Glunor®XR 500mg tablet: Each extended-release tablet contains metformin hydrochloride BP 500mg, which provides long-lasting blood sugar control and can be taken once daily.
 

Metformin is a biguanide antihyperglycemic agent, which improves glucose tolerance in patients with type 2 diabetes, lowering both basal and postprandial plasma glucose. Its pharmacologic mechanisms of action are different from other classes of oral antihyperglycemic agents. Metformin decreases hepatic glucose production, decreases intestinal absorption of glucose and improves insulin sensitivity by increasing peripheral glucose uptake and utilization. Unlike sulfonylurea, metformin does not produce hypoglycemia in either patient with type 2 diabetes or normal subjects and does not cause hyperinsulinemia.
 

Glunor®XR is an oral antihyperglycemic drug that is indicated in the following cases: 

• Non-insulin dependent diabetes mellitus (NIDDM) or type 2diabetes, as an adjunct to diet & exercise to improve glycemic control.
• Insulin dependent diabetes mellitus (IDDM), as adjunct therapy in combination with insulin to patients who are often obese.
• May be used concomitantly with a sulfonylurea or insulin to improve glycemic control in adults.

Metformin hydrochloride extended-release tablets (Glunor®XR) should generally be given once daily with the evening meal. In both the cases it should be started at a low dose, with gradual dose escalation, both to reduce gastrointestinal side effects and to permit identification of the minimum dose required for adequate glycemic control of the patient.
 

Adults : The usual starting dose of Glunor®XR is 500 mg once daily with the evening meal. Dosage increases should be made in increments of 500mg weekly, up to a maximum of 2000 mg once daily with the evening meal. If glycemic control is not achieved on Glunor®XR 2000 mg once daily, a trial of Glunor®XR 1000 mg twice daily should be considered.

FOR SWITCHING: Patients receiving Metformin treatment may be safely switched to metformin extended-release tablets (Glunor®XR), once daily at the same total daily dose, up to 2000 mg once daily. Following a switch from metformin to metformin extended-release tablets, glycemic control should be closely monitored and dosage adjustments made accordingly.

Child: Not recommended.

Hypersensitivity to the drug, renal impairment, diabetic coma and ketoacidosis, chronic renal diseases, cardiac failure & recent myocardial infarction, trauma, dehydration, alcohol dependence, pregnancy, breast-feeding etc.

Monitoring renal function regularly is advised in all patients taking metformin. Therapy should be stopped 2-3 days before surgery and clinical investigations such as intravenous urology, angiography and reinstated only after control of renal function has been regained. Patients receiving continuous therapy should have an annual estimation of vitamin B12 levels. During concomitant therapy with sulfonylurea, blood glucose should be monitored. Metformin & insulin therapy should be carried out in hospital until the correct ratio of the two drugs has been established.

Usually well-tolerated but minor GI disturbances sometimes occur which can be avoided easily by taking the drug with or after food. Some patients may experience a metalic taste. Lactic acidosis may occur but its incidence is very low (approximately 0.03 cases/1000patient-year). It may induce malabsorption of vitamin B12 and folic acid.

Cimetidine reduces the renal clearance of Metformin. Alcohol potentiates the antihyperglycemic and hyperlactataemic effect of Metformin. It may enhance the effects of anti-coagulants. As such patients receiving the two drugs may need adjustment of the anti-coagulant dosage. Nifedipine appears to enhance the absorption of Metformin but Metformin has minimal effects on Nifedipine.

Store below 25°C in a dry place, away from light. Keep out of reach of children.

Glunor®XR 500: Box containing 10 x 5’s tablets in blister pack. Each tablet contains metformin hydrochloride BP 500 mg.



Manufactured by:
ESKAYEF BANGLADESH LTD
DHAKA, BANGLADESH
® REGD.TRADEMARK