As mono or combined therapy
with sulphonylurea in patients with Non-insulin-dependent diabetes mellitus (type-2 diabetes) especially if overweight and whose blood glucose level cannot be controlled by diet alone.
As an adjuvant therapy
in insulin-dependent diabetic patients with hardly controlled symptoms.
Metformin 500 mg
18 Years Old and Above
3 times 1 film-coated tablet per day. Dosage should be increased gradually, one tablet 500 mg three times daily often enough to give a good diabetic control. Maximum daily dose: 3,000 mg.
When combined with existing sulfonylurea therapy which is not giving adequate control, one tablet of 500 mg metformin HCl should be added initially, with the dosage of metformin HCl being gradually increased until optimal control is obtained.
When metformin HCl is used concomitantly with insulin the guidelines are as follows:
- When the dosage of insulin is less than 60 units per day, one tablet of 500 mg metformin HCl may be added initially, followed by a gradual reduction of insulin (4 units every 2-4 days). The tablets may be increased at weekly intervals.
- When the dosage of insulin is more than 60 units per day, the addition of metformin HCl may occasionally cause a rapid fall in the blood sugar level. Careful observation of such patients is advised in the first 24 hours after the introduction of metformin HCl. After this, the recommendations stated previously (point a) should be followed.
Metformin HCl should be given with food or after meal in divided doses.