Panfora

Panforum is a hypoglycemic medicine for oral ingestion.

Indications of the pantophone

It is used for diabetes mellitus category 2 (adults, especially those with heightened weight), when to achieve a positive result by adjusting the glucose values with exercise, and in addition, the diet fails.

Release form

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

Pharmacodynamics

Metformin is a biguanide with sugar-reducing properties. It helps to reduce postprandial and basal values of glucose in the blood. The substance does not stimulate an increase in the volume of insulin secretion, so it does not cause hypoglycemia.

The antipyretic effect develops as a result of several mechanisms:

• an increase in muscle sensitivity with respect to insulin, which improves glucose uptake in the peripheral area, as well as its use;
• decrease in the production of glucose within the liver by suppressing the processes of glycogenolysis and gluconeogenesis;
• Suppression of glucose absorption processes inside the intestine.

The direct effect of metformin on glycogen synthetase promotes the processes of glycogen binding inside cells. The active component increases the size of the transport capacity for glucose in all currently known transport proteins located inside the membranes (GLUT). The medicine helps to reduce the total cholesterol together with cholesterol, which has a low level of density, and besides triglycerides.

Pharmacokinetics

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

It is believed that the pharmacokinetic parameters of metformin are non-linear. After application in allowed dosages with standard intervals between doses, the equilibrium state with respect to plasma parameters is noted after 24-48 hours. These values are often less than 1 mg / ml.

The peak plasma metformin levels after taking the maximum allowable dose remain within 4 mg / ml. The food consumed reduces the speed and degree of absorption of drugs.

Excretion of unchanged metformin occurs with urine. The half-life of the dose taken is approximately 6.5 hours. If a person has decreased renal function, the level of renal clearance decreases in proportion to the QC indices. Because of this, the half-life is prolonged, and the plasma level of metformin is increased.

Dosing and administration

Monotherapy, as well as complex treatment together with other antidiabetic drugs for ingestion.

The size of the initial portion is 1-inch tablet (0.5 g), which you need to use twice or three times a day, with or after eating. After 10-15 days, you need to adjust the size of the dose, taking into account the glucose in the blood. To improve the tolerability of the drug, you should increase the dosage gradually. For a day, you can take no more than 3 grams of medication.

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

Combination with insulin.

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

Elderly patients.

Because elderly people often have problems in the work of the kidneys, the size of the Panfora portion should be selected, taking into account the state of renal activity.

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Use of the pantophone during pregnancy

Pregnant women are not allowed to take Panfor.

Contraindications

Among the contraindications:

• the presence of intolerance against metformin or other elements of the drug;
• comatose state of a diabetic character or DKA;
• kidney failure or problems with renal activity (the level of creatinine within the blood serum is> 135 μmol / l (male) or 110 μmol / l (female));
• diseases of an acute nature, against which it is possible to weaken renal activity - for example, dehydration;
• shock or severe form of infection;
• injection of contrasting ligaments containing iodine, inside the vessels;
• diseases of an acute or chronic nature, against which sometimes there is tissue hypoxia - heart failure or respiratory insufficiency;
• recent shock or myocardial infarction;
• hepatocellular insufficiency;
• acute degree of alcohol poisoning or alcoholism;
• lactation period.

Side effects of the pantophone

The taking of tablets is capable of provoking the development of some side effects:

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

Overdose

After taking drugs in a dose of up to 85 grams, there was no development in patients of hypoglycemia (even if this became the cause of lactic acidosis). Severe intoxication or the presence of concomitant factors can lead to lactic acidosis.

To eliminate this violation, you must immediately hospitalize the victim. The most effective way to excrete metformin with lactate is the procedure of hemodialysis.

Interactions with other drugs

Prohibited combinations of drugs.

Contrasting elements containing iodine can cause kidney deficiency, which results in the accumulation of metformin and, accordingly, increases the risk of lactic acidosis. Because of this, you need to stop taking Pandora before doing the testing. Restart treatment is allowed only after 48 hours after the end of the test, and also provided that the performed studies have diagnosed healthy renal function.

Combinations of drugs in which application should be particularly careful.

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

ACE inhibitors are able to reduce glucose levels, which may require a change in metformin dosage.

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Storage conditions

Panther should be kept in a closed place from small children, a dark place. The temperature should not exceed 25 ° C.

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Shelf life

Panfor is allowed to be used for 3 years from the date of manufacture of the medicinal product.