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Interactions with other drugs, food and drink, and other factors may increase or decrease the effect of certain analgesics and alter their half-life. Because some listed analgesics are prodrugs or have active metabolites, individual variation in liver enzymes (e.g., CYP2D6 enzyme) may result in significantly altered effects.
The metformin pK a values make it a stronger base than most other basic medications with less than 0.01% nonionized in blood. Furthermore, the lipid solubility of the nonionized species is slight as shown by its low logP value (log(10) of the distribution coefficient of the nonionized form between octanol and water) of −1.43.
Vildagliptin/metformin is indicated in the treatment of type-2 diabetes mellitus: [4] [6] [7] it is indicated in the treatment of adults who are unable to achieve sufficient glycaemic control at their maximally tolerated dose of oral metformin alone or who are already treated with the combination of vildagliptin and metformin as separate tablets.
Pioglitazone/metformin is indicated as an adjunct to diet and exercise: [medical citation needed] To improve glycemic control in patients with type 2 diabetes, or; For patients who are already treated with a separate combination of pioglitazone and metformin, For patients whose diabetes is not adequately controlled with metformin alone, or
In the United States, sitagliptin/metformin is indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes. [5] [6]In the European Union, sitagliptin/metformin is indicated as an adjunct to diet and exercise to improve glycemic control in people with type 2 diabetes; in combination with a sulfonylurea as an adjunct to diet and exercise "in people ...
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Further, metformin comes in the form of immediate-release tablets, extended-release tablets, and as a liquid. Each type of metformin has different requirements in terms of when and how to take it:
Kidney function should be assessed before starting metformin. Phenformin and buformin are more prone to cause acidosis than metformin; therefore they have been practically replaced by it. However, when metformin is combined with other drugs (combination therapy), hypoglycemia and other side effects are possible. [citation needed]