I-MAX 500MG TABLET (TABLET)

Administration : Should be taken with food. Contraindications : Renal impairment and liver failure because of an increased risk of hypoglycemia. Patients with heart failure, recent myocardial infarction, dehydration, alcoholism or any other condition likely to predispose to lactic acidosis. Special Precautions : Renal impairment may also predispose patients to lactic acidosis. Regular renal and hepatic monitoring is essential. Dosage / Overdosage Initial dose of 500 mg three times daily with or after meals, gradually increased if necessary to a maximum of 3 g daily. Interactions Amiloride, cimetidine, digoxin, morphine, procainamide, quinidine, vancomycin, trimethoprim. May increase levels w/ cimetidine. Adverse Reactions Gastrointestinal adverse effects including anorexia, nausea and diarrhea may occur and is dose dependent. These effects can be limited by administering with food and starting with low dose (500 mg once or twice a day), then slowly titrating the dose upwards according to the clinical response. Patients may experience a metallic taste and there may be weight loss. Absorption of various substances including vitamin B12 may be impaired. Hypoglycemia is less of a problem with metformin than with the sulfonylureas. Lactic acidosis is rare and occurs predominantly in patients with renal impairment.