سعر ميبافاج 500مجم 30 اقراص 2024

Metformin hydrochloride 500 mg tablets (Mepaco, Egypt), a biguanide oral antidiabetic for type 2 diabetes; 30 tablets per pack.

• Adjunct to diet and exercise to improve glycaemic control in adults and pediatric patients 10 years of age and older with type 2 diabetes mellitus.Population: Adults and children 10 years and olderDailyMed (U.S. National Library of Medicine)

• Most common adverse reactions (over 5%, more than placebo) in adult trials: diarrhoea (about 53%), nausea/vomiting (about 26%), flatulence (about 12%), asthenia, indigestion, abdominal discomfort and headache.International label, equivalent formulation · DailyMed (U.S. National Library of Medicine)

• Severe renal impairment (eGFR below 30 mL/min/1.73 m2).International label, equivalent formulation · DailyMed (U.S. National Library of Medicine)
• Hypersensitivity to metformin; acute or chronic metabolic acidosis, including diabetic ketoacidosis.International label, equivalent formulation · DailyMed (U.S. National Library of Medicine)

• Boxed warning - lactic acidosis: post-marketing cases of metformin-associated lactic acidosis, sometimes fatal; risk factors include renal impairment, concomitant carbonic anhydrase inhibitors (e.g. topiramate), age 65 or older, radiological studies with contrast, surgery and other procedures, hypoxic states, excessive alcohol intake and hepatic impairment. Discontinue immediately and hospitalise if suspected.International label, equivalent formulation · DailyMed (U.S. National Library of Medicine)
• Iodinated contrast: stop metformin at the time of, or before, an iodinated contrast procedure in patients with eGFR 30-60, a history of hepatic impairment, alcoholism or heart failure, or intra-arterial contrast; re-evaluate eGFR 48 hours after and restart if renal function is stable.International label, equivalent formulation · DailyMed (U.S. National Library of Medicine)
• Vitamin B12 deficiency: metformin may lower vitamin B12 levels; measure haematological parameters annually and vitamin B12 every 2-3 years in at-risk patients.International label, equivalent formulation · DailyMed (U.S. National Library of Medicine)

• Carbonic anhydrase inhibitors (topiramate, zonisamide, acetazolamide, dichlorphenamide)May cause hyperchloraemic non-anion-gap metabolic acidosis and increase the risk of lactic acidosis; monitor more frequently.DailyMed (U.S. National Library of Medicine)
• Drugs that reduce metformin clearance (e.g. ranolazine, vandetanib, dolutegravir, cimetidine)Increase systemic metformin exposure and may increase the risk of lactic acidosis; consider benefit-risk.DailyMed (U.S. National Library of Medicine)
• AlcoholAlcohol potentiates the effect of metformin on lactate metabolism; warn patients against excessive alcohol intake.DailyMed (U.S. National Library of Medicine)

• Limited published data with metformin in pregnancy have not reported a clear association with major birth defects, miscarriage or adverse maternal or fetal outcomes; poorly controlled diabetes in pregnancy carries maternal and fetal risks.International label, equivalent formulation · DailyMed (U.S. National Library of Medicine)
• Limited published studies report that metformin is present in human milk; no adverse effects on breastfed infants have been reported; weigh benefits of breastfeeding against the mother's clinical need.International label, equivalent formulation · DailyMed (U.S. National Library of Medicine)

• Metformin hydrochloride: Decreases hepatic glucose production, decreases intestinal absorption of glucose and improves insulin sensitivity by increasing peripheral glucose uptake and utilisation (US label). PubChem values refer to metformin base.