Bigsens XR Range 500 mg/750 mg/1 000 mg XR tablets.

Indication

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

Dosage (summary)

Initial dose: 500 mg to 850 mg taken orally twice daily with meals. Maintenance dose: 1500 mg to 2000 mg per day, divided into two or three doses. Maximum dose: 3000 mg per day.

Onset of Action / Duration

Onset of action: 2 to 4 hours; peak effect: 4 to 8 hours; duration of action: up to 24 hours.

Special Populations

• Elderly patients
• Patients with renal impairment
• Patients with hepatic impairment

Pregnancy & Breastfeeding

Metformin is classified as a Category B medication. It is generally not recommended during pregnancy unless the benefits outweigh the risks. Caution is advised during lactation as it is excreted in breast milk.

Key Drug Interactions

• Alcohol may increase the risk of lactic acidosis.
• Cationic drugs that are eliminated by renal tubular secretion may increase metformin levels.
• Concomitant use of diuretics, corticosteroids, and other medications that affect glucose metabolism may require dose adjustments.

Contraindications

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

Common side effects

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

Counselling Points

• Take with meals to reduce gastrointestinal side effects.
• Maintain adequate hydration and report any signs of lactic acidosis (e.g., muscle pain, difficulty breathing).
• Regular monitoring of blood glucose levels is essential.