Bigsens XR 750 & XR 1 000 750 mg, 1000 mg Tablet

Indication

Management of type 2 diabetes mellitus, particularly in overweight patients, to improve glycemic control.

Dosage (summary)

Initial dose is typically 500 mg to 850 mg taken orally with meals, titrated as needed up to a maximum of 2000 mg to 3000 mg per day in divided doses.

Onset of Action / Duration

Onset of action is generally within 1 to 2 hours, with peak effects occurring around 2 to 4 hours after administration.

Special Populations

• Elderly patients may require dose adjustments due to renal function decline.
• Patients with renal impairment should have their renal function monitored regularly.
• Patients with hepatic impairment should use with caution.

Pregnancy & Breastfeeding

Metformin is generally not recommended during pregnancy unless the benefits outweigh the risks. It is excreted in breast milk; caution is advised.

Key Drug Interactions

• Cationic drugs that are eliminated by renal tubular secretion may increase metformin levels.
• Alcohol can potentiate the effects of metformin on lactate metabolism.
• Concomitant use with other antidiabetic agents may increase the risk of hypoglycemia.

Contraindications

• Severe renal impairment (eGFR < 30 mL/min).
• Acute or chronic metabolic acidosis, including diabetic ketoacidosis.
• Hypersensitivity to metformin or any of its components.

Common side effects

• Gastrointestinal disturbances (nausea, vomiting, diarrhea).
• Lactic acidosis (rare but serious).
• Vitamin B12 deficiency with long-term use.

Counselling Points

• Advise patients to take metformin with meals to reduce gastrointestinal side effects.
• Instruct patients to maintain a balanced diet and regular exercise.
• Inform patients about the signs and symptoms of lactic acidosis.