Metformin

Reduction in risk or delay of onset of type 2 DM in adults, overwt patients w/ impaired glucose & fasting tolerance &/or increased HbA1c who are at high risk for developing overt type 2 DM & still progressing towards type 2 DM despite implementing intensive lifestyle change for 3-6 mth. Monotherapy or in combination w/ other oral antidiabetic agents or w/ insulin for type 2 DM in adults when dietary management & exercise alone does not result in adequate glycaemic control. Reduction of diabetic complications in overwt type 2 diabetic patients treated w/ IR metformin as 1st-line therapy after diet failure.

Adult w/ normal renal function (GFR ≥90 mL/min) Initially 1 500-mg tab once daily, adjusted based on blood glucose measurements after 10-15 days. Dosage may be increased every 10-15 days, up to max: 4 500-mg or 2 750-mg or 2 1,000-mg tab daily. Patient already treated w/ metformin Initially same daily dose of metformin IR tab. Transfer from another oral antidiabetic agent Discontinue the other agent & initiate as indicated. Combination w/ insulin 500 or 750 mg daily, adjust insulin dose based on blood glucose measurements. Patient w/ renal impairment (GFR 45-89 mL/min) Max: 2,000 mg daily, (GFR 30-44 mL/min) Max: 1,000 mg daily.