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Himet
National Laboratories Ltd.
Generic: Metformin Hydrochloride
Safety Advices
বাংলা
English
UNSAFE
It is unsafe to consume alcohol with Himet.
SAFE IF PRESCRIBED
Himet is generally considered safe to use during pregnancy. Animal studies have shown low or no adverse effects to the developing baby; however, there are limited human studies.
SAFE IF PRESCRIBED
Himet is probably safe to use during breastfeeding. Limited human data suggests that the drug does not represent any significant risk to the baby.
CAUTION
Your ability to drive may be affected if your blood sugar is too low or too high. Do not drive if these symptoms occur.
CAUTION
Himet should be used with caution in patients with kidney disease. Dose adjustment of Himet may be needed. Please consult your doctor.
Use of Himet is, however, not recommended in patients with severe kidney disease. Regular monitoring of kidney function test is advisable while you are taking this medicine.
CAUTION
Himet should be used with caution in patients with liver disease. Dose adjustment of Himet may be needed. Please consult your doctor.
Himet is generally started with low dose in patients with mild to moderate liver disease and its use is not recommended in patients with severe liver disease.
Medicine Overview of Himet 850mg Tablet
Introduction
Himet is a medicine used to treat type 2 diabetes mellitus. It helps control blood sugar levels and thus prevent serious complications of diabetes. It is also used to treat menstruation related disorder known as Polycystic ovary syndrome (PCOS) in women. Himet is best taken with food to avoid nausea and abdominal pain. You should take it regularly, at the same time each day, to get the most benefit. You should not stop taking this medicine unless your doctor recommends it. Your lifestyle plays a big part in controlling diabetes. Therefore, it is important to stay on the diet and...
... Show moreUses of Himet
- Type 2 diabetes mellitus
Side effects of Himet
Common
- Nausea
- Vomiting
- Taste change
- Diarrhea
- Abdominal pain
- Loss of appetite
How to use Himet
Take this medicine in the dose and duration as advised by your doctor. Swallow it as a whole. Do not chew, crush or break it. Himet is to be taken with food.
How Himet works
Himet is an anti-diabetic medication (biguanide). It works by lowering glucose production in the liver, delaying the absorption of sugar (glucose) from the intestines and increasing the body's sensitivity to insulin.
What if you forget to take Himet?
If you miss a dose of Himet, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular schedule. Do not double the dose.
Quick Tips
- You have been prescribed Himet to control the blood sugar level and reduce the risk of diabetic complications such as heart attacks.
- Chances of weight gain and low blood sugar are lesser with this medicine as compared to other diabetes medicines.
- Hypoglycemia (low blood sugar level) may occur when taken along with other antidiabetic medicines, alcohol or on delaying/skipping a meal. Carry a sugar source with you for immediate relief.
- Tell your doctor immediately if you experience any deep or rapid breathing, persistent nausea, vomiting, and stomach pain as Himet may cause a rare but serious condition called lactic acidosis, which is an excess of lactic acid in the blood.
- Prolonged use of Himet may lead to vitamin B12 deficiency which may lead to anemia, causing fatigue, pale skin, shortness of breath or headache. Notify your doctor if you experience any of these as you may require supplements.
- Your doctor will monitor your blood sugar levels and kidney functions regularly while you are taking this medication.
Brief Description
Indication
Type 2 DM, Polycystic ovarian syndrome,
Administration
Should be taken with food.
Adult Dose
Oral Type 2 diabetes mellitus Adult: Conventional preparation: Initially, 500 mg bid or tid, or 850 mg 1-2 times daily, may increase gradually to 2000 mg daily at intervals of at least 1 wk. Maximum daily dose of 2550 mg per day. Modified-release preparation: Initially, 500 mg once daily, may increase in increments of 500 mg at intervals of at least 1 wk to max 2000 mg once daily at night. If glycaemic control is not sufficient, dose may be divided to give 1000 mg bid. Not to exceed 2000 mg/day Polycystic ovary syndrome Initial: 500 mg/day in the morning...
... Show moreChild Dose
Oral
Type 2 diabetes mellitus
Child: >10 yr Initially, 500 mg 1-2 times daily or 850 mg once daily, may increase gradually to max 2000 mg daily in 2 or 3 divided doses at intervals of at least 1 wk.
Renal Dose
Renal impairment
Obtain eGFR before starting metformin
eGFR <30 mL/min/1.73 m²: Contraindicated
eGFR 30-45 mL/min/1.73 m²: Not recommended to initiate treatment
Monitor eGFR at least annually or more often for those at risk for renal impairment (eg, elderly)
If eGFR falls below 45mL/min/1.73 m² while taking metformin, risks and benefits of continuing therapy should be evaluated
If eGFR falls below 30 mL/min/1.73 m²: while taking metformin, discontinue the drug
Contraindication
Acute or chronic metabolic acidosis with or without coma (including diabetic ketoacidosis). Renal failure, severe renal or hepatic impairment, acute conditions which may affect renal function e.g. dehydration, severe infection or shock. Cardiac failure, CHF, IDDM, severe impairment of thyroid function; acute or chronic alcoholism. Acute or chronic diseases which may cause tissue hypoxia e.g. cardiac or respiratory failure, recent MI or shock. Pregnancy, lactation.
Mode of Action
Metformin is a biguanide w/ antihyperglycaemic effects, lowering both basal and postprandial plasma glucose. It decreases hepatic glucose production by inhibiting gluconeogenesis and glycogenolysis; delays intestinal absorption of glucose; and enhances insulin sensitivity by increasing peripheral glucose uptake and utilisation.
Precaution
Caution when used in patients with CHF especially in those with unstable or acute heart failure. Risk of lactic acid accumulation increases with the degree of renal impairment. May need to discontinue treatment in patients with stress-related states e.g. fever, trauma, infection or surgery. Metformin should be temporarily discontinued for 48 hr in patients undergoing radiologic studies involving intravascular admin of iodinated contrast materials. Elderly. Monitor renal function regularly. Because of possibility of hypoglycemia in combination therapy with a sulphonylurea or insulin, diabetic control should be monitored by blood sugar readings.
Lactation: Enters breast milk; not recommended
Side Effect
Anorexia, nausea, vomiting, diarrhoea, wt loss, flatulence, occasional metallic taste; weakness; hypoglycaemia; rash, malabsorption of vit B12. Chest discomfort, flushing, palpitation, chills, headache, lightheadedness, indigestion, abdominal discomfort.
Potentially Fatal: Lactic acidosis in presence of renal failure and alcoholism. Patients may experience a metallic taste and there may be weight loss, which in some diabetics could be an advantage.
Interaction
Additive effect w/ sulfonylureas. Thiazide diuretics, corticosteroids, phenothiazines, OC, sympathomimetics, niacin, Ca channel blockers and isoniazid may exacerbate loss of glycaemic control. ACE inhibitors may reduce fasting blood glucose concentrations. May increase serum level w/ cimetidine.
Potentially Fatal: Concurrent use w/ iodinated contrast agents may increase the risk of metformin-induced lactic acidosis.
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