Glocophage XR

Glucophage XR is a blood sugar-lowering medication in the Biguanides class, containing Metformin Hydrochloride as its active ingredient. It is used to treat Type 2 Diabetes Mellitus in combination with diet and exercise, or together with other diabetes medications or insulin.

This is a controlled medication that must be used only under the guidance of a doctor or pharmacist.

Indications:

• Treatment of Type 2 Diabetes as initial therapy or in combination with other medications
• Prediabetes in high-risk patients (Off-label)
• Polycystic Ovary Syndrome (PCOS) to improve insulin resistance (Off-label)

Glucophage XR lowers blood sugar levels both before and after meals through multiple mechanisms:

• Inhibits hepatic gluconeogenesis — Reduces glucose production in the liver
• Reduces intestinal glucose absorption — Decreases the amount of sugar absorbed into the body
• Improves peripheral insulin sensitivity — Helps cells respond better to insulin

The XR (Extended-Release) formula is designed to release the medication slowly over 24 hours, resulting in fewer gastrointestinal side effects than the regular formula. The drug is excreted unchanged through urine.

For Adults and Children 17 Years and Older

• Starting dose: 500 mg once daily with evening meal
• Dose adjustment: May increase by 500 mg weekly based on response
• Maximum dose: 2,000 mg once daily
• If blood sugar control is inadequate, may split into 2 doses

For Children 10-16 Years

• Insufficient data available for XR formulation in this age group
• Should use immediate-release formulation as directed by physician

For Patients with Kidney Disease/Elderly

• Dose reduction required for patients with impaired kidney function (eGFR 30-60 mL/min/1.73 m²)
• Contraindicated in severe kidney failure (eGFR < 30 mL/min/1.73 m²)

Important Instructions

• Swallow tablets whole — do not crush, break, or chew as this destroys the extended-release mechanism
• Take with evening meal to reduce nausea and better control morning blood sugar levels

If You Miss a Dose

• Skip the missed dose and take the next dose at the regular time
• Do not double the dose to make up for the missed one

Common Side Effects

• Gastrointestinal: Diarrhea, nausea/vomiting, abdominal pain, loss of appetite
• Nervous system: Headache, fatigue, metallic taste in mouth

These symptoms usually occur early and gradually improve as the body adjusts.

Serious Side Effects to Watch For

Lactic Acidosis — Rare but serious, especially in patients with impaired kidney function

Symptoms requiring immediate medical attention:

• Unusual fatigue
• Muscle pain
• Difficulty breathing, deep rapid breathing
• Severe abdominal pain
• Severe nausea and vomiting
• Confusion, drowsiness

Vitamin B12 Deficiency

Long-term use of Metformin may reduce vitamin B12 absorption in the intestines. Your doctor may recommend periodic B12 level testing.

Contraindications

• Allergy to Metformin or other Biguanides
• Severe kidney failure (eGFR < 30 mL/min/1.73 m²)
• Children under 10 years (for XR formulation)

Precautions

• Avoid alcohol: Do not consume large amounts of alcohol as it increases the risk of lactic acidosis
• Before X-ray with contrast dye: Stop medication 48 hours before and after the procedure
• Liver/kidney disease patients: Dose adjustment required with regular kidney function monitoring

Pregnancy and Breastfeeding

• Pregnancy: Not recommended. Consult your doctor. Insulin is generally recommended for pregnant women with diabetes.
• Breastfeeding: The drug is excreted in breast milk. Not recommended.

Drug Interactions

• Use caution with diuretics, steroids, or other medications affecting blood sugar levels
• Contraindicated with iodinated contrast media

You can order Glucophage XR online at Intimo Life. Registration and pharmacist consultation are required to ensure this medication is appropriate for your health condition and to receive proper usage guidance.

Why choose the XR formulation?

The XR formula releases medication slowly, allowing once-daily dosing and reducing gastrointestinal side effects commonly seen with the regular formula.

Does Glucophage XR cause low blood sugar?

When used alone, this medication does not stimulate insulin secretion, so it does not cause low blood sugar. However, when combined with other diabetes medications or insulin, the risk may increase.

Will it cause weight gain?

This medication has minimal effect on weight. Most patients maintain stable weight or may experience slight weight loss, unlike some other diabetes medications that may cause weight gain.

What monitoring is needed during treatment?

Kidney function (eGFR) should be checked at least once yearly. Vitamin B12 levels may also be monitored if using the medication long-term.

What if blood sugar is not controlled adequately?

If symptoms do not improve within 3-6 months, consult your doctor to consider adjusting or adding other medications.

How is Glucophage XR different from other diabetes medications?

Compared to Sulfonylureas (such as Gliclazide), Metformin does not directly stimulate insulin secretion, so it does not cause weight gain and has a lower risk of low blood sugar when used alone.

• Thai FDA (Food and Drug Administration)
• UpToDate - Metformin: Drug Information
• Drugs.com - Metformin
• MedlinePlus - Metformin
• American Diabetes Association

FDA - Metformin Hydrochloride LabelNHS UK - MetforminMayo Clinic - Metformin (Oral Route)MedlinePlus - MetforminDrugs.com - Metformin