HUMAMET Metformin Hydrochloride 850mg Tablet 1's
Indications/Uses
Humamet can be given alone as an initial treatment or to supplement treatment with a sulfonylurea. In patients with insulin-dependent diabetes mellitus (type I) who are not adequately controlled, Humamet can be added to their existing treatment regimen.
Dosage/Direction for Use
The dosage of Humamet must be individualized based on both effectiveness and tolerance but should not exceed the maximum dose of 2,550 mg.
If in combination therapy with either a sulfonylurea or insulin, diabetic control should be checked by blood sugar readings because of the possibility of hypoglycemia.
The dose should be increased gradually. One 500-mg tablet, 3 times daily is often enough to give good diabetic control. This may be achieved within a few days, but it is not unusual for the full effect to be delayed for up to 2 weeks. If control is incomplete, a cautious increase in dosage to maximum of 3 g daily is justified. Once control has been obtained, it may be possible to reduce the dosage.
When combined with existing sulfonylurea therapy which is not giving adequate control, one 500-mg tablet should be added initially, the dosage of Humamet being gradually increased until optimal control is obtained. Often, the sulfonylurea may be reduced and in some patients, withdrawn. Humamet can then be continued as the sole therapy.
Overdosage
In excessive dosage and particularly, if there is a possibility of accumulation, lactic acidosis should be suspected.
Intensive supportive therapy is recommended which should be particularly directed as correcting fluid loss and metabolic disturbance.
Administration
Contraindications
Patients with the following conditions: Renal disease or dysfunction, chronic liver disease, cardiac failure, recent myocardial infarction; acute or chronic metabolic acidosis, including diabetic ketoacidosis with or without coma. Diabetic ketoacidosis should be treated with insulin. History of, or states associated with lactic acidosis or hypoxemia, alcoholism.
The use of Humamet should be stopped 2-3 days before surgery or clinical investigations eg, IV urography and IV angiography. It should be resumed only after control of renal function has been regained.
Special Precautions
Patients receiving Humamet should have their vitamin B12 levels estimated annually since decreased vitamin B12 absorption has been reported.
When used alone, Humamet is not prone to cause hypoglycemia. However, when given in combination with a sulfonylurea, blood glucose levels should be monitored.
Use in Pregnancy & Lactation: Safety in pregnant women and in nursing mothers has not been established. The use of Humamet during pregnancy or in breastfeeding is not advised.
Use In Pregnancy & Lactation
Adverse Reactions
Very rarely, lactic acidosis has been associated with Humamet treatment. It is a serious metabolic complication due to accumulation of metformin. It may also occur in association with a number of pathophysiologic conditions including diabetes mellitus, and whenever there is significant tissue hypoperfusion and hypoxemia. Lactic acidosis is characterized by elevated blood lactate levels, decreased blood pH, electrolyte disturbances with an increase in anion gap and an increased lactate/pyruvate ratio. Lactic acidosis is a medical emergency that must be treated in a hospital immediately.
Drug Interactions
In healthy subjects given single 500-mg doses of cefalexin and metformin, plasma metformin peak plasma concentration (Cmax) and area under the curve (AUC) increased by an average of 34% and 24%, respectively, and metformin renal clearance decreased by an average of 14%. No information is available about the interaction of cefalexin and metformin following multiple dose administration.
Storage
Action
Pharmacokinetics: Absorption, Bioavailability and Elimination: The absolute bioavailability of a metformin HCl 500-mg tablet given under fasting condition is approximately 50-60%. Absorption of metformin HCl occurs mainly from the small intestine. It is stable and does not bind to plasma proteins. It is excreted in the urine apparently unchanged.
MedsGo Class
Features
- Metformin