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Oral Antidiabetic Agents

Treatment of type 2 diabetes mellitus in adult when dietary management & exercise alone does not result in adequate glycaemic control. May be used as monotherapy or in combination w/ other oral antidiabetic agents or w/ insulin. Adjuvant treatment in poorly controlled type 1 diabetics.

Monotherapy & combination w/ other oral antidiabetic agents: 850 mg 2-3 tab daily. Max: 3 g daily. Combination w/ insulin 850 mg 2-3 tab daily & adjust insulin according to blood glucose measurements.

Should be taken with food.

Diabetic ketoacidosis, diabetic pre-coma; renal failure, renal dysfunction (serum creatinine > 135 micromole/L in men & > 110 micromole/L in women). Acute conditions w/ potential to alter renal function, eg dehydration, severe infection, shock, intravascular administration of iodinated contrast agents. Acute or chronic disease which may cause tissue hypoxia, eg cardiac or resp failure, recent MI, shock, hepatic insufficiency, acute alcohol intoxication, alcoholism. Lactation.

Lactic acidosis is rare & may occur in significant renal failure. Regular renal monitoring is needed. Suspend therapy during surgery & clinical investigations using IV iodinated contrast media. Metformin alone does not cause hypoglycaemia; alert patient to risk of hypoglycaemia when used w/ other antidiabetic agents.

GI disturbances, metallic taste. Rarely, lactic acidosis, mild erythema.

Alcohol & IV iodinated contrast media may increase risk of lactic acidosis. Glucocorticoids & diuretics. β2 agonist, ACE inhibitors.

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