Metformin combination

NA 20mgofglybutide, 2,000 mg of metformin Combination medication Used as initial therapy 1.25/250 mg twice a day... 

Specific patient populations Metformin combination products are not recommended for use during pregnancy or in pediatric patients. Initial and maintenance dosing should be conservative in patients with advanced age because of the potential for decreased renal function in this population. Dosage adjustment requires a careful assessment of renal function. Do not titrate elderly, debilitated, or malnourished patients to the maximum dose to avoid the risk of hypoglycemia. 

Chiasson JL, Naditch LMiglitol Canadian University Investigator Group. The synergistic effect of miglitol plus metformin combination therapy in the treatment of type 2 diabetes. Diabetes Care 2001 24(6) 989-94. 

Furlong NJ, Hulme SA, O Brien SV, Hardy KJ. Repaglinide versus metformin in combination with bedtime NPH insulin in patients with type 2 diabetes established on insulin/metformin combination therapy. Diabetes Care 2002 25(10) 1685-90. 

Jaber LA, Nowak SN, Slaughter RR Insulin-metformin combination therapy in obese patients with type 2 diabetes. J Clin Pharmacol 25 89-94, 2002. 

In the metformin monotherapy cohort 4.7% of patients died (35.5% cardiovascular deaths), compared with 17.9% of patients in the SU monotherapy cohort (42.4% cardiovascular deaths). After adjusting for aU available confounders, the risk for mortality and cardiovascular mortality in patients in the SU only cohort remained significantly increased with 1.43 and 1.70, respectively compared to the metformin monotherapy. Patients in the combination cohorts had significantly increased risk of mortality (2.47 and 2.16) and cardiovascular mortality (2.29 and 2.43) despite the adjustment for all available confounders and irrespective whether the patients started either with sulfonylureas or metformin and then added the other drug. A significantly reduced risk for overall mortality [odds ratio (OR) = 0.60] and cardiovascular mortahty was already earher observed in a Canadian observational study [37] of 1,150 users of metformin therapy in comparison with 3,033 users of sulfonylureas. By contrast, in that study sulfonylurea plus metformin combination therapy was also associated with reduced all-cause mortality (OR = 0.66). 

In this study, we used IT Microcosm for a prediction of the synergism of the hypoglycemic activity shown by Metformin combinations with five other antidiabetic drags used in chnical practice for antidiabetic therapy (Fig. 12.8) [114]. 

Nine Metformin combinations with these drags were used in protracted antidiabetic therapy in mrrlticenter clinical studies with durations of 16 to 26 weeks and 328 to 1250 patients. 

A systematic review of nine randomised clinical trials of adequate methodological quality addressed the efficacy and safety of metformin combined with lifestyle interventions in the management of adolescent obesity. The results indicate that among obese adolescents with no associated diseases, the administration of metformin is relatively effective in the short term for reducing BMI. Long-term drug s effects were unknown [22 ]. 

Game MA, Khmana ML, Nisar S, Shah PA, Shah ZA, KuJshrestha B, et al. Improved efficacy of low-dose spironolactone and metformin combination than either drug alone in the management of women with polycystic ovary syndrome (PCOS) a six-month, open-label randomized study. J Chn Endocrinol Metab 2013 98(9) 3599-607. 

---