سعر ماكسوفاج اكس ار 1000مجم 30 اقراص 2024

Metformin hydrochloride 1000 mg extended-release tablets (30 tablets, 3 strips), Eva Pharma / Next Pharma (Egypt); oral biguanide antidiabetic.

• Type 2 diabetes mellitus in adults (especially overweight) when diet and exercise alone are insufficient; monotherapy or with other oral antidiabetics or insulinPopulation: Adultselectronic medicines compendium (emc)
• Reduction in the risk or delay of onset of type 2 diabetes in high-risk overweight adults with IGT and/or IFG and/or raised HbA1c despite 3-6 months of intensive lifestyle changePopulation: Adultselectronic medicines compendium (emc)
• Polycystic ovary syndrome: stimulation of ovulation to support conceptionPopulation: Adult women with PCOSelectronic medicines compendium (emc)

• Very common: nausea, vomiting, diarrhoea, abdominal pain, loss of appetite (mostly at initiation, usually resolving). Common: vitamin B12 decrease/deficiency, taste disturbance. Very rare: lactic acidosis, liver function test abnormalities/hepatitis, skin reactions.International label, equivalent formulation · electronic medicines compendium (emc)

• Hypersensitivity to metformin or excipients; any acute metabolic acidosis (lactic acidosis, diabetic ketoacidosis); diabetic pre-coma; severe renal failure (GFR <30 mL/min); acute conditions that may alter renal function (dehydration, severe infection, shock); diseases that may cause tissue hypoxia (decompensated heart failure, respiratory failure, recent myocardial infarction, shock); hepatic insufficiency, acute alcohol intoxication, alcoholism.International label, equivalent formulation · electronic medicines compendium (emc)
• US label: severe renal impairment (eGFR <30 mL/min/1.73 m2), hypersensitivity to metformin, acute or chronic metabolic acidosis including diabetic ketoacidosis.International label, equivalent formulation · DailyMed (U.S. National Library of Medicine)

• Lactic acidosis (very rare, serious) occurs mostly with acute worsening of renal function, cardiorespiratory illness or sepsis; temporarily stop metformin in dehydration (severe vomiting/diarrhoea, fever, reduced fluid intake). Stop before or at the time of iodinated contrast imaging and restart no sooner than 48 h after, once renal function is stable.International label, equivalent formulation · electronic medicines compendium (emc)
• Boxed warning (US): postmarketing metformin-associated lactic acidosis has resulted in death, hypothermia, hypotension and resistant bradyarrhythmias; onset is often subtle (malaise, myalgias, respiratory distress, somnolence, abdominal pain).International label, equivalent formulation · DailyMed (U.S. National Library of Medicine)

• AlcoholAlcohol intoxication increases the risk of lactic acidosis (especially with fasting, malnutrition or hepatic impairment); avoid alcohol and alcohol-containing medicines.electronic medicines compendium (emc)
• Iodinated contrast agentsDiscontinue metformin before or at the time of the imaging procedure; restart no sooner than 48 h after, once renal function is re-evaluated and stable.electronic medicines compendium (emc)
• NSAIDs (incl. COX-2 inhibitors), ACE inhibitors, angiotensin II receptor antagonists, diuretics (especially loop diuretics)May adversely affect renal function and increase lactic acidosis risk; monitor renal function closely when starting these with metformin.electronic medicines compendium (emc)

• A large amount of data (>1000 exposed outcomes) indicates no increased risk of congenital abnormalities or feto/neonatal toxicity after metformin exposure in the periconceptional phase and/or during pregnancy; if clinically needed, metformin can be considered during pregnancy as an addition or alternative to insulin. Metformin crosses the placenta.International label, equivalent formulation · electronic medicines compendium (emc)
• US label: published studies with metformin use during pregnancy have not reported a clear association with major birth defects, miscarriage or adverse maternal/fetal outcomes; poorly controlled diabetes in pregnancy carries maternal and fetal risks.International label, equivalent formulation · DailyMed (U.S. National Library of Medicine)
• Metformin is excreted in breast milk; no adverse effects were observed in breastfed infants, but because data are limited, breastfeeding is not recommended during treatment.International label, equivalent formulation · electronic medicines compendium (emc)

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