Comet XR 500mg 10pcs

✔️ Indications

Comet XR 500mg is used for

• Treatment of type 2 diabetes mellitus when diet and exercise alone are insufficient to achieve adequate glycemic control, particularly in overweight individuals.
• Adults may use metformin either on its own or in combination with other oral antidiabetic medications or insulin.
• Children and adolescents as young as ten years old can take metformin either by itself or in combination with insulin.
• There was a reduction in diabetic complications in overweight type 2 diabetes adult patients treated with metformin as the first-line therapy after diet failure.

✔️ Pharmacology

The biguanide class of antihyperglycemic drug metformin is used to treat type 2 diabetes. Plasma glucose levels at rest and after meals are both decreased. It works in a different way from sulfonylureas and doesn't result in hypoglycemia. Metformin improves peripheral glucose uptake and utilization to increase insulin sensitivity. It decreases intestinal glucose absorption, which in turn decreases hepatic glucose production.

✔️ Dosage & Administration

Metformin Hydrochloride Dosage: The dosage of metformin hydrochloride should be adjusted based on effectiveness and tolerance, but not to go over the highest recommended daily dosages.

• Adults: The recommended initial dose of metformin is 850 mg once daily or 500 mg twice daily, administered with meals. Increases in dosage should be made in divided doses of 500 mg every week or 850 mg every two weeks, up to a maximum of 2000 mg per day. A maximum daily dose of 2550 mg of glucosamine may be administered to patients who need more glycemic control. Taking doses over 2000 mg three times daily with meals may improve tolerance.
• Children: The recommended Metformin starting dose is 500 mg twice daily, taken with meals. Increases in dosage should be made in weekly increments of 500 mg, up to a daily cap of 2000 mg, administered in divided doses.

The extended-release tablet of metformin should not be chewed, chopped, or crushed before being taken. 

• Adult: 500 mg of Metformin XR once daily with dinner is the typical starting dose. The dosage should be increased by 500 mg weekly increments, up to a maximum of 2000 mg taken with a meal once daily in the evening, or 1000 mg twice daily. Up to the maximum recommended daily dose, a patient taking a Metformin immediate-release tablet may be switched to a Metformin extended-release tablet.
• Children: Children have not been studied with metformin extended-release tablets.
• Patient with renal impairment: Patients with an eGFR of less than 30 mL/min/1.73 m2 should not take metformin. Evaluate the risks and rewards of counting if the eGFR is less than 45 mL/min/1.73 m2.

✔️ Interaction

Co-administration of carbonic anhydrase (Topiramate, Zonisamide) may increase the risk of lactic acidosis. Drugs like Ranolazine, dolutegravir, and Cimetidine that lower Metformin clearance may contribute to Metformin buildup. Alcohol can enhance the impact of metformin on lactate metabolism.

✔️ Contraindications

• Hypersensitivity to any of the excipients or the active ingredient
• Acute metabolic acidosis of any kind (such as lactic acidosis, diabetic ketoacidosis).
• Renal failure that is severe (GFR 30 mL/min).
• Acute illnesses like dehydration, severe infections, and shock have the potential to affect renal function.
• Acute or chronic illnesses that can result in tissue hypoxia include alcoholism, acute alcohol intoxication, recent myocardial infarctions, cardiac or respiratory failure, shock, and hepatic insufficiency.

✔️ Side Effects

Disorders of metabolism and nutrition: 

• Lactic acidosis is extremely rare. During long-term metformin use, there is a decrease in serum levels and a reduction in vitamin B12 absorption. It is advised to take this etiology into account if a patient has megaloblastic anemia. In post-marketing experience, peripheral neuropathy cases in patients with vitamin B12 deficiency have been reported (frequency not known)
• A common nervous system condition is taste disturbance. The cause of encephalopathy is not yet known.
• Gastrointestinal disorders, such as nausea, vomiting, diarrhea, abdominal pain, and loss of appetite, are very common. Most frequently, these unfavorable side effects appear at the beginning of therapy and usually go away on their own. Metformin should be taken in two or three daily doses, ideally during or after meals, to help prevent them. The dose can be gradually increased to enhance gastrointestinal tolerability.
• Hemolytic anemia is a blood and lymphatic system disease that is not well understood.
• It is extremely uncommon for liver function test issues or hepatitis to go away after stopping metformin.
• Disorders of the skin and subcutaneous tissues: Erythema, pruritus, and urticaria are incredibly uncommon.

✔️ Pregnancy & Lactation

An increased risk of congenital defects and perinatal mortality is associated with uncontrolled diabetes (gestational or permanent) during pregnancy. In order to keep blood glucose levels as close to normal as possible and lower the risk of fetal abnormalities, it is advised that diabetes be managed with insulin rather than metformin when a patient is planning to become pregnant or is already pregnant.

During breastfeeding, metformin is secreted in human breast milk. No negative effects were observed in newborns or infants who were breastfed. Metformin uses while nursing is not advised due to a lack of research. When deciding whether or not to stop breastfeeding, one should weigh the advantages with any potential risks to the child.

✔️ Precautions & Warnings

• Your doctor has prescribed Comet XR 500 to help you manage your blood sugar levels and lower your risk of developing complications from diabetes, like heart attacks.
• Prolonged use of Comet XR 500 may lead to vitamin B12 deficiency which may lead to anemia, causing fatigue, pale skin, shortness of breath, or headache. Notify your doctor if you experience any of these as you may require supplements.
• In comparison to other diabetes medications, there is less risk of weight gain and low blood sugar with this medication. If you experience any deep or rapid breathing, persistent nausea, vomiting, or stomach pain, call your doctor right away. Comet XR 500 may result in the rare but serious condition known as lactic acidosis, which is characterized by an excess of lactic acid in the blood.
• When taking other anti-diabetic medications, alcohol, or postponing/skipping a meal, hypoglycemia (low blood sugar level) may happen. Bring some sugar with you for quick relief.
• While you are taking this medication, your doctor will check your blood sugar levels and kidney function on a regular basis.

✔️ Storage Conditions

Keep the temperature below 30°C and away from light and moisture. Keep out of children's reach.