Metformin Long - Instructions For Use, 1000 Mg, 750 And 500 Mg, Price

2024 Author: Rachel Wainwright | [email protected]. Last modified: 2023-12-15 07:39

Metformin long

Metformin Long: instructions for use and reviews

1. 1. Release form and composition
2. 2. Pharmacological properties
3. 3. Indications for use
4. 4. Contraindications
5. 5. Method of application and dosage
6. 6. Side effects
7. 7. Overdose
8. 8. Special instructions
9. 9. Application during pregnancy and lactation
10. 10. Use in childhood
11. 11. In case of impaired renal function
12. 12. For violations of liver function
13. 13. Use in the elderly
14. 14. Drug interactions
15. 15. Analogs
16. 16. Terms and conditions of storage
17. 17. Terms of dispensing from pharmacies
18. 18. Reviews
19. 19. Price in pharmacies

Latin name: Metformin long

ATX code: A10BA02

Active ingredient: metformin (Metformin)

Manufacturer: LLC "Ozon" (Russia); PJSC "Biosintez" (Russia)

Description and photo update: 09.10.2019

Prices in pharmacies: from 203 rubles.

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Metformin long is an oral antidiabetic drug from the biguanide group.

Release form and composition

Dosage forms of Metformin long:

• prolonged-release tablets: biconvex, from almost white to white, on one side there is a dividing line, almost odorless; dosage of 500 mg - capsular, dosages of 750 and 1000 mg - oval (3, 5 or 10 pieces in blister packs, in a cardboard box 1, 2, 3, 6, 9, 10 or 12 packs; 10, 20, 30, 40, 50, 60, 90, 100 or 120 pcs. In polyethylene terephthalate cans, in a pack of cardboard 1 can);
• tablets of prolonged action, film-coated: biconvex, oblong, on one side there is a dividing line; two layers are distinguished on the cross section: the film shell (outer) is light blue (for a dosage of 850 mg) or blue (for a dosage of 1000 mg) in color, the core (inner) is from almost white to white (10, 30 or 60 pcs in polymer cans made of polyethylene / polypropylene, in a pack of cardboard 1 can; 5 pcs. in blister packs, in a cardboard pack 2, 6, 12, 20 or 24 packs; 10 pcs. in blister packs, in a pack cardboard 1, 3, 6, 10 or 12 packs; 20 pcs. in blister packs, in a cardboard box 3, 5 or 6 packs).

Each pack also contains instructions for the use of Metformin Long.

Composition for one sustained release tablet:

• active substance: metformin hydrochloride - 500/750/1000 mg;
• auxiliary ingredients: hypromellose - 374.8 / 377.52 / 380.24 mg; povidone (K-25) - 16.2 / 20.88 / 25.56 mg; colloidal silicon dioxide - 4.5 / 5.8 / 7.1 mg; magnesium stearate - 4.5 / 5.8 / 7.1 mg.

Composition for one prolonged-release film-coated tablet:

• active substance: metformin hydrochloride - 850/1000 mg;
• auxiliary ingredients: povidone (K-30) - 120/140 mg; hypromellose - 160.8 / 187.6 mg; lactose monohydrate (milk sugar) - 57.2 / 58.4 mg; calcium stearate - 12/14 mg;
• film shell: Opadray II blue - 35/40 mg [lactose monohydrate (milk sugar) - 40%; hypromellose (hydroxypropyl methylcellulose 2910) - 28%; titanium dioxide - 22.78%; triacetin - 8%; dye brilliant blue FCF (E133) aluminum varnish - 0.98%; dye iron oxide black (E172) - 0.22%; dye iron oxide yellow (E172) - 0.02%].

Pharmacological properties

Pharmacodynamics

Metformin, a hypoglycemic substance belonging to the pharmacological group of biguanides, reduces both basal and postprandial blood plasma glucose levels. Since metformin does not induce insulin secretion, it does not cause hypoglycemia.

Metformin exhibits the following therapeutic properties:

• increases the sensitivity of peripheral receptors to insulin and enhances the utilization of glucose by cells;
• delays the absorption of glucose in the intestine;
• reduces the synthesis of glucose by the liver by inhibiting gluconeogenesis and glycogenolysis;
• increases the transport capacity of all types of glucose transporters - membrane glucose transporters;
• stimulates glycogen synthesis by acting on glycogen synthase;
• has a beneficial effect on lipid metabolism by lowering total cholesterol, triglycerides and low density lipoproteins.

Taking Metformin Long ensures the stabilization of the patient's body weight or promotes its moderate decrease.

Pharmacokinetics

Average time to reach maximum concentration (T _Cmax) of metformin in blood plasma after a single dose:

• extended-release tablets, 500 mg (3 pcs.) or 750 mg (2 pcs.) (dose 1500 mg) - 5 hours (range 4-12 hours);
• prolonged-release tablets, 1000 mg (after meals) - 5 hours (range 4-10 hours), the value of the maximum concentration (C _{max) of} metformin in plasma - 1214 ng / ml;
• prolonged-release film-coated tablets, 850/1000 mg (after meals) - 2.5 / 5 hours (range 4-10 hours).

C _max and AUC (area under the concentration-time curve) at steady state are similar to those for metformin with conventional release, increasing disproportionately to the dose taken. A single dose of 2000 mg of metformin in the form of sustained-release tablets provides an AUC value equal to that of taking conventional-release tablets 2 times a day at a dose of 1000 mg. The change in C _max and AUC in the same patient over a certain period of time (intraindividual variability) as a result of taking metformin extended-release tablets is similar to that observed after taking conventional-release tablets.

With a single dose of metformin in the form of prolonged-release tablets at a dose of 1000 mg simultaneously with food, AUC increases by 77%, C _max - by 26% and T _Cmax - by about 1 hour. Absorption of the substance from prolonged-release tablets from the composition of the food taken is not depends. Cumulation with repeated administration of metformin in the form of extended-release tablets at a dose of up to 2000 mg is not observed.

Metformin is rapidly distributed in tissues, practically does not bind to plasma proteins, and is able to accumulate in erythrocytes. In blood, the C _max value is lower than in plasma, and is reached after about the same time. The average volume of distribution (V _d) is from 63 to 276 liters.

Metformin hydrochloride is weakly metabolized, after taking its metabolites in the body are not found.

The drug is excreted by the urinary system unchanged. In healthy volunteers, the clearance of metformin reaches more than 400 ml / min, which is 4 times higher than the clearance of endogenous creatinine. This indicates the presence of active tubular secretion. T _1/2 (half-life) - approximately 6.5 hours.

In patients with impaired renal function, a decrease in the clearance of metformin is observed in proportion to the clearance of creatinine (CC), respectively, T _1/2 increases, which contributes to an increase in the concentration of metformin in the blood plasma and an increase in the risk of its cumulation.

Indications for use

Metformin Long is recommended for the treatment of type 2 diabetes mellitus in adult patients (especially overweight) with ineffective nutritional and physical activity.

The drug is used both as monotherapy and as part of a combination treatment in combination with insulin and other oral hypoglycemic agents.

Contraindications

Absolute:

• diabetic ketoacidosis, precoma, diabetic coma;
• hepatic impairment / impaired hepatic function;
• chronic alcoholism, acute alcohol intoxication;
• renal failure / impaired renal function (CC <45 ml / min);
• acute conditions that can provoke the risk of developing impaired renal function: dehydration (as a result of chronic or severe diarrhea, repeated bouts of vomiting), shocks of various etiologies, severe infectious diseases (for example, infection of the respiratory or urinary tract);
• tissue hypoxia, which is a clinically pronounced manifestation of acute or chronic diseases (acute heart failure, chronic heart failure with unstable hemodynamic parameters, respiratory failure, acute myocardial infarction);
• extensive trauma and surgery in patients who are indicated for insulin therapy;
• lactic acidosis (including information in history);
• pregnancy;
• children and adolescents up to 18 years old;
• a period of time less than 48 hours before and 48 hours after intravenous urography, angiography, and other radioisotope / radiological studies requiring the administration of an iodine-containing contrast agent;
• adherence to a hypocaloric diet, the daily calorie content is less than 1000 kcal;
• lactase deficiency, lactose intolerance, glucose / galactose malabsorption (for extended-release film-coated tablets);
• established hypersensitivity to metformin or to any of the excipients of the drug.

Care must be taken to use Metformin Long: patients over 60 years of age who perform heavy physical work, since they have an increased risk of developing lactic acidosis; patients with renal insufficiency (CC from 45 to 59 ml / min); women during breastfeeding.

Metformin long, instructions for use: method and dosage

Metformin Long tablets are intended for oral administration. They must be swallowed whole, not chewed, washed down with a sufficient amount of liquid.

The frequency of taking a hypoglycemic agent is 1 time per day, during an evening meal or immediately after it.

The endocrinologist selects the dose of Metformin Long individually, taking into account the data on the concentration of glucose in the blood.

Recommended doses (taken once a day, during dinner or immediately after):

• initial (for patients who have not previously received metformin): it is recommended to start therapy with taking 1 tablet per day (Metformin Long prolonged-release tablet 750 or 500 mg, prolonged-release film-coated tablet, 850 mg); it is recommended to adjust the dose once every 10-15 days on the basis of data on the level of glucose in the blood plasma (with a slow increase in the dose, the tolerance of the drug on the part of the digestive system improves);
• initial (when switching from another hypoglycemic drug): the dose of long-acting metformin is selected similarly to the scheme described in the previous paragraph, starting with dosages of Metformin Long 500, 750 or 850 mg, with a possible transition in the future to Metformin Long 1000 mg;
• therapeutic: 2 tablets - 1700 mg (2 tablets of prolonged action, film-coated, 850 mg); 1 tablet (extended-release tablet or extended-release film-coated tablet, Metformin Long 1000 mg);
• maximum: 3 tablets - 2550 mg (3 tablets of prolonged action, film-coated, 850 mg); 2 tablets - 2000 mg (prolonged-release tablets or prolonged-release film-coated tablets, 1000 mg); an increase to the maximum dose is acceptable when it is not possible to achieve adequate glycemic control when taking the recommended doses. If, when taking the maximum recommended daily dose of 2000 mg of Metformin Long 1 time per day, it is not possible to achieve adequate glycemic control, it can be divided into 2 doses of 1 tablet of 1000 mg: morning (during breakfast) and evening (during dinner).

Sustained-release tablets or prolonged-release film-coated tablets at a dosage of 1000 mg are prescribed for maintenance therapy in diabetic patients who have previously taken metformin in the form of conventional-release tablets at a dosage of 1000 and 2000 mg. When switching to Metformin Long, it is prescribed in a daily dose equivalent to that of metformin with regular release. It is not recommended to switch to metformin extended-release in patients who are taking conventional-release tablets in doses greater than 2000 mg.

To achieve better glycemic control, Metformin Long can be used as part of a combination treatment with insulin. In this case, the standard initial dose of the drug is 500, 750 or 850 mg (1 tablet) once a day during dinner. At the same time, the specialist selects the insulin dose based on the results of blood glucose tests. In the future, it is possible to switch to prolonged-release tablets at a dosage of 1000 mg.

When taking Metformin Long at the maximum recommended daily dose does not provide adequate glycemic control, it may be necessary to switch to metformin with conventional release - 3000 mg per day.

Metformin Long is intended for long-term daily use without interruption. If the patient, for any reason, is forced to discontinue therapy, this should be reported to his endocrinologist.

If the next dose is missed, the next dose must be taken at the usual time; a double dose of metformin cannot be taken.

Side effects

Classification of adverse reactions from systems and organs (in accordance with the following frequency of development: very often - not less than 10%; often - not less than 1%, but not more than 10%; infrequently - not less than 0.1%, but not more than 1 %; rarely - not less than 0.01%, but not more than 0.1%; extremely rarely - less than 0.01%; the frequency has not been established - today data on the prevalence of side effects are unknown):

• metabolism and nutrition: extremely rare - lactic acidosis; long-term use of Metformin Long can cause a decrease in the absorption of vitamin B ₁₂ (diagnosing megaloblastic anemia in a patient requires taking into account the possibility of such an etiology of the disease);
• nervous system: often - dysgeusia (the appearance of a metallic taste in the mouth);
• gastrointestinal tract (GIT): very often - abdominal pain, nausea / vomiting, diarrhea, lack of appetite (most often observed at the beginning of therapy, in most cases go away on their own). In order to avoid the development of symptoms from the gastrointestinal tract, it is recommended to take metformin with meals or immediately after meals. With a slow increase in the dose, the gastrointestinal tolerance of Metformin Long improves;
• hepatobiliary system: extremely rarely - impaired liver function indicators, hepatitis (completely disappear after the abolition of metformin);
• skin and subcutaneous tissue: extremely rare - skin redness, itching, urticaria, and other skin reactions.

You must inform your doctor about the intensification of any side effects indicated in the instructions for use of Metformin Long, or the manifestation of other reactions.

Overdose

There is a known case of taking metformin at a dose of 85 g, which is 42.5 times higher than the maximum permissible daily dose. The patient did not have hypoglycemia, but the development of lactic acidosis was noted. With a high overdose of the drug or the presence of associated risk factors, an excessive amount of lactic acid may be produced, which the body is not able to metabolize quickly enough. Lactic acidosis develops, the symptoms of which are myalgia, increased drowsiness, severe weakness, abdominal pain, and respiratory disorders. In patients with a severe course of the disease, arterial hypotension and resistant bradyarrhythmia were recorded.

When the first signs of lactic acidosis appear, the use of Metformin Long should be stopped immediately, and the patient should be urgently hospitalized. After determining the concentration of lactate in the blood, the diagnosis should be verified. Hemodialysis is the most effective measure for removing lactate and metformin from the body. If necessary, symptomatic treatment is also carried out.

special instructions

Lactic acidosis is a rare but serious complication with a high mortality rate in the absence of emergency treatment. It can develop due to the accumulation of metformin, most often in diabetic patients with severe renal failure. Other associated risk factors for the development of lactic acidosis are ketosis, decompensated diabetes mellitus, prolonged fasting, liver failure, alcoholism, and any condition accompanied by severe hypoxia. Taking into account the above can help reduce the incidence of this complication. In addition, the likelihood of developing lactic acidosis increases in the case of the appearance of a complex of nonspecific signs: muscle cramps, dyspeptic disorders, abdominal pain and severe asthenia. Symptoms of lactic acidosis are manifested by muscle cramps,severe malaise and general weakness, vomiting, abdominal pain, acidotic dyspnea, hypothermia followed by coma. Diagnostic laboratory indicators of the state: blood pH 5 mmol / l; increased anionic gap; increased ratio of lactate to pyruvate. They stop taking Metformin Long and immediately consult a doctor at the first suspicion of lactic acidosis.

The use of intravascular radiopaque iodine-containing agents can cause renal dysfunction with increased accumulation of metformin, which increases the likelihood of lactic acidosis. Depending on the severity of renal failure, metformin is canceled 48 hours before or directly during an x-ray examination using iodine-containing radiopaque agents. Resume taking Metformin Long no earlier than 48 hours after the procedure, provided that, as a result of the examination, renal function was recognized as normal.

With elective surgical operations, it is necessary to stop using Metformin Long 48 hours before they are performed. It is possible to continue therapy with metformin no earlier than 48 hours after the completion of the operation, provided that, as a result of the examination, renal function was recognized as normal.

Since the elimination of metformin occurs through the urinary system, it is necessary to regularly determine creatinine clearance (CC) before starting therapy and then. With normal renal function at least once a year, in elderly patients and patients with CC at the lower limit of the norm - from 2 to 4 times a year. Special care is required for the simultaneous use of diuretics, antihypertensive drugs or non-steroidal anti-inflammatory drugs in elderly patients with possible impaired renal function.

Patients with heart failure are at increased risk of hypoxia and renal failure. In the chronic course of heart failure, regular monitoring of cardiac and renal functions is necessary during the use of metformin. The use of Metformin Long is contraindicated in patients with heart failure, aggravated by unstable hemodynamics.

After starting metformin therapy, you should continue to eat an even carbohydrate diet throughout the day and exercise regularly. If you are overweight, it is important to follow a hypocaloric diet (but not less than 1000 kcal / day).

It is required to inform the attending physician about any therapy and any infectious diseases (respiratory tract infections, colds, urinary tract infections, etc.).

Routine laboratory tests are recommended to control diabetes.

Monotherapy with metformin does not cause hypoglycemia, but the use of the drug in combination with other hypoglycemic agents (sulfonylurea derivatives, repaglinide, etc.) or insulin requires caution. Symptoms of hypoglycemia: headache, weakness, dizziness, hyperhidrosis, heart palpitations, blurred vision / concentration.

Auxiliary ingredients in the composition of Metformin Long tablets can be excreted unchanged through the intestine, which does not affect the therapeutic activity of the drug.

Influence on the ability to drive vehicles and complex mechanisms

With monotherapy with the drug, the effect of metformin on human cognitive functions is practically absent. But its use in combination with insulin, sulfonylurea derivatives, repaglinide, and other hypoglycemic drugs can cause hypoglycemia. Its symptoms such as weakness, dizziness, visual impairment can reduce the ability to concentrate and slow down the speed of psychomotor reactions, which negatively affects driving and working with complex mechanisms.

Application during pregnancy and lactation

The use of Metformin Long during pregnancy is contraindicated. The relationship between decompensated diabetes mellitus in pregnant women and an increased risk of congenital malformations of newborns and perinatal mortality has been established. There are limited data indicating the absence of the effect of metformin in pregnant women on the risk of developing congenital malformations of the fetus / child.

The drug should be immediately discontinued in women planning pregnancy, as well as when pregnancy occurs while taking Metformin Long, and replaced with insulin therapy. In order to reduce the risk of developing fetal malformations, the concentration of glucose in the blood plasma must be maintained at a level closest to normal.

During lactation, Metformin is excreted in breast milk. Adverse reactions during breastfeeding in newborns were not observed, but since the amount of data is limited, it is not recommended to use the drug for lactating women. The decision to discontinue breastfeeding should be based on the balance between benefits and the potential risk of side effects for the baby.

In studies on rats, it was found that metformin does not affect fertility in males / females, provided that it is used in doses that exceed the recommended maximum daily dose for humans by 3 times.

Pediatric use

Due to the lack of data on the use of Metformin Long in pediatric practice, its prescription for the treatment of children and adolescents under the age of 18 is contraindicated.

With impaired renal function

Metformin Long can be used for moderate renal failure (CC 45-59 ml / min) only in the absence of concomitant conditions that increase the risk of lactic acidosis. The initial dose for long-acting metformin for these patients is 500, 750 or 850 mg (1 tablet) once a day. The maximum dose is 1000 mg per day, taken 1 time or divided into 2 doses.

Kidney function should be closely monitored every 3–6 months.

If CC is <45 ml / min, Metformin Long should be stopped immediately.

For violations of liver function

In liver failure / liver dysfunction, Metformin Long is contraindicated.

Patients with hepatic insufficiency should take into account that with acute alcohol intoxication, they have an increased risk of developing lactic acidosis.

Use in the elderly

Elderly patients dose adjustment of Metformin Long is performed taking into account the assessment of renal function, which is carried out regularly, at least twice a year.

Patients over 60 years old who perform heavy physical work should take the drug with caution because of the increased risk of lactic acidosis.

Drug interactions

The simultaneous use of Metformin Long and iodine-containing X-ray contrast agents for radiological studies is contraindicated. In patients with functional renal failure and diabetes mellitus, such a study can cause the development of lactic acidosis.

The combination of metformin with alcohol-containing beverages and drugs with ethanol is not recommended, since in acute alcohol poisoning, the risk of lactic acidosis increases, especially with insufficient nutrition, adherence to a low-calorie diet and liver failure.

Medicines / Substances, the use of which requires caution with metformin:

• drugs of indirect hyperglycemic action [tetracosactide, danazol, glucocorticosteroids for systemic / topical use, β ₂ -adrenomimetics, chlorpromazine (when taken in doses over 100 mg per day), diuretics]: this combination may require more frequent monitoring of blood glucose levels, especially at the beginning of treatment; the dose of metformin, if necessary, is adjusted taking into account the level of glycemia both during complex therapy and after its completion;
• diuretics: combination with loop diuretics can provoke the development of lactic acidosis due to possible renal failure; Metformin Long should not be administered concomitantly with diuretics if CC is <60 ml / min;
• insulin, sulfonylurea derivatives, acarbose, salicylates: hypoglycemia may develop;
• nifedipine: helps to increase the absorption and maximum concentration of metformin;
• vancomycin, amiloride, digoxin, procainamide, ranitidine, morphine, quinidine, quinine, triamterene, trimethoprim (cationic drugs secreted in the renal tubules): are competitors of metformin for the transport systems of tubular secretion, are able to increase its maximum concentration;
• glucagon, isoniazid, phenothiazides, estrogens, phenytoin, sympathomimetics, oral contraceptives, slow calcium channel blockers, nicotinic acid, levothyroxine sodium: can reduce the hypoglycemic effect of metformin;
• cimetidine: reduces the rate of elimination of metformin, as a result of which the development of lactic acidosis is possible;
• propranolol, ibuprofen: when combined with metformin in healthy volunteers, no changes in their pharmacokinetic parameters were observed;
• indirect anticoagulants: metformin can reduce their effect, therefore, when used together, regular monitoring of the International Normalized Ratio (INR) is required;
• kolesevelam: increases the plasma concentration of metformin in the blood (increases the AUC without a significant increase in C _max); this combination of drugs may require dose adjustment or stricter blood sugar control for safe concomitant use.

In the case of the combined use of Metformin Long with other medicinal substances / preparations, an appointment with a doctor is required if the patient's condition worsens or if such adverse reactions as nausea / vomiting, diarrhea, dyspepsia, flatulence intensify. Immediate medical attention is required if weakness, muscle pain, chills, increased drowsiness, abdominal pain / discomfort, shortness of breath, slow / irregular heartbeats, or other unusual symptoms develop, because they may be the first signs of a rare but serious complication such as lactic acidosis.

Drug interaction of metformin, which is a substrate of the organic cation transporter (Organic Cation Transporter) 1 and 2 (OCT1 and OCT2), with other drugs:

• verapamil and other OCT1 inhibitors: capable of inhibiting the hypoglycemic effect of metformin;
• rifampicin and other OCT1 inducers: able to potentiate the absorption of metformin in the gastrointestinal tract, enhancing its hypoglycemic efficacy;
• dolutegravir, vandetanib, ranolazine, trimethoprim, cimetidine, isavuconazole, other OCT2 inhibitors: help to reduce the elimination of metformin by the kidneys, which contributes to an increase in its concentration in blood plasma;
• crizotinib, olaparib, other OCT1 and OCT2 inhibitors: May reduce the hypoglycemic effect of metformin.

Analogs

Analogues of Metformin Long are: Bagomet, Glyformin, Glyformin Prolong, Glucophage, Diasfor, Diaformin OD, Merifatin, Metadien, Metforvel, Metformin Long Canon, Metformin MV-Teva, Metformin Sandoz, Metformin-Akrikhin, Sigduo Formethin, Long and Dr. …

Terms and conditions of storage

Store at temperatures up to 25 ° C. Keep out of the reach of children.

The shelf life of film-coated tablets of prolonged action is 2 years; prolonged-release tablets - 3 years.

Terms of dispensing from pharmacies

Dispensed by prescription.

Reviews about Metformin Long

Since diabetes is one of the most common diseases in the world, many drugs are produced under various names containing metformin, the first-line active ingredient for the treatment of type 2 diabetes. In discussions of the therapeutic efficacy of these drugs, it is extremely difficult to highlight reviews of Metformin Long.

According to experts, undesirable side reactions from the gastrointestinal tract that develop when taking metformin cause discomfort and may in some cases be the reason for discontinuation of the drug. Metformin long is a drug with a prolonged release of the active substance that allows you to more effectively control glycemia throughout the day (provided that you take the tablets once a day), in comparison with conventional metformin, and provides better tolerance from the gastrointestinal tract.

Price for Metformin Long in pharmacies

Registered prices for Metformin Long on the VED (Essential and Essential Medicines) List:

• tablets of prolonged action, film-coated: dosage 850 mg (in a polymer can 60 pcs., in a carton pack 1 can; in a contour cell package 10 pcs., in a carton box 6 packs) - 149.48 rubles; dosage 1000 mg (in a polymer can 30 pcs., in a cardboard box 1 can; in a contour cell package 10 pcs., in a cardboard box 3 packages) - 226.98 rubles;
• prolonged-release tablets: Metformin long 500 mg (in a contour cell package 10 pcs., in a cardboard box 3 packs) - 177.24 rubles; Metformin Long 750 mg (in a polymer can 60 pcs., In a cardboard box 1 can) - 353.83 rubles; dosage of 1000 mg (in a polymer can 60 pcs., in a cardboard box 1 can) - 474.59 rubles.

Metformin long: prices in online pharmacies

Drug name Price Pharmacy

Metformin long 850 mg film-coated tablets of prolonged action 60 pcs. 203 r Buy

Metformin long 500 mg film-coated tablets of prolonged action 30 pcs. 220 RUB Buy

Metformin Long Canon 500 mg extended release tablets 60 pcs. 229 r Buy

Metformin long 750 mg film-coated tablets of prolonged action 30 pcs. 263 r Buy

Metformin long tab. prolonged release 750 mg 30 Pcs. 274 r Buy

Metformin long 1000 mg film-coated tablets, 30 pcs. 274 r Buy

Metformin Long Canon prolonged release tablets. 500mg 60 pcs. 275 RUB Buy

Metformin long 500 mg film-coated tablets of prolonged action 60 pcs. 327 r Buy

Metformin long tab. prolonged release 500 mg 60 pcs. 371 r Buy

Metformin long 750 mg film-coated tablets of prolonged action 60 pcs. 387 r Buy

Metformin long tab. prolonged release 750 mg 60 pcs. 398 RUB Buy

Metformin Long Canon prolonged release tablets. 750mg 60 pcs. 402 RUB Buy

Metformin Long Canon 750 mg sustained-release tablets 60 pcs. 402 RUB Buy

Metformin Long Canon 1000 mg extended release tablets 60 pcs. RUB 485 Buy

Metformin Long 1000 mg sustained release tablets 60 pcs. RUB 513 Buy

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Maria Kulkes Medical journalist About the author

Education: First Moscow State Medical University named after I. M. Sechenov, specialty "General Medicine".

Information about the drug is generalized, provided for informational purposes only and does not replace the official instructions. Self-medication is hazardous to health!