The Brand Name DIAFER Has Generic Salt :: Metformin 

DIAFER  Is From Company EAST WEST Priced :: Rs. 13.8

DIAFER have Metformin is comes under Sub class Insulin , Anti Diabetic drugs of  Main Class Endocrine,Steroid Hormones , Metabolic System

Main Medicine Class:: Endocrine,Steroid Hormones , Metabolic System  Sub Medicine Class :: Insulin , Anti Diabetic drugs 

Indications for Drugs ::

Polycystic ovarian syndrome, Type 2 DM

Drug Dose ::

The usual starting dose is 500 mg twice daily or 850 mg once a day, given with meals. Dosage increase should be made in increments of 500 mg weekly or 850 mg every 2 weeks up to a total of 2000 mg per day, given in divided doses. Patients can be titrated from 500 mg twice a day to 850 mg twice a day after 2 weeks. For these patients requiring additional glycaemic control, metformin may be given to a maximum daily dose of 2550 mg per day. Doses above 2000 mg may be better tolerated when given three times a day with meals. The usual starting dose of Metformin HCl extended – release tablet is 500 mg once daily with the evening meal. Dosage increase may be made up to a max. of 2000 mg once daily with the evening meal. Polycystic ovary syndrome Initial: 500 mg/day in the morning for 1 wk, then 500 mg twice daily for 1 wk, then 1.5-1.7 g/day in 2-3 divided doses.

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. Adult: PO Type 2 DMInitial: 500 mg 2-3 times/day, may increase slowly. Max:2.25 g/day. Polycystic ovary syndrome Initial: 500 mg/day in the morning for 1 wk, then 500 mg twice daily for 1 wk, then 1.5-1.7 g

Drug Precautions ::

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.

Drug Side Effects ::

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.

Pregnancy category ::

2

Drug 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.

Drug Interactions ::

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.