What is Siofor?
Siofor is an oral hypoglycemic (lowering blood glucose concentration) drug intended for the treatment of type II diabetes mellitus (non-insulin-dependent) by controlling blood sugar levels.
It is used in complex treatment along with diet, as well as special exercises for people with type 2 diabetes and obesity.
The active ingredient of this medication is metformin. Its pharmacological effect works by inhibiting the production of glucose (gluconeogenesis) in the liver. It reduces the absorption of glucose in the intestine. It also dulls the feeling of hunger and promotes weight loss.
Siofor is sometimes used with insulin or other medications, but not to treat type 1 diabetes.
Is Siofor prescribed if there is no diabetes?
The drug Siofor has proven itself as an effective means for weight loss. Therefore, many people who are overweight take this medicine for weight loss. As a rule, this happens without medical advice. You can buy Siofor without a prescription.
Metformin is a substance that allows you to lose weight without harming your health. There is a practice of using it for the treatment of childhood obesity (for patients over 10 years of age).
Today, research is already being conducted on the fact that Siofor allows you to prolong life. Moreover, this is true for both overweight and thin people. However, to date, these studies have not yet been completed.
What you need to know before you start taking Siofor
First of all, you should not take this medicine if you have an individual intolerance to the active and auxiliary substances of the drug Siofor.
Siofor should not be taken if you have:
- severe kidney disease;
- metabolic acidosis (high blood acid or acid-base imbalance) - this can increase the risk of infections and heart problems, and can also worsen kidney problems.
If you need to have an X-ray or any type of computed tomography (CT) scan that uses dye injected into veins, you may need to temporarily stop taking Siofor 2 days before and after such procedures.
If while taking Siofor you have any severe infection, chronic alcoholism, or if you are 65 years of age or older, then there is a risk of lactic acidosis - this is a dangerous accumulation of lactic acid in the blood.
With long-term use of Siofor, there is a deterioration in the absorption of vitamin B12 (cyanocobalamin), this is especially important for people suffering from anemia.
Controlling diabetes is important during pregnancy, and high blood sugar can cause complications for both mother and baby.
Siofor may stimulate ovulation in premenopausal women (the initial period of decreased ovarian function) and may increase the risk of unintended pregnancy.
What drug can replace Siofor?
Finding a replacement for the drug Siofor is quite problematic, because its main active ingredient (metformin) can be called unique. Sometimes taking Siofor does not reduce blood sugar levels to the desired levels. Most likely, this indicates that the patient has advanced diabetes, or type 2 diabetes has turned into type 1 diabetes. In this case, no glucose-lowering drugs will help the patient. Insulin injections will be required. The pancreas has completely used up all its reserves and is no longer able to produce insulin. A person begins to lose weight sharply and develops complications of diabetes. If insulin therapy is not started in time, the patient will die.
Sometimes patients want to replace Siofor not because it does not help, but because the drug causes negative reactions from the body, for example, diarrhea. In this case, you can try switching to Glucophage Long. Smoothly increasing the dose will help get rid of digestive problems. In general, observations show that severe diarrhea develops in patients who did not comply with this rule and immediately began taking the maximum daily dose of the drug.
Contraindications to the use of the drug Siofor
If you have a history of one or more of the following health conditions, Siofor suitable
- kidney disease;
- liver diseases;
- heart problems such as congestive heart failure;
- ketonuria (increased levels of ketones in urine);
- ketoacidosis (high levels of ketones in the blood).
You should not take Siofor if you are pregnant or if you are breastfeeding.
Siofor is prohibited for use in children under 10 years of age. At the age of 10 to 12 years, the drug should be taken with caution under the strict guidance of a doctor.
Pharmacological properties of the drug Siofor
Metformin is a biguanide that has a hypoglycemic effect, reducing both basal and postprandial blood glucose concentrations. Metformin does not stimulate insulin secretion and therefore does not cause hypoglycemia. The hypoglycemic effect of metformin is probably due to the following mechanisms: a decrease in glucose production in the liver due to inhibition of gluconeogenesis and glycogenolysis; increasing the sensitivity of muscle tissue to insulin, which improves glucose absorption in the periphery and its utilization; decreased absorption of glucose in the intestine. Metformin, acting on glycogen synthetase, stimulates intracellular glycogen synthesis and increases the transport capacity for glucose of all previously known membrane transport proteins (GLUTs). In humans, metformin has a positive effect on fat metabolism, regardless of its effect on blood glucose levels, and reduces the level of cholesterol, LDL cholesterol, and TG in the blood plasma. By reducing the content of TG in the blood serum, it also has an antithrombotic effect. After oral administration of metformin, its maximum plasma concentration is reached after 2.5 hours, absolute bioavailability is 50–60%. When taken orally, absorption of metformin is incomplete and has a saturation character; Metformin is believed to have nonlinear pharmacokinetics. When using the drug in the usual dose and at the usual intervals, the state of equilibrium concentration in the blood plasma is achieved after 24–48 hours. Binding to plasma proteins can be ignored. Metformin passes into red blood cells. The maximum concentration in whole blood is lower than in plasma and is established at approximately the same time. Metformin is excreted unchanged in the urine. In humans, decomposition products have not been determined until this time. The renal clearance of metformin is 400 ml/min, indicating that metformin is eliminated by glomerular filtration and tubular secretion. With an orally administered dose, the half-life is 6.5 hours. With deterioration of renal function, renal clearance decreases in proportion to creatinine clearance, thereby increasing the half-life and increasing the concentration of metformin in the blood plasma.
Directions for use and dosage of Siofor
Siofor is available in dosages of 0.5 g (500 mg), 0.85 g (850 mg) and 1 g (1000 mg).
Usual Adult Dose for Type 2 Diabetes:
Initial dose: 500 mg orally 2 times a day or 850 mg orally 1 time a day, or half a tablet (1/2) at a dosage of 1000 mg, divided into two doses per day.
If necessary, increase the dose, but always gradually - this will help avoid side effects from the gastrointestinal tract.
Depending on the level of glycemia (blood glucose) as prescribed by the doctor, the dose may be:
- at a dose of 0.5 g - 3-4 tablets per day;
- at a dose of 0.85 g - 2-3 tablets. in a day;
- at a dose of 1 g - up to 2 tablets per day.
The maximum daily dose should not exceed 3 g per day, divided into three doses per day.
At the age of 12 to 18 years, the maximum daily dose of Siofor should not exceed 2 g per day, divided into 2-3 doses.
For complex treatment of type 1 diabetes mellitus:
To improve blood sugar control, Siofor can be combined with insulin. In this case, the dosage and use regimen is the same as in the treatment of non-insulin-dependent diabetes (type 2).
Siofor 500
Use during pregnancy and breastfeeding
The drug is contraindicated for use during pregnancy and lactation (breastfeeding).
The patient should be warned about the need to notify the doctor if pregnancy occurs. When planning or becoming pregnant in a patient with type 2 diabetes mellitus, the drug should be discontinued and blood glucose levels should be normalized or brought as close to normal as possible using insulin therapy to reduce the risk of developing defects in the fetus due to the pathological effects of hyperglycemia.
Metformin passes into the milk of laboratory animals. There are no similar data for humans, so a decision should be made to stop breastfeeding or to discontinue the drug Siofor®, taking into account the need to use the drug in the mother.
Use for liver dysfunction
The drug is contraindicated in liver failure.
Use for renal impairment
The drug is contraindicated in renal failure or impaired renal function (creatinine clearance <60 ml/min);
Use in children
The use of the drug is contraindicated in children under 10 years of age.
The drug should be used with caution in children aged 10 to 12 years.
Use in elderly patients
The drug should be used with caution in patients over 60 years of age who perform heavy physical work, which is associated with an increased risk of developing lactic acidosis.
special instructions
Lactic acidosis is a serious pathological condition, extremely rare, associated with the accumulation of lactic acid in the blood, which can be caused by the accumulation of metformin. The described cases of the development of lactic acidosis in patients receiving metformin were observed mainly in patients with diabetes mellitus with severe renal failure. Prevention of lactic acidosis involves identifying all associated risk factors, such as decompensated diabetes, ketosis, prolonged fasting, excessive alcohol consumption, liver failure and any condition associated with hypoxia. If the development of lactic acidosis is suspected, immediate discontinuation of the drug and emergency hospitalization are recommended.
Since metformin is excreted by the kidneys, plasma creatinine concentrations should be determined before starting treatment and regularly thereafter. Particular caution should be exercised in cases where there is a risk of impaired renal function, for example, when starting therapy with antihypertensive drugs, diuretics or NSAIDs.
Treatment with Siofor® should be temporarily replaced with therapy with other hypoglycemic drugs (for example, insulin) 48 hours before and 48 hours after an X-ray examination with intravenous administration of iodinated contrast agents.
The use of Siofor® should be discontinued 48 hours before planned surgery under general anesthesia, spinal or epidural anesthesia. Therapy should be continued after resumption of oral nutrition or no earlier than 48 hours after surgery, provided normal renal function is confirmed.
Siofor® does not replace diet and daily exercise - these types of therapy must be combined in accordance with your doctor's recommendations. During treatment with Siofor®, all patients should adhere to a diet with even carbohydrate intake throughout the day. Overweight patients should follow a low-calorie diet.
Standard laboratory tests for patients with diabetes must be performed regularly.
Before using Siofor® in children aged 10 to 18 years, the diagnosis of type 2 diabetes mellitus should be confirmed.
During one-year controlled clinical studies, the effect of metformin on growth and development, as well as puberty in children, was not observed; data on these indicators with longer-term use are not available. In this regard, careful monitoring of relevant parameters in children receiving metformin is recommended, especially in the prepubertal period (10-12 years).
Monotherapy with Siofor® does not lead to hypoglycemia, but caution is recommended when using the drug simultaneously with insulin or sulfonylurea derivatives.
Impact on the ability to drive vehicles and operate machinery
The use of the drug Siofor® does not cause hypoglycemia, and therefore does not affect the ability to drive vehicles and maintain machinery.
When using the drug Siofor® simultaneously with other hypoglycemic drugs (sulfonylurea derivatives, insulin, repaglinide), hypoglycemic conditions may develop, so care must be taken when driving vehicles and other potentially hazardous activities that require concentration and speed of psychomotor reactions.
What should you not do while taking Siofor?
Excessive alcohol consumption should while taking Siofora, since alcohol-containing drinks increase the decrease in blood sugar, as a result of which the risk of developing lactic acidosis (a complication of diabetes mellitus, accompanied by the accumulation of lactate in the blood due to lack of insulin) may increase.
It is worth remembering that although Siofor is used in complex treatment for type 1 diabetes, it is strictly not recommended to take it independently as an auxiliary therapy without a doctor’s prescription.
Taking Siofor affects the functioning of the liver. Is it true?
In fact, Siofor is not prescribed to patients with liver cirrhosis and other serious diseases of the hepatobiliary system. In general, diabetes mellitus, which is complicated by liver pathologies, is very difficult to treat.
At the same time, Siofor can be used to treat patients with fatty liver hepatosis. In parallel, the patient will need to adhere to a low-carbohydrate diet.
Regarding the question regarding the effect of Siofor on the liver, fried and smoked foods and alcoholic beverages cause much more harm to the organ. If you switch to proper nutrition, which is devoid of harmful food additives, then the liver will definitely respond with health.
What are the side effects of Siofor?
Common side effects of Siofor may include:
- hypoglycemia (low blood sugar);
- disturbance of taste sensations;
- digestive disorders (nausea, vomiting, metallic taste, diarrhea).
Some people taking this medication are at risk of developing lactic acidosis, which can be fatal. contact an ambulance as soon as possible if you have one or more symptoms of this condition:
- unusual muscle pain;
- feeling cold;
- labored breathing;
- dizziness;
- feeling very tired;
- sharp pain in the abdomen;
- vomit;
- slow or irregular heartbeat.
The influence of Siofor on internal organs and hormonal levels
If the patient has fatty liver hepatosis, then taking Siofor will help get rid of this disorder. This is only possible if the person follows a low-carbohydrate diet. If the patient has hepatitis, then you should definitely consult with a specialist regarding the possibility of taking the medicine.
Siofor helps normalize blood sugar levels and helps prevent the development of kidney failure. However, if a person already has kidney disease, then taking metformin is contraindicated for him. Therefore, before starting treatment you need to undergo appropriate tests.
Siofor is a drug that allows you to lose weight. If a person is healthy, then this medicine is not able to cause any problems with the kidneys and liver.
When women take Siofor to treat polycystic ovary syndrome, their hormonal levels improve.
Symptoms and consequences of an overdose of Siofor
an overdose of this drug may occur These conditions are accompanied by symptoms such as:
- gastrointestinal problems (severe abdominal pain, nausea, vomiting, diarrhea);
- confusion, severe weakness;
- decrease in body temperature;
- bradycardia (decreased heart rate);
- decrease in blood pressure.
If you notice at least one of the symptoms presented above, you need to immediately go to an ambulance followed by hospitalization for timely medical care, which involves hemodialysis (blood purification) to remove excess lactic acid from the body.
Interactions of the drug Siofor
Combinations that require special caution The hypoglycemic effect of Siofor is potentiated by the simultaneous use of other hypoglycemic agents and insulin, NSAIDs, MAO inhibitors, oxytetracycline, ACE inhibitors, fibrates, cyclophosphamide. Cimetidine slows down the elimination of metformin and increases the risk of developing lactic acidosis. The hypoglycemic effect of Siofor is reduced by GCS, combined estrogen-progestogen drugs, sympathomimetics, thyroid hormone drugs, glucagon, phenothiazines and thiazide diuretics, nicotinic acid derivatives. Therefore, more frequent monitoring of blood glucose levels is necessary in patients receiving these drugs, especially at the beginning of treatment. If necessary, the dose of the antidiabetic drug is adjusted both during such treatment and after its cessation. The simultaneous use of guar gum or cholestyramine interferes with the absorption of the drug and reduces its effect. Combinations that are not recommended Concomitant use of alcohol may enhance the hypoglycemic effect of the drug and cause the development of lactic acidosis, especially with concomitant fasting, malnutrition or liver failure.
Interaction of Siofor with other drugs and substances
Many medications can interact with Siofor, making it less effective or increasing the risk of lactic acidosis.
List of drugs that may interact with Siofor:
- X-ray contrast agents - increase the cumulation (accumulation) of Siofor and increase the risk of lactic acidosis;
- danazol (synthetic male hormone - androgen) - can lead to hyperglycemia (high blood sugar);
- nifedipine (a drug that lowers blood pressure), cimetidine (anti-ulcer) - slow down the elimination of Siofor from the body;
- other hypoglycemic agents - the effect of hypoglycemia is enhanced;
- indirect anticoagulants - Siofor weakens their effect;
- furosemide (diuretic) - Siofor reduces its concentration in the blood plasma.
Note!
The combined use of Siofor and alcohol increases the risk of developing a complication of diabetes, called lactic acidosis. This condition can be fatal.
This list of joint interactions with Siofor is not complete; for more detailed information, you should consult a medical specialist.
Siofor: all the features of treatment
Taking Siofor depending on food
The drug is taken either with meals or immediately after meals. If you take the pill in advance, this increases the risk of side effects from the digestive system. For example, a person may experience diarrhea, increased flatulence, etc.
If the patient suffers from a decrease in glucose levels in the morning, then doctors recommend taking Siofor in the evening before going to bed. Moreover, preference should be given to a drug based on metformin with a prolonged action, for example, the drug Glucophage Long.
How long should treatment last?
If a woman suffers from polycystic ovary syndrome, then she will need to take the drug until she manages to get rid of the problem. After pregnancy occurs, treatment is stopped.
If Siofor is prescribed for the treatment of type 2 diabetes mellitus, then it should be long-term. Therapy often lasts throughout life. If you refuse treatment, the person will begin to gain weight, and the disease will progress.
There is no need to worry about prolonged use of the drug. This will not harm your health, but, on the contrary, will help preserve it. Moreover, for patients with diabetes, treatment is a vital necessity.
To avoid B12-deficiency anemia, which can develop due to prolonged treatment with Siofor, doctors recommend drinking vitamin B12 once or twice a year. In this case, you cannot refuse the main treatment.
Is it possible to take the drug at intervals of one day?
If you take Siofor every other day, you will not be able to achieve a lasting decrease in blood sugar. You will also not be able to lose extra pounds. Therefore, you need to strictly follow your doctor’s recommendations and take the drug according to the instructions, that is, daily.
The initial dose of the drug should be from 50 to 850 mg per day. It will take time to bring it to the maximum allowable.
Siofor and alcohol
When treated with Siofor, you can drink alcohol, but in small quantities. However, we are talking specifically about small doses of alcohol. If you neglect this recommendation, then the likelihood of developing severe side effects, in particular lactic acidosis, increases. This condition is life-threatening. Therefore, it is strictly prohibited to abuse alcoholic beverages.
At the same time, treatment with Siofor does not force a person to give up alcohol forever. If there are no other contraindications to its use, then it is allowed to occasionally drink a small portion of alcoholic beverages. At the same time, there is no dependence on the time of taking the drug in relation to drinking alcohol, that is, it is permissible to drink alcohol almost immediately after taking the next dose.
Maximum daily dose of Siofor
As mentioned above, starting treatment with high daily doses is prohibited. When the body adapts, the patient will need to take one tablet three times a day, during main meals. A single dose is 850 mg.
If a person takes a long-acting drug, then the maximum daily dose of metformin is reduced to 2000 mg. You should take the drug before bedtime, once a day. This will prevent a morning spike in blood sugar.
Often people take Siofor on their own to slow down the aging of the body. In this case, there is no need to take the maximum daily dose of the drug. It is enough to limit yourself to 500-1700 mg per day. There is currently no updated information about taking Siofor against aging.
Hypothyroidism and Siofor: features of administration
Hypothyroidism is not a contraindication for taking Siofor. The drug allows you to lose weight, but it is not able to solve the problem of hormone deficiency in the body.
Hypothyroidism is treated by an endocrinologist. It is he who must select hormonal therapy, which is based on the diagnostic data of a particular patient.
Also, people with hypothyroidism need to follow a diet, removing from their menu foods that can cause deterioration in well-being. Treatment can be supplemented by taking vitamin and mineral complexes.
Preventive use of Siafor
Prevention of type 2 diabetes involves following a low-carbohydrate diet. Not a single drug, including the most expensive, can prevent the development of this disease if a person eats junk food.
Following the principles of a healthy diet and maintaining a healthy lifestyle is the most effective prevention of not only diabetes, but also high blood pressure, atherosclerosis and other pathologies.
