The name of your medicine is APO-Metformin 500, 850 or 1000. It contains the active ingredient, metformin (as metformin hydrochloride).
There are two types of diabetes:
APO-Metformin 500, 850 or 1000 can be used in type 2 diabetes in adults and children over 10 years of age. It is especially useful in those who are overweight, when diet and exercise are not enough to lower high blood glucose levels (hyperglycaemia). For adult patients, metformin can be used alone, or in combination with other oral diabetic medicines or in combination with insulin in insulin requiring type 2 diabetes.
Ask your doctor if you have any questions about why this medicine has been prescribed for you. Your doctor may have prescribed this medicine for another reason.
This medicine is available only with a doctor's prescription.
Metformin belongs to a group of medicines called biguanides.
Metformin lowers high blood glucose by helping your body make better use of the insulin produced by your pancreas.
If your blood glucose is not properly controlled, you may experience hypoglycaemia (low blood glucose) or hyperglycaemia (high blood glucose).
People with type 2 diabetes are unable to make enough insulin or their body does not respond properly to the insulin it does make. This causes a build up of glucose in the blood, which can lead to serious medical problems with your heart, eyes, circulation or kidneys.
Ask your doctor if you have any questions about why this medicine has been prescribed for you.
Your doctor may have prescribed metformin for another reason.
There is no evidence that this medicine is addictive.
Do not take this medicine if:
Symptoms of an allergic reaction may include: shortness of breath, wheezing or difficulty breathing; swelling of the face, lips, tongue, throat or other parts of the body; muscle pain or tenderness or joint pain or rash, itching or hives on the skin.
If you think you are having an allergic reaction, contact your doctor immediately or go to the Accident and Emergency department at the nearest hospital.
Do not take this medicine if you have any of the following conditions:
Do not take this medicine if you plan to have any X-ray procedures requiring an injection of iodinated contrast (dye).
Using this type of dye while you are taking metformin may cause severe kidney problems and increase the risk of a serious condition called lactic acidosis. Your doctor will tell you when to temporarily stop taking the tablets before the X-ray and when it is safe to restart them.
Do not take this medicine if you are pregnant or plan to become pregnant.
The safety of metformin in pregnant women has not been established.
Insulin may be more suitable for controlling blood glucose during pregnancy. Your doctor may replace metformin with insulin while you are pregnant.
Do not take this medicine if you are breast-feeding.
Metformin is not recommended while you are breastfeeding. Your doctor will discuss the options available to you.
Before you start taking this medicine, tell your doctor if you:
1. You have allergies to:
2. You have or have had any medical conditions, especially the following:
3. drink alcohol.
4. You are currently pregnant or you plan to become pregnant. Do not take this medicine whilst pregnant until you and your doctor have discussed the risks and benefits involved.
5. You are currently breastfeeding or you plan to breastfeed. Do not take this medicine whilst breastfeeding until you and your doctor have discussed the risks and benefits involved.
6. You are planning to have surgery or an anaesthetic.
7. You are currently receiving or are planning to receive dental treatment.
8. You are taking or are planning to take any other medicines. This includes vitamins and supplements that are available from your pharmacy, supermarket or health food shop.
Some medicines may interact with metformin. These include:
If you are taking any of these you may need a different dose or you may need to take different medicines.
Other medicines not listed above may also interact with metformin.
Follow carefully all directions given to you by your doctor or pharmacist.
Their instructions may be different to the information in this leaflet.
Your doctor or pharmacist will tell you how much of this medicine you should take. This depends on your condition and whether or not you are taking any other medicines.
Do not stop taking your medicine or change your dosage without first checking with your doctor.
The usual dose of metformin for adults is 500 mg one to two times a day, up to a maximum of 1 g three times a day.
People over 65 years of age or those with kidney problems may need smaller doses.
Children & Adolescents:
The usual starting dose for children from 10 years of age and adolescents is one tablet of 500 mg or 850 mg once daily. Your doctor may increase or decrease the dose, depending on your blood glucose levels.
The maximum recommended dose is 2 g taken as two or three divided doses.
Swallow the tablets with a glass of water.
Take your medicine during or immediately after a meal, at about the same time each day.
This will reduce the chance of a stomach upset.
Taking your medicine at the same time each day will have the best effect. It will also help you remember when to take it.
Continue taking your medicine for as long as your doctor tells you.
Metformin will help control your diabetes but will not cure it. Therefore, you may have to take it for a long time.
Make sure you have enough to last over weekends and holidays.
If it is almost time to take your next dose, skip the missed dose and take your next dose at the usual time. Otherwise take it as soon as you remember and then go back to taking your medicine as you would normally.
Do not take a double dose to make up for the dose that you missed.
This may increase the chance of you getting low blood sugar levels (hypoglycaemia).
If you have trouble remembering to take your medicine, ask your pharmacist for some hints to help you remember.
If you think that you or anyone else may have taken too much of this medicine, immediately telephone your doctor or the Poisons Information Centre (Tel: 13 11 26 for Australia) for advice. Alternatively go to the Accident and Emergency Department at your nearest hospital.
Do this even if there are no signs of discomfort or poisoning. You may need urgent medical attention.
If you take too much metformin you may feel sleepy, very tired, sick, vomit, have trouble breathing and have unusual muscle pain, stomach pain or diarrhoea. These may be early signs of a serious condition called lactic acidosis (build up of lactic acid in the blood).
You may also experience symptoms of hypoglycaemia (low blood glucose). This usually only happens if you take too much metformin together with other medicines for diabetes or with alcohol.
If you do experience any signs of hypoglycaemia, raise your blood glucose quickly by eating jelly beans, sugar or honey, drinking a non-diet soft drink or taking glucose tablets.
Make sure that you, your friends, family and work colleagues can recognise the symptoms of hypoglycaemia and hyperglycaemia and know how to treat them.
Metformin does not normally cause hypoglycaemia, although you may experience it if you also take other medicines for diabetes such as sulfonylureas or repaglinide; or if you also use insulin.
Hypoglycaemia can occur suddenly. Initial signs may include:
If not treated promptly, these may progress to:
If you experience any of the symptoms of hypoglycaemia, you need to raise your blood glucose immediately.
You can do this by doing one of the following:
Unless you are within 10 to 15 minutes of your next meal or snack, follow up with extra carbohydrates such as plain biscuits, fruit or milk.
Taking this extra carbohydrate will prevent a second drop in your blood glucose level.
Hyperglycemia is often asymptomatic (doesn't cause any immediate symptoms) in many people. However some people will develop symptoms. Those people who develop symptoms may experience the following:
If you develop any signs of hyperglycaemia, contact your doctor immediately.
Your doctor may need to consider additional or other treatments for your diabetes.
The risk of hyperglycaemia is increased in the following situations:
Tell your doctor that you are taking this medicine if:
Your blood glucose may become difficult to control at these times. You may also be more at risk of developing a serious condition called lactic acidosis. At these times, your doctor may replace metformin with insulin.
Go to your doctor regularly for a check-up. Your doctor may want to perform blood tests to check your kidneys, liver, heart and vitamin B12 level while you are taking this medicine.
Check your blood glucose levels regularly.
This is the best way to tell if your diabetes is being controlled properly. Your doctor or diabetes educator will show you how and when to do this.
When you start treatment with metformin, it can take up to two weeks for your blood glucose levels to be properly controlled.
Carefully follow the advice of your doctor and dietician on diet, drinking alcohol and exercise.
If you have to be alert, for example when driving, be especially careful not to let your blood glucose levels fall too low.
Low blood glucose levels may slow your reaction time and affect your ability to drive or operate machinery. Drinking alcohol can make this worse. However metformin by itself is unlikely to affect how you drive or operate machinery.
If you become sick with a cold, fever or flu, it is very important to continue taking metformin even if you feel unable to eat your normal meal. Your diabetes educator or dietician can give you a list of foods to use for sick days.
If you are travelling, it is a good idea to:
Tell your doctor or pharmacist as soon as possible if you do not feel well while you are taking metformin.
Metformin helps most people with diabetes, but it may have unwanted side effects in a few people.
If you are over 65 years of age, report any side effects to your doctor immediately.
People over his age may have an increased chance of getting side effects.
Ask your doctor or pharmacist to answer any questions you may have.
Do not be alarmed by the following lists of side effects. You may not experience any of them. All medicines can have side effects. Sometimes they are serious but most of the time they are not.
Tell your doctor or pharmacist if you notice any of the following and they worry you:
These are generally mild side effects. Stomach upset and diarrhoea are common but usually short-lived. Taking your medicine with meals can help reduce nausea and diarrhoea. Skin rash has been reported rarely.
Tell your doctor immediately or go to Accident or Emergency at the nearest hospital if you notice any of the following symptoms of Lactic Acidosis (build up of lactic acid in the blood):
Lactic acidosis is a very rare but serious side effect requiring urgent medical attention or hospitalisation.
Although rare, if lactic acidosis does occur it can be fatal. The risk of lactic acidosis is higher in the elderly, those whose diabetes is poorly controlled, those with prolonged fasting, those with certain heart conditions, those who drink alcohol and those with kidney and liver problems.
Other side effects not listed above may occur in some patients.
Tell your doctor or pharmacist if you notice anything that is making you feel unwell.
If you think you are having an allergic reaction to metformin tell your doctor immediately or go to the Accident and Emergency department at your nearest hospital.
Symptoms of an allergic reaction may include some or all of the following:
Keep your medicine in its original packaging until it is time to take it.
If you take your medicine out of its original packaging they may not keep well.
Keep your medicine in a cool dry place where the temperature will stay below 25°C.
Do not store your medicine, or any other medicine, in the bathroom or near a sink. Do not leave it on a window sill or in the car. Heat and dampness can destroy some medicines.
Keep this medicine where children cannot reach it.
A locked cupboard at least one-and-a-half metres above the ground is a good place to store medicines.
If your doctor or pharmacist tells you to stop taking this medicine or it has passed its expiry date, your pharmacist can dispose of the remaining medicine safely.
500 mg tablets:
1. White coloured, film-coated biconvex capsule shaped tablet with central break-line on one side and '500' embossed on the other side.
They are packaged in a blister pack of 100 tablets.
2. White to off-white, round, biconvex, film-coated tablet, scored and engraved "M" over European bisect "500" on one side. Plain on the other side.
They are packaged in a blister pack of 100 tablets.
850 mg tablets:
1. White coloured, film-coated, round biconvex tablets plain on one side and '850' embossed on the other side.
They are packaged in a blister pack of 60 tablets.
2. White to off-white, capsule shaped, biconvex, film-coated tablet, engraved "APO 850" on one side and plain on the other side.
They are packaged in a blister pack of 60 tablets.
1000 mg tablets:
White, film-coated, capsule-shaped, biconvex tablet, plain on one side and a breakline on the other.
They are packed in a blister pack of 10, 30, 60 and 90 tablets.
Each tablet contains 500 mg, 850 mg or 1000 mg of metformin hydrochloride as the active ingredient.
It also contains the following inactive ingredients:
This medicine is gluten-free, lactose-free, sucrose-free, tartrazine-free and free of other azo dyes.
APO-Metformin 500 tablets (blister pack): AUST R 174815.
APO-Metformin 850 tablets (blister pack): AUST R 174816.
APO-Metformin 1000 tablets (blister pack): AUST R 176509.