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Glucophage XR: Comprehensive Information
Glucophage XR is an extended-release formulation of metformin hydrochloride, a widely used oral antidiabetic medication belonging to the biguanide class. It is prescribed primarily for the management of type 2 diabetes mellitus.
- Composition: The active ingredient is metformin hydrochloride. It is available in extended-release tablets, typically in strengths of 500 mg, 750 mg, and 1000 mg. The extended-release technology allows for a slower release of the drug into the bloodstream over several hours, which can help reduce gastrointestinal side effects and allow for once-daily dosing.
- Indications: Glucophage XR is indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus. It is often a first-line therapy, especially in patient swho are overweight. It can be used as monotherapy or in combination with other antidiabetic agents, such as sulfonylureas, insulin, or thiazolidinediones.
- Mechanism of Action: Metformin primarily works by decreasing hepatic glucose production (gluconeogenesis), decreasing intestinal absorption of glucose, and improving insulin sensitivity by increasing peripheral glucose uptake and utilization. Unlike sulfonylureas, it does not typically stimulate insulin secretion, thus it does not usually cause hypoglycemia when used as monotherapy.
- Safety Profile:
Benefits: Glucophage XR effectively lowers blood glucose levels, helps with weight management (often neutral or slight weight loss), and has shown cardiovascular benefits in some studies, particularly in overweight patients. The extended-release formulation is associated with a lower incidence of gastrointestinal side effects compared to immediate-release metformin.
Common Side Effects: The most common side effects are gastrointestinal, including diarrhea, nausea, vomiting, abdominal pain, and metallic taste. These are often dose-related and may decrease over time or with the extended-release formulation. Vitamin B12 deficiency can occur with long-term use.
Contraindications: Glucophage XR is contraindicated in patients with:
- Severe renal impairment (eGFR < 30 mL/min/1.73 m²).
- Acute or chronic metabolic acidosis, including diabetic ketoacidosis with or without coma.
- Known hypersensitivity to metformin hydrochloride.
- Conditions that may predispose to renal impairment, such as dehydration, severe infection, shock, or concurrent use of drugs with nephrotoxic potential.
Warnings: Lactic acidosis is a rare but serious adverse reaction that can occur due to metformin accumulation. Risk factors include renal impairment, hepatic impairment, excessive alcohol intake, and conditions cuasing hypoxemia. Patients should be advised to avoid excessive alcohol intake. Renal function must be monitored regularly. Discontinuation is required before contrast-enhanced imaging procedures and surgery.
Dosage Table
| Condition | Recommended Dosage | Treatment Duration |
|---|---|---|
| Type 2 Diabetes Mellitus (initial) | 500 mg once daily with the evening meal | Monitor glucose levels; adjust dose as needed. Maximum dose typically 2000 mg daily. |
| Type 2 Diabetes Mellitus (maintenance) | 1000 mg once daily with the evening meal (after titration) | Continue as long as effective and tolerated. |
| Type 2 Diabetes Mellitus (combination therapy) | Varies based on concomitant medication; follow physician's guidance. | Continuous monitoring and adjustment required. |
Frequently Asked Questions
Q1: How should I take Glucophage XR?
A: Glucophage XR should be taken once daily with the evening meal. Swallow the tablet whole; do not crush, cut, or chew it. The tablet shell may pass in the stool, which is normal and does not affect the drug's efficacy.
Q2: What is the difference between Glucophage and Glucophage XR?
A: Glucophage XR is an extended-release formulation, meaning it releases metformin slowly over time. This can lead to fewer gastrointestinal side effects and allows for once-daily dosing compared to the immediate-release Glucophage, which is typically taken multiple times a day.
Q3: Can Glucophage XR cause hypoglycemia?
A: When ued alone (monotherapy), Glucophage XR rarely causes hypoglycemia. However, the risk increases when it is combined with other diabetes medications like sulfonylureas or insulin, or if a patient consumes insufficient calories or excessive alcohol.
Q4: How long does it take for Glucophage XR to work?
A: While blood glucose levels may start to improve within a few days, the full therapeutic effect of Glucophage XR may take several weeks to become apparent. Consistent adherence to medication, diet, and exercise is crucial.
