Malangizo a Metfogamma 1000 ogwiritsira ntchito, contraindication, mavuto, ndemanga

Dzinalo:Metfogamma 1000

Kupanga ndi mawonekedwe a kumasulidwa

Mapiritsi, okhala ndi zokutira kwamafuta oyera, amakhala osatha, ali ndi ngozi, osanunkhiza. Piritsi limodzi lili ndi 1000 mg ya meformin hydrochloride. Othandizira: hypromellose (15000 CPS) - 35.2 mg, povidone (K25) - 53 mg, magnesium stearate - 5.8 mg.

Ma Shell: hypromellose (5 CPS) - 11.5 mg, macrogol 6000 - 2.3 mg, titanium dioxide - 9.2 mg.

Mu matuza 30 kapena 120 mapiritsi. Atakwezedwa m'makatoni.

Zachipatala ndi gulu la mankhwala

Oral hypoglycemic mankhwala

Gulu la Pharmacotherapeutic

Hypoglycemic wothandizila kukonzekera pakamwa pa gulu la Biguanide

Pharmacological zochita za mankhwala Metfogamma 1000

Oral hypoglycemic mankhwala ochokera pagulu la Biguanide. Amalepheretsa gluconeogeneis m'chiwindi, amachepetsa mayamwidwe m'matumbo, imathandizira kugwiritsidwa ntchito kwa glucose, komanso imakulitsa chidwi cha minofu kuti insulini. Zisakhudze kubisalira kwa insulin ndi ma cell a kancre.

Lowers triglycerides, LDL.

Imakhazikika kapena kuchepetsa thupi.

Ili ndi fibrinolytic mwina chifukwa chokakamira minofu ya plasminogen activator inhibitor.

Pharmacokinetics

Pambuyo pakukonzekera pakamwa, metformin imatengedwa kuchokera m'mimba. Bioavailability mutatenga muyezo mlingo 50-60%. C max pambuyo pakamwa makonzedwe amapezeka pambuyo 2 maola

Sizikugwirizana ndi mapuloteni a plasma. Amadziunjikira mu ndulu zakumaso, minofu, chiwindi, ndi impso.

Amatulutsidwa popanda mkodzo. T 1/2 ndi maola 1.5-4.5.

Pharmacokinetics mu milandu yapadera yamankhwala

Ndi matenda aimpso, kuwonongeka kwa mankhwalawa ndikotheka.

Type 2 shuga mellitus (osadalira insulini) popanda chizolowezi cha ketoacidosis (makamaka kwa odwala omwe ali ndi kunenepa kwambiri) ndi mankhwala othandizira pakudya.

Contraindication

Hypersensitivity, hyperglycemic coma, ketoacidosis, matenda aimpso, matenda a chiwindi, mtima kulephera, kupweteka kwamkati, kupuma, kulephera kwa madzi, matenda opatsirana, ntchito zambiri komanso kuvulala, uchidakwa, zakudya zopatsa mphamvu zochepa (zosakwana 1000 kcal / tsiku), lactic acidosis (kuphatikizapo lactic acidosis) mbiri), pakati, kuyamwa. Mankhwalawa sanalembedwe masiku awiri asanachitike opaleshoni, radioisotope, maphunziro a x-ray ndikuyambitsa mankhwala osiyanitsa komanso patatha masiku awiri atangomaliza. Zoposa zaka 60, kuchita masewera olimbitsa thupi (chiwopsezo chowonjezereka cha kukhala ndi lactic acidosis mwa iwo).

Mlingo komanso njira yogwiritsira ntchito Metfogamma 1000

Khazikikani payekhapayekha, poganizira kuchuluka kwa shuga m'magazi.

Mlingo woyambirira nthawi zambiri amakhala 500 mg-1000 mg (1 / 2-1 tabu.) / Tsiku. Kuwonjezereka kwapang'onopang'ono kwa mlingo kumatheka kutengera mphamvu ya mankhwala.

Mlingo wokonza ndi 1-2 g (mapiritsi 1-2) / tsiku. Mlingo wambiri watsiku ndi tsiku ndi 3 g (mapiritsi atatu). Cholinga cha mankhwalawa muyezo waukulu sichimawonjezera mphamvu ya mankhwalawa.

Mapiritsi amayenera kumwedwa ndi chakudya chonse, kutsukidwa ndi madzi pang'ono (kapu yamadzi).

Mankhwalawa adapangira kuti azigwiritsa ntchito kwakanthawi.

Chifukwa chowonjezera chiopsezo cha lactic acidosis, mu zovuta zazikulu za metabolic, mlingo uyenera kuchepetsedwa.

Zotsatira zoyipa

Kuchokera m'mimba: mseru, kusanza, kupweteka kwam'mimba, kutsegula m'mimba, kusowa kwa chakudya, kutsekemera kwazitsulo mkamwa (monga lamulo, kusiya kwa chithandizo sikofunikira, ndipo zizindikiro zimatha mwaiwo osasinthanso mlingo wa mankhwala, pafupipafupi komanso kuopsa kwa zovuta zomwe m'magazi angachepetse ndi kuwonjezeka kwapang'onopang'ono kwa mlingo wa metformin), kawirikawiri - pathological kupatuka kwa mayesero a chiwindi, hepatitis (kudutsa atasiya mankhwala).

Zotsatira zoyipa: zotupa pakhungu.

Kuchokera ku endocrine system: hypoglycemia (mukamagwiritsa ntchito mankhwala osayenera).

Kuchokera kumbali ya kagayidwe: kawirikawiri - lactic acidosis (imafuna kuleka kwamankhwala), pogwiritsa ntchito nthawi yayitali - hypovitaminosis B₁₂ (malabsorption).

Kuchokera ku hemopoietic system: Nthawi zina - megaloblastic anemia.

Mimba komanso kuyamwa

Mankhwalawa adapangidwa kuti agwiritse ntchito panthawi yomwe ali ndi pakati komanso mkaka wa m'mawere .Kupangika kwa chiwindi kugwira ntchito. Mankhwalawa amalembedwa kuti agwiritse ntchito ntchito yaimpso ya chiwindi. Kugwiritsa ntchito mphamvu yaimpso.

Gwiritsani ntchito odwala okalamba

Sitikulimbikitsidwa kugwiritsa ntchito mankhwalawa odwala omwe ali ndi zaka zopitilira 60 omwe amagwira ntchito zolimbitsa thupi, chifukwa chowonjezera chiopsezo cha lactic acidosis.

Malangizo apadera a kuvomerezedwa Metfogamma 1000

Pa mankhwala, kuwunika aimpso ndikofunikira; kutsimikiza kwa plasma lactate kuyenera kuchitika kawiri pachaka, komanso maonekedwe a myalgia. Ndi chitukuko cha lactic acidosis, kusiya kwa mankhwala kumafunika. Kukhazikitsidwa sikulimbikitsidwa chifukwa cha matenda oopsa, kuvulala, ndi chiopsezo chofuna madzi m'thupi. Ndi mankhwala ophatikizika a sulfonylurea, kuyang'anitsitsa shuga wamagazi ndikofunikira. Ntchito zophatikizidwa ndi insulin tikulimbikitsidwa kuchipatala.

Bongo

Zizindikiro lactic acidosis imayamba. Zomwe zimayambitsa kukula kwa lactic acidosis amathanso kukhala cumulation wa mankhwalawa chifukwa cha kuwonongeka kwa impso. Zizindikiro zoyambirira za lactic acidosis ndi mseru, kusanza, kutsegula m'mimba, kutsitsa kutentha kwa thupi, kupweteka kwam'mimba, kupweteka kwa minofu, mtsogolo kumatha kuwonjezera kupuma, chizungulire, chikumbumtima chodwala komanso kukula kwa chikomokere.

Chithandizo: ngati pali zizindikiro za lactic acidosis, chithandizo ndi Metfogamma 1000 chiyenera kuyimitsidwa nthawi yomweyo, wodwalayo ayenera kuchipatala mwachangu ndipo atatsimikiza kuchuluka kwa lactate, atsimikizireni matendawa. Hemodialysis imathandiza kwambiri pochotsa lactate ndi metformin m'thupi. Ngati ndi kotheka, chitani mankhwala othandizira.

Mankhwala ophatikiza ndi sulfonylureas, hypoglycemia imayamba.

Kuchita ndi Mankhwala Ena

Ndi munthawi yomweyo kugwiritsa ntchito nifedipine kumapangitsa mayamwidwe a metformin, C_maxImachepetsa mayeso.

Mankhwala a Cationic (amlodipine, digoxin, morphine, procainamide, quinidine, quinine, ranitidine, triamteren, vancomycin) omwe amatulutsidwa mu tubules kupikisanila kachitidwe ka ma tubular system, ndipo akamalandira chithandizo chambiri, amatha C_max 60% metformin.

Pogwiritsa ntchito munthawi yomweyo ndi sulfonylurea zotumphukira, ma acarbose, insulin, NSAIDs, ma inhibitors a MAO, oxytetracycline, ma inhibitors a ACE, clofibrate zotumphukira, cyclophosphamide ndi beta-blockers, ndizotheka kuwonjezera mphamvu ya hypoglycemic ya metformin.

Pogwiritsa ntchito munthawi yomweyo ndi GCS, kulera kwapakamwa, epinephrine (adrenaline), sympathomimetics, glucagon, mahomoni a chithokomiro, thiazide ndi loopback diuretics, phenothiazine zotumphukira ndi nicotinic acid, kuchepa kwa mphamvu ya hypoglycemic ya metformin ndikotheka.

Cimetidine amachepetsa kuchotsedwa kwa metformin, chifukwa chomwe chiopsezo cha lactic acidosis chikuwonjezeka.

Metformin itha kufooketsa mphamvu ya ma anticoagulants (zotumphukira za coumarin).

Ndi munthawi yomweyo makonzedwe ndi Mowa, kukula kwa lactic acidosis ndikotheka.

Terms a Tchuthi cha Pharmacy

Mankhwala ndi mankhwala.

Migwirizano ndi magwiritsidwe akusungidwa Metfogamma 1000

Mankhwalawa amayenera kusungidwa kuti ana asawatenthe pa kutentha osaposa 25 ° C. Moyo wa alumali ndi zaka 4.

Kugwiritsa ntchito mankhwala a Metfogamm 1000 pokhapokha ngati adokotala adafotokoza, malongosoledwewo amaperekedwa kuti awathandize!

Kutulutsa mawonekedwe a Metfogamma 1000, ma CD ndikuphatikizira ndi mankhwala.

Mapiritsi okhala ndi mbali
1 tabu
metformin hydrochloride
1 g

Othandizira: hypromellose (15,000 CPS), magnesium stearate, povidone (K25).

Mapangidwe a Shell: hypromellose (5CPS), macrogol 6000, titanium dioxide.

Ma PC 10 - matuza (3) - mapaketi a makatoni.
Ma PC 10 - matuza (12) - mapaketi a makatoni.
15 ma PC. - matuza (2) - mapaketi a makatoni.
15 ma PC. - matuza (8) - mapaketi a makatoni.

Kufotokozera kwa ZOTHANDIZA ZABWINO.
Zonse zomwe zaperekedwa zimangoperekedwa kuti mudziwe bwino za mankhwalawo, muyenera kufunsa dokotala zokhudzana ndikugwiritsa ntchito.

Pharmfological kanthu Metfogamma 1000

Oral hypoglycemic wothandizila kuchokera pagulu la Biguanides (dimethylbiguanide). Kupanga kwa zochita za metformin kumalumikizidwa ndi kuthekera kwake kuponderezera gluconeogeneis, komanso mapangidwe a mafuta achilengedwe omasuka ndi makulidwe a oxidation. Metformin siyimakhudzanso kuchuluka kwa insulin m'magazi, koma imasintha ma pharmacodynamics pochepetsa kuchuluka kwa insulini kuti imasulidwe ndikuwonjezera kuchuluka kwa insulin kuti proinsulin. Cholumikizira chofunikira pakupanga metformin ndicho kukoka kwa glucose komwe kumachitika ndi minofu ya minofu.

Metformin imathandizira kufalikira kwa magazi m'chiwindi ndikuthandizira kusintha kwa glucose kukhala glycogen. Amachepetsa msana wa triglycerides, LDL, VLDL. Metformin imakweza michere yamagazi ya fibrinolytic mwa kuponderezana ndi minyewa yokhala ngati minofu ya plasminogen activator inhibitor.

Pharmacokinetics wa mankhwala.

Metformin imatengedwa kuchokera m'mimba. Cmax mu plasma imafikira pafupifupi maola awiri atatha kumwa. Pambuyo 6 maola, mayamwidwe kuchokera m'mimba thirakiti limatha ndipo ndende ya metformin mu plasma imayamba kuchepa.

Sizikugwirizana ndi mapuloteni a plasma. Amadziunjikira mu ndulu zakumaso, chiwindi ndi impso.

T1 / 2 - 1.5-5.5 maola.

Pankhani ya kuwonongeka kwaimpso, kuwerengetsa kwa metformin ndikotheka.

Mlingo ndi njira ya mankhwala.

Kwa odwala osalandira insulin, masiku atatu - 500 mg katatu kapena tsiku kapena 1 g 2 nthawi / tsiku nthawi yakudya kapena itatha. Kuyambira tsiku la 4 mpaka tsiku la 14 - 1 g katatu kapena tsiku. Pambuyo pa tsiku la 15, mlingo umasinthidwa poganizira kuchuluka kwa shuga m'magazi ndi mkodzo. Mlingo wokonza ndi 100-200 mg / tsiku.

Ndi munthawi yomweyo kugwiritsa ntchito insulin pa mlingo wochepera 40 mayunitsi / tsiku, muyezo wa metformin ndi womwewo, pamene mlingo wa insulin ungachepetse pang'onopang'ono (mwa magawo 4-8 / tsiku tsiku lililonse). Ngati wodwala amalandira zoposa 40 magawo / tsiku, ndiye kuti kugwiritsa ntchito metformin ndi kuchepa kwa insulin kumafunikira chisamaliro chachikulu ndikuchitika kuchipatala.

Zotsatira zoyipa Metphogamm 1000:

Kuchokera pamimba yogaya: ndikotheka (nthawi zambiri kumayambiriro kwa chithandizo) mseru, kusanza, kutsekula m'mimba.

Kuchokera ku endocrine system: hypoglycemia (makamaka ikagwiritsidwa ntchito mosakwanira).

Kuchokera kumbali ya kagayidwe: nthawi zina - lactic acidosis (pamafunika kutha kwa chithandizo).

Kuchokera pa hemopoietic dongosolo: nthawi zina - megaloblastic anemia.

Zotsatira zamankhwala:

Aphwanya kwambiri chiwindi ndi impso, mtima ndi kupuma kulephera, pachimake gawo la myocardial infarction, uchidakwa, matenda ashuga, ketoacidosis, lactic acidosis (kuphatikizapo mbiri), matenda ashuga apakati, pakati, kuyamwa, kuchepa kwa thupi.

KULENGA NDI MALO
Contraindified mu mimba ndi mkaka wa m`mawere.

Malangizo apadera ogwiritsira ntchito Metfogamma 1000.

Sikulimbikitsidwa kumatenda owopsa, kuchulukitsa kwamatenda opatsirana komanso otupa, kuvulala, matenda opweteka kwambiri, komanso chiopsezo chofuna kuperewera madzi m'thupi.

Osagwiritsa ntchito musanachite opareshoni komanso patatha masiku awiri atachitidwa opereshoni.

Sikulimbikitsidwa kugwiritsa ntchito metformin mwa odwala omwe ali ndi zaka zopitilira 60 ndi omwe akugwira ntchito zolimbitsa thupi, zomwe zimakhudzana ndi chiopsezo chowonjezeka cha lactic acidosis.

Pa mankhwala, m`pofunika kuwunika aimpso, kutsimikiza kwa lactate zili plasma ayenera kuchitika osachepera 2 pachaka, komanso mawonekedwe a myalgia.

Metformin itha kugwiritsidwa ntchito limodzi ndi sulfonylureas. Potere, makamaka kuyang'anira kuchuluka kwa shuga m'magazi ndikofunikira.

Kugwiritsira ntchito metformin monga gawo la mankhwala osakanikirana ndi insulin tikulimbikitsidwa kuchipatala.

Kugwirizana kwa Metfogamma 1000 ndi mankhwala ena.

Pogwiritsa ntchito munthawi yomweyo ndimomwe zimachokera ku sulfonylurea, acarbose, insulin, salicylates, ma inhibitors a MAO, oxytetracycline, zoletsa ACE, ndi clofibrate, cyclophosphamide, zotsatira za hypoglycemic za metformin zitha kupititsidwa patsogolo.

Pogwiritsa ntchito munthawi yomweyo ndi GCS, njira yolerera ya mahomoni pakumwa, adrenaline, glucagon, mahomoni a chithokomiro, zotumphukira zochokera kwa thiazide, diuretics, zotumphukira za nicotinic acid, kuchepa kwa mphamvu ya hypoglycemic ya metformin ndikotheka.

Kugwiritsa ntchito cimetidine mozungulira kungakulitse chiopsezo cha lactic acidosis.

Zithunzi za 3D

Mankhwala

Amalepheretsa gluconeogeneis m'chiwindi, amachepetsa mayamwidwe m'matumbo, imathandizira kugwiritsidwa ntchito kwa glucose, komanso imapangitsa chidwi cha minofu kulowa insulin. Amachepetsa mulingo wa triglycerides ndi lipoproteins wotsika m'magazi. Imakhala ndi fibrinolytic effect (imalepheretsa zochitika za minofu ya mtundu wa plasminogen activator inhibitor), imakhazikika kapena kuchepetsa thupi.

Zotsatira zoyipa

Kuchokera pamtima ndi magazi (hematopoiesis, hemostasis): nthawi zina megaloblastic anemia.

Kuchokera m'mimba: mseru, kusanza, kupweteka m'mimba, kutsegula m'mimba, kusowa kwa chakudya, kulawa kwazitsulo mkamwa.

Kuchokera kumbali ya kagayidwe: hypoglycemia, nthawi zina, lactic acidosis (imafuna kusiya kwa mankhwala).

Zotsatira zoyipa: zotupa pakhungu.

Pafupipafupi komanso kuopsa kwa zovuta zakumbuyo kumatha kuchepa ndikukula pang'onopang'ono kwa mlingo wa metformin. Nthawi zina, patakhala kupatuka kwa chiwindi zitsanzo kapena chiwindi kuwonongeka atasiya mankhwala.

Kuchokera kumbali ya kagayidwe: ndi chithandizo cha nthawi yayitali - hypovitaminosis B₁₂ (malabsorption.)

Mlingo ndi makonzedwe

Mkati ndikudya, kumwa zamadzi zambiri (kapu yamadzi). Mlingo umayikidwa payekha, poganizira kuchuluka kwa shuga m'magazi.

Mlingo woyambira nthawi zambiri amakhala 500-1000 mg (1 / 2-1 mapiritsi) patsiku, kuwonjezereka kwapang'onopang'ono kwa mlingo kumatheka kutengera mphamvu ya mankhwala.

Kukonza tsiku lililonse mlingo 1-2 g (mapiritsi 1-2) patsiku, pazipita - 3 g (mapiritsi atatu) patsiku. Kukhazikitsidwa kwa Mlingo wapamwamba sikukula mphamvu ya mankhwalawa.

Odwala okalamba, tsiku lililonse mlingo sayenera kupitirira 1000 mg / tsiku.

Njira ya chithandizo ndi yayitali.

Chifukwa chowonjezera chiopsezo cha lactic acidosis, mlingo wa mankhwalawa umayenera kuchepetsedwa pazovuta zazikulu za metabolic.

Malangizo apadera

Sichikulimbikitsidwa ngati matenda opatsirana owopsa kapena kufalikira kwamatenda opatsirana opatsirana komanso otupa, kuvulala, matenda opweteka kwambiri kugwiritsa ntchito mafayilo osiyanitsa). Sayenera kugwiritsidwa ntchito mwa odwala pazakudya zomwe zimachepetsa mphamvu ya caloric (zosakwana 1000 kcal / tsiku).Kugwiritsira ntchito mankhwalawa sikulimbikitsidwa mwa anthu opitilira zaka 60 omwe amagwira ntchito zolimbitsa thupi (chifukwa chowonjezera chiopsezo chokhala ndi lactic acidosis).

N`zotheka kugwiritsa ntchito mankhwalawa kuphatikiza ndi sulfonylurea zotumphukira kapena insulin. Potere, makamaka kuyang'anira kuchuluka kwa shuga m'magazi ndikofunikira.

Kukopa pa kuyendetsa magalimoto ndi kugwira ntchito ndi njira. Palibe zotsatira (mukamagwiritsa ntchito ngati monotherapy). Kuphatikiza ndi ma hypoglycemic othandizira ena (sulfonylurea derivatives, insulin, ndi zina), kukulitsa zochitika za hypoglycemic ndizotheka, momwe kuthekera kuyendetsa magalimoto ndi kuchita zina zomwe zingakhale zoopsa zomwe zimafunikira chidwi chochulukirapo komanso kuthamanga kwa zochitika zama psychomotor.

Wopanga

Wogwirizira matifiketi olembetsera: Verwag Pharma GmbH & Co KG, Kalverstrasse 7, 71034, Beblingen, Germany.

Wopanga: Dragenopharm Apotheker Püschl GmbH & Co KG, Germany.

Ofesi yoyimira / bungwe lolandila zodandaula: ofesi yoyimira kampani ya Vervag Pharma GmbH & Co CG mu Russian Federation.

117587, Moscow, msewu waukulu wa Warsaw, 125 F, bldg. 6.

Tel. ((495) 382-85-56.

Momwe mungagwiritsire ntchito: Mlingo ndi njira ya chithandizo

Mkati, nthawi yakudya kapena itangotha, kwa odwala omwe samalandira insulin - 1 g (mapiritsi 2) kawiri pa tsiku kwa masiku atatu kapena 500 mg katatu pa tsiku, kuyambira masiku 4 mpaka 14 - 1 g katatu patsiku, pakatha masiku 15 Mlingo ungathe kuchepetsedwa poganizira zomwe zili m'magazi ndi mkodzo. Kukonza tsiku lililonse mlingo - 1-2 g.

Mapiritsi a retard (850 mg) amatengedwa 1 m'mawa ndi madzulo. Pazipita tsiku mlingo 3 g.

Ndi munthawi yomweyo kugwiritsa ntchito insulin pa mlingo wochepera 40 mayunitsi / tsiku, muyezo wa metformin ndi womwewo, pamene mlingo wa insulin ungachepetse pang'onopang'ono (mwa magawo 4-8 / tsiku tsiku lililonse). Pamene mlingo wa insulin woposa 40 mayunitsi / tsiku, kugwiritsa ntchito metformin ndi kuchepa kwa insulin kumafunikira chisamaliro chachikulu ndikuchitika kuchipatala.

Mafunso, mayankho, ndemanga pa mankhwala a Metfogamma 1000

Zomwe zimaperekedwa zimakonzekera akatswiri azamankhwala komanso zamankhwala. Chidziwitso chokwanira chokhudza mankhwalawa chili m'malangizo omwe amaphatikizidwa ndi zomwe amapanga ndi wopanga. Palibe chidziwitso chomwe chatumizidwa patsamba lino kapena tsamba lililonse la tsamba lathu chomwe chingagwire ntchito ngati cholowa m'malo mwapadera kwa akatswiri.

Kuchita ndi mankhwala ena

Nifedipine imachulukitsa mayamwidwe, C_mosamalaImachepetsa mayeso. Mankhwala a Cationic (amiloride, digoxin, morphine, procainamide, quinidine, quinine, ranitidine, triamteren, ndi vancomycin) omwe amatulutsidwa mu tubules kupikisanila kachitidwe ka mayendedwe a tubular ndipo, ndi chithandizo chambiri, amatha kuonjezera C_mosamala ndi 60%.

Mukagwiritsidwa ntchito munthawi yomweyo ndi zotumphukira za sulfonylurea, acarbose, insulin, mankhwala osapweteka a antibelicine, monoamine oxidase inhibitors, oxytetracycline inhibitors, angiotensin-converting enzyme, • ascibrate derivatives, cyclophosphamide, glucose-kuongeza mphamvu ya kuwonjezera. , epinephrine, sympathomimetics, glucagon, mahomoni a chithokomiro, thiazide ndi pet evymi "okodzetsa, opangidwa kuchokera phenothiazine, asidi nicotinic akhoza kuchepetsa kanthu hypoglycemic wa metformin.

Cimetidine amachepetsa kuchotsedwa kwa metformin, yomwe imawonjezera chiopsezo cha lactic acidosis. Metformin itha kufooketsa mphamvu ya ma anticoagulants (zotumphukira za coumarin). Ndi kumwa nthawi yomweyo, lactic acidosis imayamba.

Zolemba ntchito

Pa chithandizo, ndikofunikira kuwunika ntchito yaimpso. Osachepera 2 pachaka, komanso maonekedwe a myalgia, kutsimikiza kwa lactate zomwe zili m'madzi a m'magazi kuyenera kuchitika. Ndizotheka kugwiritsa ntchito Metfogamma® 1000 kuphatikiza ndi sulfonylurea zotumphukira kapena insulin. Potere, makamaka kuyang'anira kuchuluka kwa shuga m'magazi ndikofunikira.

Zotsatira zakutha kuwongolera magalimoto ndi kugwira ntchito ndi zida Mukamagwiritsa ntchito mankhwalawa mu monotherapy, sizingawonongeke kuyendetsa magalimoto ndi kugwira ntchito ndi makina. Metformin ikaphatikizidwa ndi ma othandizira ena a hypoglycemic (ma sulfonylurea, ma insulin, ndi zina), mikhalidwe ya hypoglycemic imatha kukhalapo yomwe ingathe kuyendetsa magalimoto ndi kuchita zina zomwe zingakhale zowopsa zomwe zimafunikira chidwi chochulukirapo komanso kugwiritsidwa ntchito kwama psychomotor mofulumira.