One thing I have noticed is that not all Metformin information in the drug packs seems to be the same.
For instance my current pack says not to take if your eGFR is below 45, 1,000 mg daily with eGFR between 45 and 60, and max dose of 3,000 mg per day otherwise. These tablets are from RelonChem.
However
@walnut_face posted
http://www.diabetes.co.uk/forum/thr...medication-e-g-metformin.115664/#post-1374572
"Read the Patient Information Leaflet (PIL) My variety of metformin advises NOT to take them if following a VLC diet of <1000 cal".
My PIL doesn't seem to mention this at all.
https://www.drugs.com/dosage/metformin.html says "Maximum dose: 2550 mg daily".
https://www.evidence.nhs.uk/formula...drugs/6122-biguanides/metformin-hydrochloride
says "Diabetes mellitus, ADULT and CHILD over 10 years initially 500 mg with breakfast for at least 1 week then 500 mg with breakfast and evening meal for at least 1 week then 500 mg with breakfast, lunch and evening meal; usual max. 2 g daily in divided doses" but also, tellingly, "
Note
Metformin doses in the BNF may differ from those in the product literature
"
Oh, and "
Lactic acidosis
Use with caution in renal impairment—increased risk of lactic acidosis; avoid in significant renal impairment. NICE
(1) recommends that the dose should be reviewed if eGFR less than 45 mL/minute/1.73 m2 and to avoid if eGFR less than 30 mL/minute/1.73 m2. Withdraw or interrupt treatment in those at risk of tissue hypoxia or sudden deterioration in renal function, such as those with dehydration, severe infection, shock, sepsis, acute heart failure, respiratory failure or hepatic impairment, or those who have recently had a myocardial infarction
"
So which information source should you rely on??????
Edit:
http://www.mhra.gov.uk/home/groups/spcpil/documents/spcpil/con1469768893814.pdf
should be the generic PIL and that has the 3,000 mg maximum limit.