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► Avamina (metformin) - Practical Medicine

Avamina (metformin) - coated tablets

The name of the preparation Character; dose; package Manufacturer Price 100% Price after refund In which pharmacy?
Avamina coated tablets; 1 g; 30 tabl. Bioton 8.05 0.00
3.84
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Avamina coated tablets; 1 g; 60 tables Bioton 15.65 0.00
4.04
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Avamina coated tablets; 500 mg; 30 tabl. Bioton 4.18 0.00
3.68
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Avamina coated tablets; 500 mg; 60 tables Bioton 8.17 0.00
3.96
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Avamina coated tablets; 850 mg; 30 tabl. Bioton 6.69 0.00
3.60
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Avamina coated tablets; 850 mg; 60 tables Bioton 13.53 0.00
4.14
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Note: reimbursed drug prices are in line with the regulations in force from July 1, 2018.

The preparation contains the substance:metformin

The drug is available on prescription

What is Avamina?

Oral anti-diabetic drug. A medicine that reduces blood Glucose (a hypoglycaemic agent).

What does Avamina contain and how does it work?

The active substance is Metformin . It is an oral antidiabetic medicine from the group of biguanide derivatives. These drugs are used to reduce blood glucose in type 2 diabetes (previously the term "non-insulin dependent diabetes" was used).Metformin reduces the production of glucose in the liver by inhibiting the processes of gluconeogenesis and glycogenolysis, increases peripheral glucose uptake and its consumption and delays the intestinal absorption of glucose. It intensifies the intracellular synthesis of glycogen and increases the transport capacity of proteins responsible for the transport of glucose across the cell membrane. Metformin does not stimulate insulin secretion and therefore does not cause hypoglycaemia. It stabilizes the body mass or affects its moderate reduction. It has a beneficial effect on lipid metabolism (it reduces total cholesterol, LDL cholesterol and triglyceride levels). In overweight adults, used as a first-line drug reduces the risk of complications associated with diabetes.
Following oral administration of the immediate-release form, the maximum metformin concentration in the blood is obtained after approximately 2.5 hours. Stationary plasma drug concentration is determined after 24-48 hours of treatment. Metformin is not metabolised in the liver, excreted unchanged in the urine. In the case of renal dysfunction, the excretion of metformin decreases which leads to an increase in its plasma concentration.

When should I use Avamina?

The preparation is indicated for the treatment of type 2 diabetes, especially in obese people, when diet and exercise are not enough to achieve a proper blood glucose level.
In adults, the preparation can be used alone or in combination with other oral antidiabetic agents or insulin.
In children over 10 years of age and adolescents, the preparation can be used alone or in combination with insulin.
Reduction in the incidence of diabetes complications in adults with type 2 diabetes and overweight has been shown to be treated with metformin as the first-line treatment after failure of diet treatment.

When not to use this preparation?

Unfortunately, even if there are indications to use the preparation, it can not always be used. You can not use the preparation if you are allergic (you are hypersensitive) to any of the ingredients.
The preparation can not be used in the case of:
· Ketoacidosis associated with diabetes mellitus
· Pre-comistic conditions in diabetes
· Renal dysfunction (creatinine clearance less than 60 ml / min)
· Acute conditions that involve the risk of renal dysfunction, such as dehydration, severe infection, shock
· Radiological tests requiring the intravascular administration of iodinated contrast preparations
· Acute or chronic diseases that may cause tissue hypoxia, such as heart failure , respiratory failure, recent myocardial infarction, shock
· Liver failure, acute alcohol intoxication, alcoholism.
The preparation is contraindicated during pregnancy and breastfeeding.

When should you take extra care with Avamina?

Certain diseases and other circumstances may constitute a contraindication to use or indication to change the dosage of the preparation. In some situations it may be necessary to carry out specific check-ups.
Very rarely, metformin accumulation may occur during treatment, which may lead to the development of lactic acidosis. Lactic acidosis is a serious metabolic complication that requires immediate treatment and may be life-threatening. An increased risk of lactic acidosis is associated with diabetes mellitus with significant renal insufficiency. Other risk factors include: poor control of blood glucose, ketosis, alcohol abuse, long-term fasting, liver failure, old age, and tissue hypoxia for any reason.
Lactic acidosis should be suspected when non-specific symptoms occur, such as muscle spasms accompanied by gastrointestinal disorders, including abdominal pain and severe weakness and exhaustion. In the case of the above-mentioned symptoms should immediately consult a doctor. Characteristic symptoms of lactic acidosis include dyspnoea, abdominal pain, low body temperature (hypothermia) and coma. Laboratory tests show a decrease in blood pH, increased blood lactate, cation and anion concentration disturbances, and increased lactate to pyruvate ratio. If you suspect lactic acidosis, you should immediately consult a doctor; treatment requires quick patient hospitalization.
The active substance in the preparation, metformin, is excreted through the kidneys.Before starting treatment and during treatment, your doctor will regularly monitor your kidney function (blood creatinine testing). In patients with normal renal function, tests should be performed at least once a year, and in patients with results at the upper limit of normal and / or elderly, at least 2-4 times a year. Elderly people often have asymptomatic renal dysfunction. Particular caution should be exercised in situations that may promote renal dysfunction, e.g. in the initial period of use of antihypertensive drugs, diuretics and non-steroidal anti-inflammatory drugs.
Intravascular administration of iodinated contrast media during radiological tests may result in renal failure. Before the test, the use of the preparation should be discontinued and resumed not earlier than after 48 hours after the examination, provided that the doctor confirms the corr ect function of the kidneys. Examine your doctor before performing the test. Do not interrupt the use of the product without the doctor's recommendation.
Before surgery under general, spinal or epidural anesthesia, the preparation should be discontinued and resumed not earlier than after 48 hours after the procedure or after returning to oral nutrition, provided that the doctor confirms the correct function of the kidneys. Consult your doctor before the procedure. Do not interrupt the use of the product without the doctor's recommendation.
The long-term effect of the preparation on the growth and maturation of children has not been determined; therefore, careful observation of children using the preparation is recommended, especially before puberty.
Due to insufficient clinical experience, special care should be taken if the preparation is used in children between 10-12. the year of life.
It should be remembered that proper diet and regular physical activity have a significant impact on blood glucose control and treatment effectiveness. During the treatment period, you should follow the recommended diet with an even distribution of carbohydrate intake during the day. Overweight people should continue their low-calorie diet.
The tests recommended by the attending physician should be carried out regularly.
It does not cause hypoglycaemia, but caution should be used if it is used in combination with insulin or other antidiabetes medicines (eg sulphonylureas).

Does this preparation affect the ability to drive vehicles?
If the preparation is used as monotherapy, it does not cause hypoglycaemia and therefore does not affect the ability to drive vehicles and operate machines / machines.
However, if the preparation is used in combination with other antidiabetes medicines (eg sulphonylureas, insulin, repaglinide), there is a risk of hypoglycaemia. In the case of hypoglycaemia, psychophysical fitness, including the speed of reaction, may be impaired. This can be a hazard when driving or operating equipment / machines.

Dosage of Avamina

The preparation is in the form of coated tablets for oral use. Do not exceed the recommended doses because it will not increase the effectiveness of the drug and may harm your health and life. If you have any doubts regarding the use of the preparation, consult a physician.
Adults:
As monotherapy or combination therapy with other oral antidiabetic agents, it is usually typically 500-850 mg 2-3 times a day, with or without a meal. After 10-15 days your doctor will adjust your dose based on your blood glucose results. Slowly increasing the dose may prevent gastrointestinal side effects. The maximum dose is 3 g per day in 3 divided doses.
In combination with insulin, usually 500-850 mg 2-3 times a day. Your doctor will adjust the insulin dose based on your blood glucose results.
The doctor may also prescribe a preparation to replace other oral hypoglycemic agents previously used. The previously used medicine should be discontinued and metformin should be used as prescribed. Follow the doctor's instructions.
In elderly people, the doctor will determine the dose based on the parameters of renal function. In this age group, regular monitoring of renal function is necessary.
Children over 10 years of age and adolescents:
In monotherapy or combination therapy with insulin: initially, usually 500-850 mg once daily, with or without a meal; after 10-15 days your doctor will adjust the dose based on your blood glucose results. Slowly increasing the dose may prevent gastrointestinal side effects. The maximum recommended dose is 2 g per day in 2-3 divided doses.

Can you use Avamina during pregnancy and breastfeeding?

During pregnancy, do not use any medicine without consulting your doctor!
It is very important that before using any medicine during pregnancy or breastfeeding, consult a physician and explain beyond any doubt the potential risks and benefits associated with the use of the drug. If you are pregnant or plan to become pregnant, please inform the doctor prescribing the prescription for this medicine.
The use of the preparation during pregnancy is contraindicated. If during pregnancy, a woman becomes pregnant or plans to become pregnant, please consult a doctor as soon as possible because it is recommended to change the treatment for insulin therapy as soon as possible.
The use of the preparation during breast-feeding is contraindicated.

Can I use other preparations in parallel?

Tell your doctor about all medicines you have recently taken, including those that are over the counter. During the period of application, taking any other medicines can only take place with the consent of the doctor or on his recommendation.
In the case of acute alcohol intoxication, the risk of lactic acidosis increases, especially in the case of starvation, malnutrition and liver failure. During treatment with metformin, avoid drinking alcohol and taking alcohol-containing preparations.
Intravascular administration of iodinated contrast agents may lead to renal failure, which may result in metformin accumulation increasing the risk of lactic acidosis. The use of the preparation should be discontinued before the test and resumed not earlier than after 48 hours after the examination, provided that the doctor confirms the correct function of the kidneys. The doctor's instructions should be strictly followed. Do not interrupt the use of the product without the doctor's recommendation.
Glucocorticoids (whether used generally or topically), beta2-mimetics and diuretics may exhibit anti-metformin activity, i.e. hyperglycemic. During their use, blood glucose should be monitored more frequently, especially at the beginning of treatment. If necessary, the doctor will adjust the dose of the antidiabetic drug during the period of application of the above-mentioned medications and again after they have been used.
Angiotensin converting enzyme inhibitors (ACE inhibitors) may reduce the level of glucose in the blood; it is necessary for the doctor to adjust the dose of metformin during the period of treatment with these formulations and again after the end of their application.

What side effects can occur?

Like all medicines, Avamina can also cause side effects, although it will not occur in all patients who use this medicine. Remember that the expected benefits of using the drug are usually greater than the damage resulting from the occurrence of side effects.
Very common are: nausea, vomiting, diarrhea, abdominal pain and loss of appetite; these symptoms are more common at the beginning of treatment and in most cases disappear spontaneously. To minimize them, it is recommended to gradually increase the dose. Often possible taste disorders. Very rarely lactic acidosis, a serious metabolic complication that may occur due to metformin accumulation; can lead to death, especially in the elderly (factors that favor the development of this complication are: poorly controlled diabetes, ketoacidosis, long-term starvation, excessive alcohol intake, hepatic failure and tissue hypoxia for any reason). Very rare: skin reactions (erythema, pruritus, urticaria), decrease in the absorption of vitamin B12 and its concentration in the serum (this may lead to megaloblastic anemia). In addition, possible abnormal liver test results or hepatitis disappear after discontinuation of the drug. Hypoglycaemia may occur in combination with other antidiabetic agents.

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