Select a medication above to begin.
Glumetza
metformin
Black Box Warnings .
Lactic Acidosis
post-marketing cases of hypothermia, hypotension, resistant bradyarrhythmias, and death; onset may be subtle with nonspecific symptoms including malaise, myalgias, respiratory distress, somnolence, abdominal pain; lab findings include lactate >5 mmol/L, anion gap acidosis (without evidence of ketonuria or ketonemia), incr. lactate/pyruvate ratio, metformin level >5 mcg/mL; risk factors may include renal impairment, concomitant meds, patients 65 yo and older, radiocontrast study, any surgery, hypoxemia, excessive acute or chronic alcohol intake, or hepatic insufficiency; D/C metformin immediately if lactic acidosis suspected, hospitalize patient and institute general supportive care, prompt HD recommended
Adult Dosing .
Dosage forms: ER TAB: 500 mg, 1000 mg
diabetes mellitus, type 2
- [1000-2000 mg PO qpm]
- Start: 1000 mg PO qpm, incr. by 500 mg/day qwk as tolerated; Max: 2000 mg/day; Alt: 1000 mg PO bid if qd inadequate; Info: give with meals; do not cut/crush/chew tab; hold tx for surgery if restricting food/fluid; D/C for iodinated contrast study if eGFR 30-60, hepatic disease history, alcoholism history, heart failure history, or receiving contrast intra-arterially; restart after 48h if stable renal function
polycystic ovary syndrome (off-label)
- [1500-2000 mg PO qpm]
- Info: give with meals; do not cut/crush/chew tab; hold tx for surgery if restricting food/fluid; D/C for iodinated contrast study if eGFR 30-60, hepatic disease history, alcoholism history, heart failure history, or receiving contrast intra-arterially; restart after 48h if stable renal function
weight gain, antipsychotic-induced (off-label)
- [1000-2000 mg PO qd]
- Start: 500 mg PO qd, incr. by 500 mg/day q1-2wk as tolerated; Max: 2000 mg/day; Info: give with meals; do not cut/crush/chew tab; hold tx for surgery if restricting food/fluid; D/C for iodinated contrast study if eGFR 30-60, hepatic disease history, alcoholism history, heart failure history, or receiving contrast intra-arterially; restart after 48h if stable renal function
renal dosing
- [diabetes mellitus, type 2]
- eGFR 30-44: avoid tx initiation; eGFR <30: contraindicated; Alt: decr. usual dose by 50% if eGFR 30-44
- HD/PD: avoid use
- [polycystic ovary syndrome]
- eGFR 30-44: avoid tx initiation; eGFR <30: contraindicated; Info: weigh risk/benefit if eGFR 30-44 during tx
- HD/PD: avoid use
- [weight gain, antipsychotic-induced]
- eGFR 30-44: avoid tx initiation; eGFR <30: contraindicated; Info: max 1 g/day if eGFR 30-44 during tx
- HD/PD: avoid use
hepatic dosing
- [see below]
- hepatic impairment: avoid use
Peds Dosing .
- Dosage forms: ER TAB: 500 mg, 1000 mg
diabetes mellitus, type 2 (off-label)
- [10 yo and older]
- Dose: 1000-2000 mg PO qpm; Start: 500 mg PO qpm, incr. by 500 mg/day qwk as tolerated; Max: 2000 mg/day; Info: give with meals; do not cut/crush/chew tab; hold tx for surgery if restricting food/fluid; D/C for iodinated contrast study if eGFR 30-60, hepatic disease history, alcoholism history, heart failure history, or receiving contrast intra-arterially; restart after 48h if stable renal function
weight gain, antipsychotic-induced (off-label)
- [10 yo and older]
- Dose: 1000-2000 mg PO qd; Start: 500 mg PO qd, incr. by 500 mg/day q1-2wk as tolerated; Max: 2000 mg/day; Info: give with meals; do not cut/crush/chew tab; hold tx for surgery if restricting food/fluid; D/C for iodinated contrast study if eGFR 30-60, hepatic disease history, alcoholism history, heart failure history, or receiving contrast intra-arterially; restart after 48h if stable renal function
renal dosing
- [diabetes mellitus, type 2]
- eGFR 30-44: avoid tx initiation; eGFR <30: contraindicated; Info: weigh risk/benefit if eGFR 30-44 during tx
- HD/PD: avoid use
- [weight gain, antipsychotic-induced]
- eGFR 30-44: avoid tx initiation; eGFR <30: contraindicated; Info: max 1 g/day if eGFR 30-44 during tx
- HD/PD: avoid use
hepatic dosing
- [see below]
- hepatic impairment: avoid use