GLUCOPHAGE TABLET 1000 MG [SIN11945P]

Product Info

GLUCOPHAGE TABLET 1000 MG

[SIN11945P]

4.1. Therapeutic indications
Treatment of type 2 diabetes mellitus, particularly in overweight patients, when dietary management and exercise alone does not result in adequate glycaemic control.

• In adults, Glucophage film-coated tablets may be used as monotherapy or in combination with other oral anti-diabetic agents or with insulin.

• In children from 10 years of age and adolescents, Glucophage film-coated tablets may be used as monotherapy or in combination with insulin.

A reduction of diabetic complications has been shown in overweight type 2 diabetic adult patients treated with metformin as first-line therapy after diet failure (see section 5.1 – please refer to the Product Insert/Patient Information Leaflet published on HSA for the full drug information).

4.2. Posology and method of administration

Oral route

Adults with normal renal function (GFR ≥ 90mL/min):
Monotherapy and combination with other oral antidiabetic agents:

• The usual starting dose is one tablet of Glucophage 500 mg or 850 mg 2 or 3 times daily, given during or after meals.

• After 10 to 15 days the dose should be adjusted on the basis of blood glucose measurements. A slow increase of dose may improve gastrointestinal tolerability.

• In patients receiving a high metformin dose (2 to 3 grams per day), it is possible to replace two Glucophage 500 mg, film-coated tablets with one Glucophage 1000 mg, film-coated tablet.

• The maximum recommended dose of metformin is 3 g daily, taken as 3 divided doses.

• If transfer from another oral antidiabetic agent is intended: discontinue the other agent and initiate metformin at the dose indicated above.

Combination with insulin:
Metformin and insulin may be used in combination therapy to achieve better blood glucose control. Metformin is given at the usual starting dose of one tablet of Glucophage 500 mg or 850 mg, film-coated tablet, 2–3 times daily, while insulin dosage is adjusted on the basis of blood glucose measurements.

Elderly:
Due to the potential for decreased renal function in elderly subjects, the metformin dosage should be adjusted based on renal function. Regular assessment of renal function is necessary (see section 4.4 – please refer to the Product Insert/Patient Information Leaflet published on HSA for the full drug information).

Renal impairment:
A GFR should be assessed before initiation of treatment with metformin containing products and at least annually thereafter. In patients at an increased risk of further progression of renal impairment and in the elderly, renal function should be assessed more frequently, e.g. every 3–6 months.

Paediatric population:
Monotherapy and combination with insulin

• Glucophage film-coated tablets can be used in children from 10 years of age and adolescents.

• The usual starting dose is one tablet of 500mg twice daily, given during meals or after meals.

After 10 to 15 days the dose should be adjusted on the basis of blood glucose measurements. A slow increase of dose may improve gastrointestinal tolerability. The maximum recommended dose of metformin is 2 g daily, taken as 2 or 3 divided doses.

4.3. Contraindications

• Hypersensitivity to metformin or to any of the excipients in section 6.1 – please refer to the Product Insert/Patient Information Leaflet published on HSA for the full drug information.

• Any type of acute metabolic acidosis (such as lactic acidosis, diabetic ketoacidosis)

• Diabetic pre-coma.

• Severe renal failure (GFR <30 mL/min).

• Acute conditions with the potential to alter renal function such as: dehydration, severe infection, shock.

• Disease which may cause tissue hypoxia (especially acute disease, or worsening of chronic disease) such as: decompensated heart failure, respiratory failure, recent myocardial infarction, shock.

• Elective major surgery (see section 4.4 – please refer to the Product Insert/Patient Information Leaflet published on HSA for the full drug information).

• Hepatic insufficiency, acute alcohol intoxication, alcoholism.