CLINICAL USE
Non-insulin dependent diabetes mellitus Polycystic ovary syndrome
DOSE IN NORMAL RENAL FUNCTION
500 mg 3 times a day; maximum 2 g daily in divided dosesPolycystic ovary syndrome: 1.5–1.7 g daily in 2–3 divided doses
PHARMACOKINETICS
DOSE IN RENAL IMPAIRMENT
GFR (mL/MIN)
40–50 25–50% of dose10–40 25% of dose. See ‘Other Information’
DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES
IMPORTANT DRUG INTERACTIONS
Potentially hazardous interactions with other drugs
ADMINISTRATION
Reconstition
–
Route
Oral
Rate of Administration
–
Comments
–
OTHER INFORMATION
Lactic acidosis is a rare but serious metabolic complication that can occur due to metformin accumulation. Reported cases have occurred primarily in diabetic patients with significant renal impairmentAs metformin is renally excreted eGFR values should be determined before initiating treatment and regularly thereafter:at least annually in patients with —normal renal functionat least 2–4 times a year in patients —with an eGFR at the lower limit of normal and in elderly subjectsSpecial caution should be exercised in the elderly in situations where renal function may become impaired, e.g. initiating therapy with antihypertensives, diuretics