Siofor

Xiophore is the trade name of a drug whose active ingredient is metformin. Metformin belongs to a class of oral hypoglycemic agents known as biguanides and is widely used to treat type 2 diabetes in adults and children over 10 years of age. It helps control blood sugar levels by increasing insulin sensitivity and reducing the amount of glucose produced by the liver.

Metformin's mechanism of action includes:

• Reducing gluconeogenesis in the liver: Metformin reduces glucose production in the liver, which is a major source of high blood sugar in people with type 2 diabetes.
• Increased insulin sensitivity: Improves the ability of muscles to utilize available insulin to convert glucose into energy.
• Slowing glucose absorption in the gut: May slightly slow the absorption of glucose from food, helping to control blood sugar levels after meals.

Siophora Application:

• As monotherapy or in combination with other oral hypoglycemic drugs or insulin to improve blood glucose control.
• In some cases, metformin is used to treat women with polycystic ovarian syndrome (PCOS) because it helps lower insulin levels and may improve some symptoms of PCOS, such as irregular menstruation.

Important points:

• Metformin is usually well tolerated but may cause side effects such as upset stomach, diarrhea, abdominal bloating, and a metallic taste in the mouth, especially at the beginning of treatment.
• Although metformin is considered safe for most people, there are certain conditions and situations in which its use may be contraindicated, including severe kidney or liver dysfunction and conditions that increase the risk of lactic acidosis, a rare but serious complication.

Before starting treatment with metformin, it is important to discuss with your doctor any potential side effects and contraindications, as well as the need for regular monitoring of your health during treatment.

Indications Siophora

1. Type 2 Diabetes Mellitus: This is the most common indication for metformin. Xiophore helps lower blood sugar levels in patients with type 2 diabetes by improving tissue sensitivity to insulin and reducing glucose production in the liver.
2. Pre-diabetic conditions: Metformin can also be used to treat pre-diabetic conditions such as type 2 diabetes. It helps prevent the progression of pre-diabetic conditions to diabetes and reduces the risk of developing serious complications.
3. PolycysticOvarian Syndrome (PCOS): Metformin can be prescribed to women with polycystic ovary syndrome to improve ovarian function, stabilize the menstrual cycle, and increase the likelihood of conception.
4. Weight control: In some patients, metformin may be prescribed for weight control, especially in those with diabetes or pre-diabetic conditions.

Release form

Xiophore (metformin) is available in a variety of dosages, both in milligram (mg) and gram fractions. Common metformin dosages include:

1. 500 mg tablets
2. 850 mg tablets
3. 1000 mg tablets

The choice of a specific dosage depends on the individual needs of the patient and the doctor's recommendations. It is important to follow the prescribed dosage and not to exceed it without consulting a medical specialist.

Pharmacodynamics

1. Reducing gluconeogenesis: Metformin reduces glucose synthesis in the liver by blocking the gluconeogenesis enzyme, resulting in a decrease in blood glucose levels.
2. Improved insulin sensitivity: Metformin increases tissue sensitivity to insulin, which helps improve glucose utilization in muscles and other tissues.
3. Slows glucose sorption in the intestine: Prevents the absorption of glucose from food in the intestine, which also helps lower blood glucose levels.
4. Reduced appetite and reduced food intake: Some patients notice that metformin reduces appetite, which may help control body weight.

Pharmacokinetics

1. Absorption: Metformin is absorbed in the gastrointestinal tract, mainly in the small intestine. Absorption is slow and incomplete, approximately 50-60% of the dose.
2. Metabolism: Metformin is not metabolized in the body, which means that the drug does not undergo metabolic transformations in the liver or other organs.
3. Excretion: About 90% of metformin is excreted through the kidneys in unchanged form during the first 24 hours after the drug administration. This process occurs by glomerular filtration and partially by transport through renal tubules.
4. Half-life: The half-life of metformin is approximately 6.2 hours, which means that about 50% of the drug is removed from the body for every 6.2 hours.
5. Time to peak concentration: Peak blood concentrations of metformin are usually reached about 2.5 hours after taking the drug.
6. Bioavailability: Bioavailability of metformin from Siofor preparation is about 50-60% compared to metformin in pure form.

Dosing and administration

1. Initial dosage: Dosage usually starts at a low dose and is gradually increased under a doctor's supervision to achieve the desired effect. The starting dose may be approximately 500 mg once or twice daily.
2. DoseIncrease: Metformin dosage may be increased as needed at intervals of several weeks depending on the response to treatment and patient tolerance. The maximum recommended daily dose of metformin is usually 2000-3000 mg.
3. Duration of use: Metformin is usually taken regularly, as prescribed by a doctor. The duration of administration depends on the characteristics and features of the patient's disease.
4. Dietand exercise: It is also important to follow a diet and exercise regularly while taking metformin for best treatment results.
5. Characteristics of patients with impaired renal function: In patients with impaired renal function it may be necessary to adjust the dosage of metformin according to the degree of renal impairment. In such cases, it is important to follow the doctor's recommendations.

Use Siophora during pregnancy

The use of metformin during pregnancy should be under strict medical supervision.

Studies show that metformin in small amounts can pass through the placenta, but data on its safety for the fetus are limited. Some studies suggest that metformin may be less harmful to a baby's development than insulin, especially with regard to the risk of a baby developing diabetes in the future. However, the presence of other risks and side effects should always be considered.

Contraindications

1. Ketoacidosis: Metformin is contraindicated in the presence of ketoacidosis, a serious complication of diabetes mellitus characterized by elevated levels of ketone bodies in the blood and acidosis. This condition may be caused by improper use of metformin, insulin therapy, or other causes.
2. Hepaticinsufficiency: In patients with severe liver dysfunction metformin may accumulate in the body and cause serious side effects. Therefore, it is contraindicated in severe hepatic impairment.
3. Renal insufficiency: Kidneys play a key role in metformin elimination from the body. Therefore, in patients with severe renal impairment (by creatinine clearance less than 30 ml/min) metformin is contraindicated due to the risk of metformin-associated lactatacidosis.
4. Alcohol intoxication: During alcohol consumption metformin may increase the risk of metformin-associated lactatacidosis.
5. Serious Infections and Stress: Temporary discontinuation of metformin is recommended in the presence of serious infections, stressful situations, surgery, or other conditions that may increase the risk of metformin-associated lactatacidosis.
6. Hypoxia: Metformin is contraindicated in hypoxia - insufficient oxygen supply to body tissues, as it may contribute to the development of metformin-associated lactatacidosis.
7. Pregnancy and breastfeeding: Data on the safety of metformin during pregnancy are ambiguous, therefore its use during pregnancy should be agreed with a doctor. Metformin is excreted into breast milk, therefore consultation with a physician is also required when using the drug during breastfeeding.

Side effects Siophora

1. Gastrointestinal disorders: The most common side effects of metformin are GI-related, such as nausea, vomiting, diarrhea, abdominal bloating, abdominal pain, and loss of appetite. These symptoms are usually mild and temporary, but can sometimes be serious.
2. Metabolic disorders: Metformin may cause changes in metabolism, such as weight loss or decreased vitamin B12 levels. In rare cases, hypoglycemia (low blood sugar) or metabolic acidosis (acid poisoning) may also occur, especially when the drug is used in high doses or in patients with impaired kidney function.
3. Liver disorders: In some people when taking metformin, liver function disorders may occur, manifested as an increase in the activity of liver enzymes.
4. Neurologic symptoms: In rare cases,neurologic side effects such as dizziness, headache, drowsiness or insomnia may occur.
5. Allergic Reactions: Although rare, some patients may develop allergic reactions to metformin, manifested as skin rash, pruritus, edema, or angioedema.

Overdose

Symptoms of overdose may include:

1. Tachypnea (accelerated breathing).
2. Hyperglycemia (high blood glucose levels).
3. Metabolic acidosis (disturbance of acid-base balance).
4. Central nervous system symptoms such as drowsiness, dizziness, severe weakness, as well as seizures and even coma in severe cases.

In case of suspected metformin overdose it is necessary to urgently seek medical attention. Treatment of overdose usually includes symptomatic therapy and correction of metabolic disorders, as well as administration of bicarbonate to correct blood acidity.

Interactions with other drugs

1. Drugs that affect therenal tubule: Drugs that affect the renal tubule can change the rate at which metformin is excreted from the body and thus increase its concentration in the blood. These drugs include angiotensin-converting enzyme inhibitors (ACEIs) and some nonsteroidal anti-inflammatory drugs (NSAIDs).
2. Drugsaffecting the gastrointestinal tract: Drugs that alter the rate of passage of food through the gastrointestinal tract, such as antacids, may affect the absorption of metformin.
3. Drugs that increase the risk of hypoglycemia: Some drugs, such as sulfonylurea (e.g. Glibenclamide) or insulin, may increase the hypoglycemic effect of metformin, which can lead to a dangerous drop in blood sugar levels.
4. Drugs that increase the risk of lactic acidosis: The drug metformin may increase the risk of lactic acidosis when used concomitantly with other drugs such as carboanhydrase inhibitors (e.g., acetazolamide) or alcohol.
5. Drugs affecting vitamin B12: Prolonged use of metformin may lead to vitamin B12 deficiency. In concomitant administration of drugs containing vitamin B12, dosage adjustment may be required.