Panfor

Panfor is an oral hypoglycemic drug.

Indications Panfora

It is used for diabetes mellitus type 2 (adults, especially those with increased weight indicators), when it is not possible to achieve a positive result by adjusting glucose indicators with the help of physical exercise, and in addition, diet.

Release form

The product is produced in tablets with prolonged effect, with a volume of 0.5 or 1 g, in the amount of 20 pieces inside a blister cell. The pack contains 5 such blisters.

Pharmacodynamics

Metformin is a biguanide with hypoglycemic properties. It helps to reduce postprandial and basal blood glucose levels. The substance does not stimulate an increase in insulin secretion, so it does not cause hypoglycemia.

The sugar-lowering effect develops as a result of several mechanisms:

• increased muscle sensitivity to insulin, resulting in improved peripheral glucose uptake and utilization;
• reduction of glucose production within the liver by suppressing the processes of glycogenolysis and gluconeogenesis;
• suppression of glucose absorption processes in the intestine.

Direct action of metformin on glycogen synthetases promotes glycogen binding processes inside cells. The active component increases the size of the transport capacity for glucose in all currently known proteins of transport nature located inside membranes (GLUT). The drug helps to reduce the indicators of total cholesterol together with cholesterol, having a low density level, and also triglycerides.

Pharmacokinetics

After taking a dose of the drug orally, it takes 2.5 hours for the substance to reach peak values. The bioavailability index fluctuates in the range of 50-60%. After taking a dose of the drug orally, its unabsorbed and excreted in the feces portion is 20-30%. After taking metformin orally, its absorption is incomplete.

Metformin pharmacokinetic parameters are considered to be nonlinear. After administration in the permitted dosages with standard intervals between doses, steady state with respect to plasma parameters is observed after 24-48 hours. These values are often less than 1 mg/ml.

Peak plasma levels of metformin after the maximum dose remain within 4 mg/ml. Food intake reduces the rate and extent of drug absorption.

Excretion of unchanged metformin occurs in the urine. The half-life of the administered dose is approximately 6.5 hours. If a person has reduced renal function, the renal clearance rate decreases proportionally to the CC values. Because of this, the half-life is prolonged and the plasma level of metformin increases.

Dosing and administration

Monotherapy, as well as complex treatment with other antidiabetic drugs for oral administration.

The initial dose is 1 tablet (0.5 g), which should be taken twice or three times a day, with or after meals. After 10-15 days, the dose will need to be adjusted, taking into account blood glucose levels. To improve the tolerability of the drug, the dosage should be increased gradually. No more than 3 g of the drug can be taken per day.

In case of transferring a patient from another oral hypoglycemic drug to Panfor, it is necessary to first stop taking the previous drug, and only then start using metformin.

Combination with insulin.

To increase the correction of glucose levels, a combination of Panfor and insulin is allowed. In this case, metformin is taken in a standard initial dose, and the insulin dosage is determined by the measured glucose level in the body.

Elderly patients.

Because elderly people often have problems with kidney function, the portion size of Panfor should be selected taking into account the state of kidney function.

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Use Panfora during pregnancy

Pregnant women are prohibited from taking Panfor.

Contraindications

Among the contraindications:

• the presence of intolerance to metformin or other components of the drug;
• comatose state of diabetic origin or DKA;
• renal failure or problems with renal function (the level of creatinine in the blood serum is >135 μmol/L (men) or 110 μmol/L (women));
• acute diseases, against which a weakening of renal function is possible - for example, dehydration;
• shock or severe infection;
• injection of contrast agents containing iodine into the vessels;
• acute or chronic diseases, against the background of which tissue hypoxia sometimes occurs - heart failure or respiratory failure;
• recent shock or myocardial infarction;
• hepatocellular insufficiency;
• acute degree of alcohol poisoning or alcoholism;
• lactation period.

Side effects Panfora

Taking pills can provoke the development of some side effects:

• Gastrointestinal reactions: diarrhea, nausea, loss of appetite, vomiting and abdominal pain are often observed. A metallic taste in the mouth is also quite common;
• lesions affecting the skin surface and subcutaneous layers: mild erythema is occasionally observed in individuals with hypersensitivity;
• problems with metabolic processes: a decrease in the absorption of cyanocobalamin is occasionally observed, up to a decrease in its serum values in the case of long-term use of the drug. The development of lactic acidosis is noted sporadically.

Overdose

After taking the drug in a dose of up to 85 g, hypoglycemia did not develop in patients (even if it caused lactic acidosis). Severe intoxication or the presence of concomitant factors can lead to lactic acidosis.

To eliminate this disorder, the victim must be hospitalized immediately. The most effective way to remove metformin together with lactate is the hemodialysis procedure.

Interactions with other drugs

Prohibited drug combinations.

Contrast elements containing iodine can cause renal failure, which results in the accumulation of metformin and, accordingly, increases the risk of lactic acidosis. For this reason, it is necessary to stop taking Panfor before performing the test. Resumption of treatment is allowed only after 48 hours have passed after the end of the test, and also provided that the studies performed have diagnosed healthy renal function.

Combinations of drugs in which use should be especially careful.

GCS (both local and systemic), diuretics and b2-adrenomimetics have endogenous hyperglycemic properties. Because of this, it is necessary to monitor sugar values before starting to use these drugs, as well as during therapy (at short intervals). If necessary, you can adjust the dosage of Panfor while taking another drug or after stopping its use.

ACE inhibitors can reduce glucose levels, which may require a change in metformin dosage.

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Storage conditions

Panfor should be kept in a dark place, out of the reach of small children. The temperature should not exceed 25°C.

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Shelf life

Panfor can be used for 3 years from the date of manufacture of the drug.