Mr.Met 500

Each uncoated bilayer (IPR) tablet contains
Metformin Hcl........... 500 mg

Mr.Met 1000

Each uncoated bilayer (IPR) tablet contains
MetforminHcl.............. 1000 mg


     Monotherapy for adults (above 17 yrs) with Type II Diabetes Mellitus as an adjunct to diet and exercise.
     Concomitant therapy with sulfonylurea or insulin.
     Management of PCOS.

For the management of Type II Diabetes Mellitus uncontrolled by diet alone:
For monotherapy: Oral dosage - Adult: initially, 500 mg once daily with the evening meal. Increase in increments of 500 mg weekly, as needed, up to a maximum of 2000 mg once daily with the evening meal.

Elderly or debilitated patients: Same as adult dosage. Avoid use if > 80 years of age unless normal renal function is documented. In general, do not titrate to the maximum dose.
Switching to metformin from other antidiabetic therapy
Adults and elderly: When transferring from antidiabetic agents other than chlorpropamide, no transition period is required. When transferring from chlorpropamide, use caution during the first 2 weeks; there may be prolonged retention of chlorpropamide in the body, which may increase the potential for hypoglycemia. 
Switching to extended release metformin from immediate release metformin:
No transition period is required. The patient receiving metformin immediate release preparation may be safely switched to metformin extended release at the same total daily dose.
Addition of a sulfonylurea or an alpha-glucosidase inhibitor to metformin
Adults and elderly: After 4 weeks of the maximum dose of metformin as described in monotherapy without adequate response, consider the gradual addition of an oral sulfonylurea, even if prior failure to a sulfonylurea has occurred. If after 1-3 months of concomitant therapy responses are unsatisfactory, consider insulin therapy and discontinuation of oral agents.
Addition of metformin in combination with insulin therapy:
Adults: The current insulin dose should be continued; initiate metformin dose at 500 mg at the evening meal. For patients not responding adequately, the dose of metformin may be increased by 500 mg after approximately 1 week and by 500mg/day every week thereafter until adequate glycemic control is achieved. The dose should not exceed 2000 mg/day. The insulin dose should usually be decreased by 10 - 25% when fasting plasma glucose decreases to < 120 mg / dl. Individualize dosage of antidiabetic drugs as needed.

Elderly or debilitated patients: Avoid use if > 80 years of age unless normal renal function is documented. In general, do not titrate to the maximum dose. 
Patients with hepatic impairment:
Generally avoid metformin use in hepatic impairment; hepatic disease increases the risk of metformin-associated lactic acidosis. 
Patients with renal impairment:
CrCl >=60 ml/min: No dosage adjustment required.
CrCl =< 60 ml/min: Metformin use is contraindicated.
For the management of polycystic ovarian syndrome (PCOS):
1.5 to 2.5 gm/day for 8-12 weeks (can be used throughout pregnancy in cases of PCOS with pregnancy).
Acidemia, acute myocardial infarction, breast-feeding, cardiogenic shock, diabetic ketoacidosis, hepatic disease, hypoxia, lactic acidosis/metabolic acidosis, renal failure, sepsis, surgery, radiographic contrast administration. 
In patients with known metformin hypersensitivity.