二甲雙胍

用途

• Non-insulin dependent diabetes mellitus (NIDDM)
• Early NIDDM
• General Use Warning
• General

給藥方式

可能的副作用

• Lethargy
• Inappetence
• Vomiting
• Diarrhea
• Weight loss
• Lactic acidosis (rare but severe)

注意事項與禁忌

• Hypersensitivity to metformin
• Renal dysfunction
• Metabolic acidosis
• Concurrent use of parenteral iodinated contrast agents (temporary contraindication)
• **Important Precautions:** * **Renal Impairment**: Metformin is primarily excreted unchanged by the kidneys. Accumulation can lead to severe lactic acidosis in patients with renal dysfunction. * **Gastrointestinal Toxicity**: Has a narrow margin of safety regarding GI upset in small animals. * **Lactation**: Excreted in maternal milk in levels equivalent to plasma. Use with caution in lactating queens. * **Dosing Challenges**: Human dosage forms (e.g., 500 mg tablets) may be difficult to accurately dose in cats, increasing the risk of toxicity.

藥物相互作用

• ACE Inhibitors: May increase risk for hypoglycemia
• Cimetidine: Can cause a 60% increase in peak metformin plasma levels and a 40% increase in AUC
• Corticosteroids: May reduce hypoglycemic efficacy
• Diuretics, Thiazide: May reduce hypoglycemic efficacy
• Furosemide: Can increase the AUC and plasma levels of metformin by 22%; metformin can decrease the peak plasma concentrations and AUC of furosemide
• Iodinated Contrast Agents (Parenteral): May cause acute renal failure and lactic acidosis if used within 48 hours of a metformin dose
• Isoniazid: May reduce hypoglycemic efficacy
• Sympathomimetic Agents: May reduce hypoglycemic efficacy

常見問題