Diabex

Generic Name: Metformin hydrochloride
Product Name: Diabex

Indication

Diabex is a blood sugar lowering drug suitable for children over 10 years and adults whose blood sugar levels fail to improve as a result of dietary and exercise management.

Diabex is also used in the treatment of anovulatory infertility due to polycystic ovary syndrome under specialist’s supervision.

Action

Diabex belongs to a group of medicines called biguanides. It lowers high blood glucose levels by helping your body make better use of the insulin produced by the pancreas. This is because people with type 2 diabetes are unable to make enough insulin or their body does not respond properly to the insulin. This causes a build up of glucose in the blood, which can lead to long-term complications such as heart disease, blindness, kidney damage, poor blood circulation and gangrene. Signs to watch out for include tiredness or lack of energy, headache, thirst, passing large amounts of urine and blurred vision.

Dose advice

You should follow all directions given to you by your doctor or pharmacist carefully.

Adults: The usual starting dose is 500mg once or twice daily. Your doctor may adjust your dose according to your blood sugar control. The maximum dose daily is 1000mg three times daily.

Children from 10 years of age & adolescents: the recommended dose is 500mg or 850mg daily. The total daily dose is 2g in 2 to 3 divided doses.

Polycystic ovary syndrome: 500mg 2-3 times daily up to maximum of 2g per day.

Diabex tablets should be taken with meals to avoid stomach upset. It has slow onset of effect and may take up 2 weeks to establish. Your doctor will perform a blood test every 4-6 months to monitor your kidney function.

Diabex may interact with some medicines. These include other classes of antihyperglycaemic agents such as sulfonylureas and repaglinide, anti-hypertensive drugs such as beta-blockers, angiotensin-receptor blocker, anticoagulants such as warfarin, diuretic tablets, thyroxine, cimetidine and glucocorticoids. The list could be extensive. If you are unsure, always check with your doctor or pharmacists.

Use in Pregnancy

The safety of Diabex in pregnancy has not been established. However, you should ensure strict blood glucose control throughout the pregnancy period as abnormal blood glucose level can cause birth defects in foetus. Insulin should be considered instead.

Use in Breastfeeding

There is no human data available to identify the effects of Diabex on breast milk. Your decision to use Diabex during breastfeeding should outweigh its risks. You should talk to your doctor regarding your concerns.

Schedule

Schedule 4

Common side effects

All medicines have side effects. The following side effects have very common occurrence which means they occured in greater than 1% of the people taking Diabex:

• stomach upset such as nausea and vomiting
• taste disturbance
• loss of appetite
• diarrhoea

Do not be alarmed by this list of possible side effects. They are generally mild and usually short-lived. You may not experience any of them. However, tell your doctor or pharmacist as soon as possible if you do not feel well while you are taking Diabex.

Uncommon side effects

Lactic acidosis is a very rare (<1/10,000) but potentially life-threatening side effect if there is a delay in seeking medical help. If you are over 65 years old and have poorly controlled diabetes, you may have higher chance of getting the side effect. Tell your doctor or go to the nearest hospital emergency department immediately if you notice any of the following signs and symptoms.

• Nausea, vomiting and stomach pain
• Feeling weak, tired or generally unwell
• Unusual muscle pain
• Sleepy or drowsy
• Slow heart beat
• Trouble breathing
• Dizziness
• Shivering and feeling extremely cold

Other very rare side effects (<1/10,000) are

• skin reactions including urticaria, pruritus and erythema
• vitamin B12 deficiency

References

1. Australian Medicines Handbook, Adelaide, Pharmaceutical Society of Australia, 2007.
2. MIMS Online [online]. 2003 [cited 2008 March 14]. Available from: [URL Link]

For further information talk to your doctor.