Glucophage Xr (Metformin Hydrochloride)

Glucophage XR is indicated for the long‑term control of blood glucose in adults with type 2 diabetes mellitus, usually as part of a comprehensive treatment plan that includes diet and exercise.

• As monotherapy in patients newly diagnosed with type 2 diabetes when metformin is appropriate.
• In combination with other oral antidiabetic agents (e.g., sulfonylureas, DPP‑4 inhibitors) to achieve glycemic targets.
• As an adjunct to insulin therapy when additional glucose lowering is needed.
• For patients who benefit from once‑daily dosing and reduced gastrointestinal side effects compared with immediate‑release metformin.

The safety profile of Glucophage XR reflects the known effects of metformin, with most patients experiencing mild, transient symptoms.

Common

• Nausea or upset stomach.
• Diarrhea or loose stools.
• Abdominal discomfort or bloating.
• Metallic taste in the mouth.
• Decreased appetite.

Serious

• Lactic acidosis, a rare but life‑threatening condition.
• Severe skin reactions such as Stevens‑Johnson syndrome.
• Persistent vomiting leading to dehydration.
• Marked decrease in vitamin B12 levels over long‑term use.

Before initiating Glucophage XR, health‑care providers assess several clinical factors to ensure safe use and to minimize risk.

• Assess renal function; avoid use if eGFR is below the recommended threshold.
• Evaluate hepatic function, as liver disease may increase lactic acidosis risk.
• Review any history of alcohol abuse, which can potentiate metformin‑associated acidosis.
• Consider vitamin B12 monitoring during prolonged therapy.
• Use caution in elderly patients due to reduced renal clearance.
• Discontinue before any radiographic study using iodinated contrast agents.

Glucophage XR may interact with other medicines, affecting its efficacy or safety.

Avoid

• Iodinated contrast agents used for imaging studies.
• Cimetidine, which can increase metformin plasma concentrations.

Use with caution

• Diuretics that may affect kidney function.
• ACE inhibitors or ARBs, especially in patients with renal impairment.
• Certain antiretroviral drugs (e.g., dolutegravir) that can alter metformin clearance.
• Beta‑blockers that may mask hypoglycemia symptoms.