Indications
For mild diabetes.
Dosage
Oral: Start with a small dose and increase the dose gradually. The usual initial dose is 0.5g once a day, twice a day; or 0.85g once a day; taken with meals; it can be increased by 0.5g every week, or 0.85g every 2 weeks, and gradually increased to 2g a day, divided times.
The maximum daily dose of this product for type 2 diabetic patients aged 10 to 16 is 2000mg; the maximum recommended dose for adults is 2550mg per day; for patients who need to further control blood sugar, the dose can be increased to 2550mg per day (that is, 0.85g once a day, 3 times); when the daily dose exceeds 2g, for better tolerance, it is best to take it in divided doses with 3 meals.
Adverse reactions
1. Nausea, vomiting, anorexia, diarrhea and other gastrointestinal reactions.
2. Large doses can block the tricarboxylic acid cycle, resulting in the accumulation of pyruvate in the cells, and the pyruvate is partially converted into lactic acid, which can cause lactic acidosis. Due to the insufficient utilization of sugar, the body uses fat, so ketonuria occurs, and it is more likely to occur in people with liver and kidney dysfunction.
Precautions
1. Regular examination of renal function can reduce the incidence of lactic acidosis, especially for elderly patients. People over 65 years old should use with caution.
2. Patients need to suspend oral administration of this product before undergoing surgery and iodine X-ray examination.
3. People with poor liver function and a history of lactic acidosis should use it with caution.
4. Stress state: such as fever, coma, infection and surgical operation, this product should be temporarily stopped, and then resume use after the stress state is relieved.
5. For patients with type 1 diabetes, this product should not be used alone.
6. This product can reduce the absorption of vitamin B12, blood routine and serum vitamin B12 levels should be monitored regularly.
7. Elderly, debilitated or malnourished patients, as well as patients with hypofunction of the adrenal gland and pituitary gland, and patients with alcoholism are more prone to hypoglycemia.
8. Patients who receive this product alone will not have hypoglycemia under normal circumstances, but hypoglycemia will occur when it is used in combination with other hypoglycemic drugs (such as sulfonylureas ), drinking alcohol, etc., and attention should be paid.
9. When taking this product to treat type 2 diabetic patients with good blood sugar control, if there are abnormal laboratory tests or clinical abnormalities (especially fatigue or unspeakable discomfort), they should quickly look for evidence of ketoacidosis or lactic acidosis, Measurements include serum electrolytes, ketone bodies, blood glucose, blood pH, lactate, pyruvate, and metformin levels. If any type of acidosis exists, this product should be discontinued immediately.
Contraindications
1. Children under 10 years old, elderly people over 80 years old, pregnant and lactating women.
2. Patients with liver and kidney insufficiency or abnormal creatinine clearance.
3. Heart failure (shock), acute myocardial infarction and other serious heart and lung diseases.
4. Severe infection or trauma, major surgery, clinical hypotension and hypoxia, etc.
5. Acute or chronic metabolic acidosis, including diabetic ketoacidosis with or without coma.
6. Concurrent with severe diabetic nephropathy or diabetic retinopathy.
7. Alcoholics, vitamin B12 and folic acid deficiencies have not been corrected.
8. Before receiving intravascular injection of iodinated contrast medium, the use of this product should be suspended.
9. People who are allergic to this product.
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