|
RISK-BENEFIT OF HIGH DOSE METFORMIN BEYOND CURRENT EVIDENCE BASED PHARMACOTHERAPY |
|---|---|
| รหัสดีโอไอ | |
| Creator | Wikawee Russameethum, Karunrat Tewthanom |
| Title | RISK-BENEFIT OF HIGH DOSE METFORMIN BEYOND CURRENT EVIDENCE BASED PHARMACOTHERAPY |
| Publisher | Faculty of Pharmacy, Silpakorn University |
| Publication Year | 2560 |
| Journal Title | Thai Bulletin of Pharmaceutical Science (TBPS) |
| Journal Vol. | 12 |
| Journal No. | 1 (January-June)2017 |
| Page no. | 55-62 |
| Keyword | high dose metformin, risk-benefit, evidence-based pharmacotherapy |
| ISSN | 1686-9540 |
| Abstract | The primary goals of Type 2 Diabetes (Type 2 Diabetes mellitus, T2DM) treatment are to achieve glycemic control in therapeutic target, decrease mortality rate and risks of both microvascular and macrovascular complications. Current guideline of T2DM treatment recommended life style modification, such as, diet control, physical exercise, first. If patients still have uncontrolled blood glucose levels, metformin should be added. Although many studies suggested different safety dose of metformin for decreasing blood glucose level, its maximum dose is 3,000 and 2,000 mg/day for standard-release and extended-release, respectively. High dose of metformin definition is more than 2,000 mg/day. At present, there is increasing evidence from many studies about the efficacy of high dose metformin for other indications including decrease risk of cardiovascular diseases and, polycystic ovary syndrome. Although metformin may cause gastrointestinal side-effects in more than 20 percent of patient, many studies found that these side effects were not related to the dose and they could be managed by gradually increasing dose or administered with food. In addition, the risk of lactic acidosis is very rare if the medication is use appropriately, and it is not related to metformin blood level. Therefore, the reason of using metformin in various dose and treatment strategies for increasing efficacy in glycemic control depend on rational/appropriate indication and individual patients' tolerability. |
