconvex tablet, debossed on one side with '' and on the other side with 'MERCK'. Treatment with Glucophage SR must be based on a risk score incorporating appropriate measures of glycaemic control and including evidence of high cardiovascular risk see glycomet 500 5. Lifestyle modifications should be continued when uses dose is initiated, unless the patient is unable to do uses dose because of medical reasons.
Glucophage SR may be used as monotherapy or in combination with other oral antidiabetic agents, or with insulin.
A slow increase of dose may improve gastro-intestinal tolerability. The maximum recommended dose is 4 tablets mg once daily glycomet sr 500 uses dose the evening meal. Monotherapy in Type 2 diabetes mellitus and combination with other oral antidiabetic agents: The maximum recommended dose is 4 tablets daily. If glycaemic control is not achieved on Glucophage SR article source once daily, Glucophage SR mg twice daily should be considered, with both doses being given with food.
If glycaemic control is still not achieved, patients may be switched to standard metformin tablets to a glycomet sr 500 uses dose dose of mg daily. In patients treated with metformin at a dose above mg daily, switching to Glucophage SR is not recommended.
Metformin and insulin may click here used in combination therapy to achieve better blood glucose control. The usual starting dose of Glucophage SR is one mg tablet /betnovate-cream-in-pregnancy-safe.html daily, while insulin dosage is adjusted on the basis of blood glucose measurements. For patients glycomet sr 500 uses dose treated with metformin and insulin in glycomet 500 therapy, the dose of Glucophage SR mg or Glucophage SR mg should be equivalent to the daily dose of metformin tablets up to a maximum of mg or mg respectively, given with the evening meal, while insulin dosage is adjusted uses dose the basis of blood glucose measurements.
Due to the potential for decreased renal function in elderly subjects, the metformin dosage should be adjusted based on renal function. Regular glycomet sr 500 uses dose of renal function is necessary see section 4.
Benefit in the reduction of uses dose or delay of the onset of type 2 diabetes mellitus has not been established in patients 75 years and older see section 5. A GFR should be assessed before initiation of treatment with metformin containing products and at least annually thereafter.
In patients glycomet sr 500 uses dose an increased risk of further glycomet sr 500 uses dose of renal impairment and in the elderly, renal function should be assessed more frequently, e.
Dose reduction may uses dose considered in relation to declining renal function. Factors that may increase what is ditropan 400 risk of lactic acidosis see section 4.
Lactic acidosis, a very rare, but serious, metabolic complication, most often occurs at acute worsening of renal function or cardiorespiratory illness or sepsis.
Metformin accumulation link at acute worsening of renal glycomet sr 500 uses dose and increases the risk of lactic acidosis.
In case of dehydration severe diarrhoea or vomiting, fever or reduced fluid intakemetformin should be temporarily discontinued and contact with a health care professional is recommended. Medicinal products that can acutely impair renal function such as antihypertensives, diuretics and NSAIDs should read more initiated with caution in metformin-treated patients.
Other risk factors for lactic acidosis are excessive alcohol intake, hepatic insufficiency, inadequately controlled diabetes, ketosis, prolonged fasting and any conditions associated with hypoxia, as well as concomitant use of medicinal products that may cause lactic glycomet sr 500 uses dose see sections 4.
Lactic acidosis is characterised by acidotic dyspnoea, glycomet sr 500 uses dose pain, muscle cramps, asthenia and hypothermia followed by coma. In case of suspected symptoms, the patient should stop taking glycomet sr 500 uses glycomet sr 500 uses dose and seek immediate medical attention.
GFR should be assessed before treatment initiation and regularly thereafter, see section 4. Patients with heart failure are more at risk of hypoxia and renal insufficiency. In patients with stable chronic glycomet sr 500 uses dose failure, metformin may be used with a regular monitoring of cardiac uses dose renal function. For patients with acute and unstable heart failure, metformin is contraindicated see section 4.
Due to the limited therapeutic efficacy data in the reduction of risk or delay of type 2 diabetes glycomet sr 500 uses dose patients 75 years and older, metformin initiation is not recommended in these patients. Intravascular administration of iodinated contrast agents may lead read article contrast induced nephropathy, resulting in metformin accumulation and an increased risk uses dose lactic acidosis.
Metformin should be discontinued prior read more or at the time of the glycomet sr 500 uses dose procedure and not restarted until at uses dose 48 hours after, provided that renal function has been re-evaluated and found to be stable, see sections 4.
Metformin must be discontinued at the time of glycomet sr 500 uses dose under general, spinal or epidural anaesthesia. Therapy may be restarted no earlier than 48 hours following surgery uses dose resumption of oral nutrition and provided that renal function has been re-evaluated and found to be stable.
All patients should glycomet sr 500 uses dose their diet with a regular distribution of carbohydrate intake during uses dose day. Overweight patients should continue their energy-restricted diet. Metformin alone never causes hypoglycaemia, although caution is advised when it is used in combination with insulin or other oral antidiabetics e. Alcohol intoxication is associated with an increased risk click the following article lactic acidosis, particularly in case of fasting, malnutrition or hepatic impairment.
Metformin must be discontinued prior to or at the time of the imaging procedure and not restarted until glycomet sr 500 uses dose least 48 hours after, provided that renal function has been re-evaluated and found to be stable, see sections 4. Some medicinal products can adversely affect renal function which may increase the risk of lactic acidosis, e. Uses dose starting or using such products in combination with metformin, close aspirin strokes of renal function is necessary.
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