Glycomet SR: Advanced Sustained-Release Metformin for Glycemic Control
Glycomet
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Glycomet SR is a scientifically formulated, sustained-release preparation of metformin hydrochloride, designed to optimize the management of type 2 diabetes mellitus. As a biguanide antihyperglycemic agent, its primary mechanism of action involves decreasing hepatic glucose production and intestinal absorption of glucose, while improving insulin sensitivity by increasing peripheral glucose uptake and utilization. This advanced formulation provides a steady plasma concentration over 24 hours, aligning pharmacological action with the body’s physiological needs and simplifying the treatment regimen for improved patient adherence and long-term metabolic outcomes.
Features
- Active Ingredient: Metformin Hydrochloride.
- Formulation: Sustained-Release (SR) Film-Coated Tablets.
- Available Strengths: 500 mg, 750 mg, 1000 mg.
- Pharmacokinetic Profile: Designed for once-daily administration, providing a controlled release of metformin over an extended period.
- Excipients: Includes hypromellose, a hydrophilic matrix former that governs the release rate, and other pharmacologically inert substances.
Benefits
- Provides consistent 24-hour glycemic control, helping to maintain stable blood glucose levels and reduce HbA1c.
- Minimizes peak-to-trough plasma concentration fluctuations, which is associated with a potentially reduced incidence of gastrointestinal side effects compared to immediate-release formulations.
- Enhances patient compliance and quality of life through a simplified, once-daily dosing schedule.
- Effectively manages fasting and postprandial plasma glucose levels as part of a comprehensive diabetes management plan.
- Does not typically cause hypoglycemia when used as monotherapy and is not associated with weight gain.
Common use
Glycomet SR is indicated as an adjunct to diet and exercise to improve glycemic control in adults and children aged 10 years and above with type 2 diabetes mellitus. It is used as monotherapy or in combination with other oral antihyperglycemic agents (e.g., sulfonylureas, DPP-4 inhibitors, SGLT2 inhibitors) or with insulin when glycemic control is not achieved on metformin alone. Its use is central to first-line treatment strategies per international diabetes guidelines.
Dosage and direction
The dosage of Glycomet SR must be individualized based on the patient’s efficacy and tolerance, while not exceeding the maximum recommended daily dose of 2000 mg. The initial dose is typically 500 mg once daily with the evening meal. Dosage may be increased by 500 mg weekly, up to a maximum of 2000 mg once daily. If gastrointestinal side effects occur, the dose can be split and administered twice daily with meals. The tablet must be swallowed whole and never crushed or chewed, as this would damage the sustained-release matrix and lead to rapid release of the entire dose.
Precautions
- Lactic Acidosis: Metformin accumulation is associated with a rare but serious metabolic complication: lactic acidosis. Exercise extreme caution in patients with conditions that may predispose to hypoxia or reduced renal or hepatic function.
- Renal Impairment: Metformin is contraindicated in patients with an eGFR below 30 mL/min/1.73m². The dose should be reviewed and potentially withheld in patients with an eGFR between 30-45 mL/min/1.73m². Renal function should be assessed before initiation and at least annually thereafter.
- Hepatic Disease: Avoid use in patients with clinical or laboratory evidence of hepatic disease.
- Surgery and Radiologic Procedures: Glycomet SR should be temporarily discontinued at the time of, or prior to, any surgical procedure or radiologic study involving intravascular iodinated contrast materials and withheld for 48 hours afterwards, only restarting after renal function has been re-evaluated and found to be normal.
- Vitamin B12 Deficiency: Long-term metformin use has been associated with vitamin B12 deficiency. Periodic measurement of hematological parameters is advised.
- Alcohol Intake: Warn patients against excessive alcohol intake, as it can potentiate the effect of metformin on lactate metabolism.
Contraindications
- Severe renal impairment (eGFR < 30 mL/min) or renal disease.
- Known hypersensitivity to metformin hydrochloride or any excipient in the formulation.
- Acute or chronic metabolic acidosis, including diabetic ketoacidosis, with or without coma.
- Acute conditions with the potential to alter renal function: dehydration, severe infection, shock.
- Acute or chronic disease which may cause tissue hypoxia (e.g., cardiac or respiratory failure, recent myocardial infarction).
Possible side effect
The most common adverse reactions are gastrointestinal in nature and may include:
- Diarrhea
- Nausea/Vomiting
- Flatulence
- Abdominal discomfort
- Indigestion
- Asthenia
- Headache These often occur during initiation of therapy and are frequently transient. A slow dose titration can significantly improve gastrointestinal tolerance. A metallic taste has also been reported. As noted, vitamin B12 deficiency with possible megaloblastic anemia is a potential long-term side effect.
Drug interaction
Concomitant administration of the following drugs may require close monitoring and potential dose adjustment:
- Cationic Drugs: Cimetidine, ranitidine, amiloride, digoxin, morphine, procainamide, quinidine, quinine, trimethoprim, and vancomycin are eliminated by renal tubular secretion and may increase metformin plasma levels by competing for common renal tubular transport systems.
- Hyperglycemic Agents: Corticosteroids, diuretics, sympathomimetics, calcium channel blockers, and isoniazid may produce hyperglycemia and may require an increase in the dose of Glycomet SR.
- Alcohol: Potentiates the effect of metformin on lactate metabolism, increasing the risk of lactic acidosis.
- Iodinated Contrast Materials: As detailed in Precautions.
Missed dose
If a dose is missed, the patient should take it as soon as remembered with food, unless it is almost time for the next scheduled dose. In that case, the missed dose should be skipped, and the regular dosing schedule resumed. The patient should not take a double dose to make up for a missed one.
Overdose
Hypoglycemia has not been seen with metformin overdose, although lactic acidosis remains the primary metabolic concern. In the event of an overdose, metformin is dialyzable with a clearance of up to 170 mL/min under good hemodynamic conditions. Therefore, prompt hemodialysis is recommended to correct the acidosis and remove the accumulated metformin. Supportive measures should also be initiated.
Storage
- Store below 30°C (86°F).
- Protect from moisture and light.
- Keep the container tightly closed.
- Keep out of reach of children.
Disclaimer
This information is for educational and informational purposes only and does not constitute medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition or before starting any new treatment. Never disregard professional medical advice or delay in seeking it because of something you have read here.
Reviews
- “As an endocrinologist, the transition to Glycomet SR for my patients has been markedly positive. The once-daily dosing significantly improves adherence, and we observe fewer GI-related discontinuations compared to the immediate-release version. It’s a cornerstone of our first-line therapy.” – Dr. E. Sharma, MD (Endocrinology)
- “Switching to the SR formulation was a game-changer for my diabetes management. The constant nausea I experienced with the regular tablets is completely gone. My HbA1c has remained stable at 6.2% for over a year with a single nightly dose.” – Patient, 58
- “From a clinical pharmacology standpoint, the sustained-release profile of Glycomet SR offers a more favorable pharmacokinetic curve. The reduced Cmax minimizes concentration-dependent side effects, making effective metformin therapy tolerable for a broader patient population.” – Clinical Pharmacologist