Formet 850

✔️ Formet 850 acts by:

• Decreasing hepatic glucose output.
• Delaying intestinal absorption of glucose.
• Improving insulin sensitivity in muscle and fat tissue.

✔️ Dosage & Administration-Immediate-Extended-Release TabletsRelease Tablets

Adults:
Initial dose: 500 mg twice daily or 850 mg once daily with meals.
Dose may be increased gradually by 500 mg weekly or 850 mg every 2 weeks up to 2000–2550 mg/day, given in divided doses.
Doses above 2000 mg are better tolerated when taken three times daily with meals.

Children (≥10 years):
Starting dose: 500 mg twice daily with meals.
Increase by 500 mg weekly, up to a maximum of 2000 mg/day in divided doses.

✔️ Dosage & Administration:

Adults:
Starting dose: 500 mg once daily with the evening meal.
Increase by 500 mg weekly up to a maximum of 2000 mg once daily, or 1000 mg twice daily with meals.
Do not crush or chew extended-release tablets.

Renal Impairment:
Contraindicated if eGFR <30 mL/min/1.73m².
Reassess benefits and risks if eGFR <45 mL/min/1.73m².

✔️ Side Effects

Common: Nausea, vomiting, diarrhea, abdominal pain, loss of appetite, metallic taste.
Very Rare: Lactic acidosis, reduced vitamin B₁₂ absorption, skin rash, or liver function abnormalities.
Long-term use may cause vitamin B₁₂ deficiency, potentially leading to anemia or neuropathy.

✔️ Pregnancy & Lactation

Pregnancy: Metformin should be avoided during pregnancy; insulin is preferred for optimal glycaemic control.

Lactation: Small amounts of metformin are excreted in breast milk. Use is not recommended during breastfeeding.

✔️ Interaction

• Nifedipine: May enhance metformin absorption.
• Cationic drugs (e.g. Digoxin, Morphine, Quinidine) may compete for renal tubular secretion.
• Thiazide diuretics, corticosteroids, estrogen, oral contraceptives, phenytoin, nicotinic acid, calcium channel blockers, and isoniazid may reduce glycaemic control.
• Alcohol and NSAIDs increase the risk of lactic acidosis.

✔️ Contraindications

• Hypersensitivity to metformin.
• Severe renal impairment (GFR <30 mL/min).
• Metabolic acidosis (including lactic acidosis, diabetic ketoacidosis).
• Conditions associated with hypoxia (e.g. cardiac or respiratory failure, shock, recent MI).
• Hepatic impairment or excessive alcohol intake.

✔️ Precautions & Warnings

• Monitor renal function regularly; discontinue if kidney function deteriorates.
• Stop therapy temporarily before surgery or radiologic procedures involving contrast dye.
• Use with caution in elderly patients due to decreased renal clearance.
• Monitor vitamin B₁₂ levels annually during long-term use.
• Avoid in conditions causing dehydration, infection, or shock.
• May cause lactic acidosis—a rare but serious condition; discontinue if symptoms like rapid breathing, fatigue, or abdominal pain occur.

✔️ Storage:

• Store below 30°C, away from moisture and direct light.
• Keep out of reach of children.
• Dispense only on prescription of a registered physician.