Given Akaralmitforman form oral tablets in patients with type II diabetes. The drug is absorbed well from the intestine. The drug combines with blood proteins as it is not metabolized in the liver and is ejected is variable in the urine. The half-life Of the drug ranges between 1.5-3 hours.
How do these drugs work?
Metformin works to maintain a constant level of glucose in the blood by increasing the sensitivity of liver, muscle, and fat tissue to insulin and this leads to:
· Reducing the amount of glucose secreted by the liver and obstructing the transformation of glycogen stored in the liver to glucose.
· Increased glucose entry and utilization in muscle and adipose tissue (and thus reduces insulin resistance).
· Limit the ability of the intestine to absorb glucose from the meal.
Metformin is characterized for drugs sulfonylureas and insulin thus:
· No effect on the beta cells in the pancreas as the mechanism of action does not depend on the secretion of insulin from the pancreas, and as a result, drug metformin does not cause A rise in the level of insulin in the blood and thus Does not lead to a sharp drop in blood sugar when used alone As it happens with drugs sulfonylureas or insulin.
· These drugs do not cause an increase in the weight of patients, as observed when using drugs sulfonylureas or insulin. This may be due to the fact that metformin does not alert the appetite to eat when the patient. And therefore the drug metformin Is considered good medicine for obese patients with type II diabetes.
It should be noted that in the event of the use of metformin with sulfonylureas drugs or with insulin may happen sharp drop in blood sugar, as well as an increase in the weight of the patient.
· Another benefit of metformin ability to reduce the level of fat in the blood, especially type low-density(LDL ) Known Bdharrh body, especially for diabetics. In a comparative study found that metformin achieved the lowest death rate (8%) compared to insulin (28%), and sulfonylureas (16%), and debt Althiazouliden (14%).
Medical Uses
Described Akaralmitforman older and younger patients with type II diabetes and especially obese people, because of insulin resistance. And this drug can be used either alone or in combination with other antihypertensive drugs in the case of sugar the inability of a single drug To reduce the level Sugar in the blood. Metformin can be used also to prevent diabetes in people at risk for this disease, as well as for the treatment of polycystic ovaries Polycystic ovaries .
Therapeutic dose
Metformin is usually taken twice a day with breakfast and dinner and the doctor dosage according to the needs of each patient. In adult patients are usually start with a dose of 500 mg taken twice daily Or 850 mg once daily. The dose is increased gradually by 500 mg per week or 850 mg every two weeks if the patient holds it until it reaches the level of sugar in the blood to Limit. The highest dose of this medication in the 2550 mg given day an average of three doses. If I give long-acting tablets metformin Vtkon initial dose of 500 mg per day taken with the evening meal in the evening. The dosage may be increased by 500 mg per week up to a maximum of 2000 mg once or twice a day. Metformin should be taken with a meal.
In children aged 10-16 years, so the initial dose of 500 mg twice a day, and can be increased by 500 mg per week up to a maximum of 2000 mg.
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