When this has no effect on insulin secretion of pancreatic beta-cells causes hypoglycemic reactions. It reduces the level of triglycerides and low-density lipoprotein trenbolone enanthate cycle in blood. Stabilizes or reduces body weight. Has fibrinolytic action by inhibiting plasminogen activator inhibitor, tissue-type. Pharmacokinetics. After oral administration metformin is absorbed from the gastrointestinal tract. The bioavailability after ingestion of standard doses of 50-60%. The maximum plasma concentration is reached 2.5 hours after oral administration. Almost does not bind to plasma proteins. It accumulates in the salivary glands, muscles, liver and kidneys. Provided unchanged by the kidneys. The half-life is about 6.5 hours.When renal function is possible accumulation of the drug.
Diabetes mellitus type 2 without a tendency to ketoacidosis (especially in patients who are obese) when poor diet.
- in combination with insulin – for diabetes mellitus type 2, especially when expressed by the degree of obesity accompanied by secondary insulin resistance.
- diabetic ketoacidosis, diabetic precoma, coma;
- impairment of renal function;
- acute conditions with the risk of renal dysfunction: dehydration (diarrhea, vomiting), fever, severe infections, a condition of hypoxia (shock, sepsis, kidney infections, bronchopulmonary disease);
- symptomatic manifestations of acute and chronic diseases which may lead to the development of tissue hypoxia (cardiac or respiratory failure, acute myocardial infarction, etc.);
- major surgery and trauma (when shown holding insulin);
- abnormal liver function;
- chronic alcoholism, trenbolone enanthate cycle acute alcohol poisoning;
- pregnancy, breast-feeding; Hypersensitivity to the drug;
- lactic acidosis (including history);
- use for at least 2 days prior to and within 2 days after the radioisotope or radiological examinations introduction iodinated contrast material;
- compliance with a hypocaloric diet (less than 1000 calories / day);
Do not use the drug in patients older than 60 years, performing heavy physical work, which is associated with an increased risk of developing lactic acidosis.
Pregnancy and lactation:
When planning a pregnancy, or in the event of pregnancy while taking NovoFormin drug, it should be withdrawn and insulin. Since the data on the penetration into breast milk is not present, the drug is contraindicated in breastfeeding. If necessary, use NovoFormin drug during breast-feeding, breast-feeding should be discontinued.
Dosage and administration
The dose is established by the doctor individually, depending on the level of glucose in the blood. Tablets 500 mg film-coated. The initial dose of 500-1000 mg / day. (1-2 tablets). After 10-15 days may further gradual increase in the dose depending on the level of blood glucose. The maintenance dose is usually 1500-2000 mg / day (3-4 tablets) Maximum dose -. 3000 mg / day. (6 tablets).
Tablets 850 mg film-coated. The initial dose is 850 mg / day. After 1015 days may further gradual increase in the dose depending on the level of blood glucose. Maintenance dose usually is 1700 mg / day.The maximum dose – 2550 mg / day. In elderly patients the recommended daily dose should not exceed 1 g (2 tablets).
NovoFormin tablets should be taken as a whole during or immediately after a meal, washed down with a little liquid (a glass of water). To reduce the side effects from the gastrointestinal tract daily dose should be divided into 2-3 doses.
Due to the increased risk of lactic acidosis, the dose should be reduced in severe metabolic disorders.
Side effect On the part of the digestive system organs: . Nausea, vomiting, “metallic” taste in the mouth, loss of appetite, diarrhea, flatulence, abdominal pain These symptoms are particularly common at the beginning of treatment and trenbolone enanthate cycle usually disappear on their own. These symptoms can be reduced by appointment antotsidov derivatives of atropine or antispasmodics. On the part of metabolism: rarely – lactic acidosis (requires discontinuation of treatment); long-term treatment – B12 vitamin deficiencies (malabsorption). From the side of hematopoiesis: in some cases – megaloblastic anemia. From the Endocrine:hypoglycemia. Allergic reactions: skin rash.
If overdose NovoFormin lactic acidosis may develop fatal. The reason for the development of lactic acidosis may also be the accumulation of the drug due to renal dysfunction. Early symptoms of lactic acidosis include nausea, vomiting, diarrhea, drop in body temperature, abdominal pain, pain in the muscles, in the future may be marked shortness of breath, dizziness, impaired consciousness and coma develop. Treatment: In the event of signs of lactic acidosis, treatment with NovoFormin should immediately stop, the patient hospitalized immediately and determine the concentration of lactate, to confirm the diagnosis. The most effective measure for the excretion of the drug and NovoFormin lactate is hemodialysis. Spend as symptomatic treatment. If the drug combination therapy with sulfonylurea NovoFormin may develop hypoglycaemia.
Interaction with other medicinal products is not recommended combinations: not recommended for concomitant use of danazol to avoid hyperglycemic action of the latter. If necessary, treatment with danazol and after discontinuation of the last required dose of the drug NovoFormin correction under the control of blood glucose. Combinations requiring special care: chlorpromazine – when taken in high doses (100 mg daily) improves blood glucose, reducing insulin release. When neuroleptic treatment and after discontinuation of the last required correction dose NovoFormin drug controlled blood glucose levels. While the use of sulfonylureas, acarbose, insulin, nonsteroidal anti-inflammatory agents, monoamine oxidase inhibitors, oxytetracycline, angiotensin converting enzyme inhibitors, clofibrate derivatives, cyclophosphamide, P blockers may increase the hypoglycemic effect of the drug NovoFormin. While the use of corticosteroids, oral contraceptives, epinephrine, sympathomimetics, glucagon, thyroid hormones, thiazide and “loop” diuretics, phenothiazine derivatives, derivatives of nicotinic acid may reduce the hypoglycemic action NovoFormin drug. Cimetidine slows down NovoFormin the drug, resulting in increased risk of developing lactic acidosis. The drug NovoFormin may weaken the effect of anticoagulants (coumarin derivatives). Drinking alcohol increases the risk of lactic acidosis in acute alcohol intoxication, particularly in cases of starvation or low calorie diet compliance, as well as liver failure.
During treatment necessary to monitor renal function. At least 2 times a year, as well as the appearance of myalgia should determine the content of lactate in plasma. In addition, 1 every 6 months is necessary to monitor the level of creatinine in serum (especially in patients of advanced age) should not be prescribed the drug NovoFormin if the blood creatinine level above 135 mmol / l in men and 110 mmol / l in women.
Perhaps NovoFormin drug use in combination with sulfonylureas. In this case, needs particularly careful monitoring of blood glucose levels.
Should be reported immediately 48 hours before and 48 hours after the radiopaque (urography, intravenous angiography) should stop taking NovoFormin preparation When the patient bronchopulmonary infections or infectious diseases of urogenital organs of this doctor During treatment should refrain from drinking alcohol, and drugs containing ethanol.
Effects on ability to drive vehicles and operate machinery
Use of the drug as a single agent does not affect the ability to drive vehicles and operate machinery.
With the combination of the drug NovoFormin with other hypoglycemic agents (sulfonylureas, insulin, and so on. D.) May develop hypoglycemic conditions under trenbolone enanthate cycle which deteriorating ability to road management and occupation of other potentially hazardous activities that require increased attention and rapid psychomotor reactions.