Metformin Hydrochloride Tablets, USP
DESCRIPTION
CLINICAL PHARMACOLOGY
Mechanism of Action
Pharmacokinetics
Absorption and Bioavailability
Distribution
Metabolism and Elimination
Special Populations
Patients with Type 2 Diabetes
Renal Insufficiency
Hepatic Insufficiency
Geriatrics
| Healthy, nondiabetic adults: 500 mg single dose (24) 850 mg single dose (74)d 850 mg three times daily for 19 dosese (9) | 1.03 (±0.33)1.6 (±0.38)2.01 (±0.42) | 2.75 (±0.81) 2.64 (±0.82) 1.79 (±0.94) | 600 (±132) 552 (±139) 642 (±173) |
| Adults with type 2 diabetes: 850 mg single dose (23) 850 mg three times daily for 19 dosese (9) | 1.48 (±0.5)1.9 (±0.62) | 3.32 (±1.08) 2.01 (±1.22) | 491 (±138) 550 (±160) |
| Elderlyf, healthy nondiabetic adults: 850 mg single dose (12) | 2.45 (±0.7) | 2.71 (±1.05) | 412 (±98) |
| Renal-impaired adults: 850 mg single dose Mild (CLcrg 61 to 90 mL/min) (5) Moderate (CLcr 31 to 60 mL/min) (4) Severe (CLcr 10 to 30 mL/min) (6) | 1.86 (±0.52)4.12 (±1.83)3.93 (±0.92) | 3.2 (±0.45) 3.75 (±0.5) 4.01 (±1.1) | 384 (±122) 108 (±57) 130 (±90) |
Pediatrics
Gender
Race
Clinical Studies
| FPG (mg/dL) Baseline Change at FINAL VISIT | 241.5-53 | 237.76.3 | NS**0.001 |
| Hemoglobin A1c (%) Baseline Change at FINAL VISIT | 8.4-1.4 | 8.20.4 | NS**0.001 |
| Body Weight (lbs) Baseline Change at FINAL VISIT | 201-1.4 | 206-2.4 | NS **NS ** |
| Fasting Plasma Glucose (mg/dL) Baseline Change at FINAL VISIT | 250.5-63.5 | 247.513.7 | 253.9-0.9 | NS**0.001 | NS**0.001 | NS**0.025 |
| Hemoglobin A1c (%) Baseline Change at FINAL VISIT | 8.8-1.7 | 8.50.2 | 8.9-0.4 | NS**0.001 | NS** 0.001 | 0.0070.001 |
| Body Weight (lbs) Baseline Change at FINAL VISIT | 202.20.9 | 203-0.7 | 204-8.4 | NS**0.011 | NS**0.001 | NS**0.001 |
| Total Cholesterol (mg/dL) Baseline Mean % Change at FINAL VISIT | 211 -5% | 212.3 1% | 213.1 -2% | 215.6 -4% | 219.6 1% |
| Total Triglycerides (mg/dL) Baseline Mean % Change at FINAL VISIT | 236.1 -16% | 203.5 1% | 242.5 -3% | 215 -8% | 266.1 4% |
| LDL-Cholesterol (mg/dL) Baseline Mean % Change at FINAL VISIT | 135.4 -8% | 138.5 1% | 134.3 -4% | 136 -6% | 137.5 3% |
| HDL Cholesterol (mg/dL) Baseline Mean % Change at FINAL VISIT | 39 2% | 40.5 -1% | 37.2 5% | 39 3% | 37 1% |
| Hemoglobin A1c (%) Baseline Change at FINAL VISIT | 8.95-2.1 | 9.32-1.56 | -0.54 ± 0.43a |
| Insulin Dose (U/day) Baseline Change at FINAL VISIT | 93.12-0.15 | 94.6415.93 | -16.08 ± 7.77b |
Pediatric Clinical Studies
| FPG (mg/dL) Baseline Change at FINAL VISIT | (n=37)162.4-42.9 | (n=36)192.321.4 | <0.001 |
| Body Weight (lbs) Baseline Change at FINAL VISIT | (n=39)205.3-3.3 | (n=38)189-2 | NS** |
INDICATIONS AND USAGE
CONTRAINDICATIONS
Metformin should be temporarily discontinued in patients undergoing radiologic studies involving intravascular administration of iodinated contrast materials, because use of such products may result in acute alteration of renal function. (See also PRECAUTIONS.)
- Renal disease or renal dysfunction (e.g., as suggested by serum creatinine levels ≥ 1.5 mg/dL [males], ≥ 1.4 mg/dL [females] or abnormal creatinine clearance) which may also result from conditions such as cardiovascular collapse (shock), acute myocardial infarction, and septicemia (see WARNINGS and PRECAUTIONS.)
- Known hypersensitivity to metformin hydrochloride.
- Acute or chronic metabolic acidosis, including diabetic ketoacidosis, with or without coma. Diabetic ketoacidosis should be treated with insulin.
WARNINGS
Lactic Acidosis
PRECAUTIONS
General
Information for Patients
Laboratory Tests
Drug Interactions (Clinical Evaluation of Drug Interactions Conducted With Metformin Hydrochloride Tablets)
Carcinogenesis, Mutagenesis, Impairment of Fertility
Pregnancy
Teratogenic effects
Nursing Mothers
Pediatric Use
Geriatric Use
ADVERSE REACTIONS
| Diarrhea | 53.2 | 11.7 |
| Nausea/Vomiting | 25.5 | 8.3 |
| Flatulence | 12.1 | 5.5 |
| Asthenia | 9.2 | 5.5 |
| Indigestion | 7.1 | 4.1 |
| Abdominal Discomfort | 6.4 | 4.8 |
| Headache | 5.7 | 4.8 |
Pediatric Patients
OVERDOSAGE
DOSAGE AND ADMINISTRATION
Recommended Dosing Schedule
Transfer From Other Antidiabetic Therapy
Concomitant Metformin and Oral Sulfonylurea Therapy in Adult Patients
Concomitant Metformin and Insulin Therapy in Adult Patients
Specific Patient Populations
HOW SUPPLIED
They are supplied by State of Florida DOH Central Pharmacy as follows:
| 53808-0459-1 | 850 mg | 30 Tablets in a Blister Pack | WHITE | 65862-009 |
Patient Information
Metformin Hydrochloride Tablets, USP
What is metformin?
Who should not take metformin?
- have kidney problems
- have liver problems
- have heart failure that is treated with medicines, such as Lanoxin® (digoxin) or Lasix® (furosemide)
- drink a lot of alcohol. This means you binge drink for short periods or drink all the time
- are seriously dehydrated (have lost a lot of water from your body)
- are going to have an x-ray procedure with injection of dyes (contrast agents)
- are going to have surgery
- develop a serious condition, such as heart attack, severe infection, or a stroke
- are 80 years or older and you have NOT had your kidney function tested
Can metformin hydrochloride tablets be used in children?
How should I take metformin hydrochloride tablets?
- have an illness that causes severe vomiting, diarrhea or fever, or if you drink a much lower amount of liquid than normal. These conditions can lead to severe dehydration (loss of water in your body). You may need to stop taking metformin for a short time.
- plan to have surgery or an x-ray procedure with injection of dye (contrast agent). You may need to stop taking metformin hydrochloride tablets for a short time.
- start to take other medicines or change how you take a medicine. Metformin can affect how well other drugs work, and some drugs can affect how well metformin work. Some medicines may cause high blood sugar.
What should I avoid while taking metformin hydrochloride tablets?
What are the side effects of metformin?
- feeling very weak, tired, or uncomfortable
- unusual muscle pain
- trouble breathing
- unusual or unexpected stomach discomfort
- feeling cold
- feeling dizzy or lightheaded
- suddenly developing a slow or irregular heartbeat
General advice about prescription medicines
This Product was Repackaged By:
State of Florida DOH Central Pharmacy 104-2 Hamilton Park Drive Tallahassee, FL 32304 United States