Metformin instruction leaflet - maximum dose of 3,000 mg

[LittleGreyCat]

Life is complicated at the moment - you may see other threads.

Anyway, I was reading the fine print about Metformin (from RelonChem) to locate the information about Vitamin B12 deficiency as a possible side effect (which I found) and I noted that the maximum adult dose was listed as 3,000 mg per day spilt into 3 doses.

I had thought that 2,000 mg per day was the maximum adult dose.

Is anyone on more than 2,000 mg?

Does anyone have, perhaps, a different brand of Metformin with different information in the leaflet?

 

[carty]

Metabet and Meijumet both have 2000 mg as maximum dose per day so does the Strides pharmacy metformin
Carol

 

[Andydragon]

Life is complicated at the moment - you may see other threads.

Anyway, I was reading the fine print about Metformin (from RelonChem) to locate the information about Vitamin B12 deficiency as a possible side effect (which I found) and I noted that the maximum adult dose was listed as 3,000 mg per day spilt into 3 doses.

I had thought that 2,000 mg per day was the maximum adult dose.

Is anyone on more than 2,000 mg?

Does anyone have, perhaps, a different brand of Metformin with different information in the leaflet?

I have a feeling standard max dosage indeed can be 3000 and extended release is 2000 in advice but it differs country wide and in the UK NICE advice maximum is 2000 for both it seems

 

[Brunneria]

Yes. Like @Andydragon , I think the slow/fast release may make the difference.

 

[LittleGreyCat]

The tablets I take are fast release.

Nobody owning up to taking more than 2,000 mg yet!

 

[Rachox]

I take 1500mg but remember being told that 2000mg is max of standard release.

 

[carty]

The ones that I quoted are all Slow release
Carol

 

[Brunneria]

https://www.medicines.org.uk/emc/medicine/23244/SPC#gref
(Max dose 3,000mg)

https://www.nhs.uk/medicines/metformin/
(Max dose 2,000mg)

https://www.nps.org.au/australian-prescriber/articles/safe-prescribing-of-metformin-in-diabetes
(Max dose 3,000mg standard release and 2,000mg slow release)

https://bnf.nice.org.uk/drug/metformin-hydrochloride.html
(Max dose 1,700mg for women with PCOS and 2,000mg for diabetics)

 

[Struma]

Licensed dose -up to 3000mg.
Recommended dose - up to 2000mg. This is because over 2000mg there is a higher incidence of lactic acidosis.
Out of interest, years ago there used to be another drug in this family called phenformin, but it was removed due to its high incidence of lactic acidosis…

edit - 850mg tiablets 3 times daily is still prescribed, there are people on this dose on the forum, they haven't posted yet.

 

[LittleGreyCat]

All good information.

If I was prescribed 3 doses a day after meals then I would struggle, through not eating 3 meals a day.
That is just being picky, though, a snack would suffice!

 

[Oldvatr]

The BNF which is the pharmacist's bible has 2000 mg as max dose for all forms of Metformin.
https://bnf.nice.org.uk/drug/metformin-hydrochloride.html

I do note a notable error in their advice as regards PCOS where they give a dosage for the condition, then later on state that Metformin is not licenced for PCOS treatment

However, the manufacturer you identified does indeed give 3 g as their max dose.
https://www.medicines.org.uk/emc/medicine/23244/SPC
They quote the EMC which is the European Medical Council. i.e. Europe's equivalent to NICE.

 

[Struma]

The BNF which is the pharmacist's bible has 2000 mg as max dose for all forms of Metformin.
https://bnf.nice.org.uk/drug/metformin-hydrochloride.html

I do note a notable error in their advice as regards PCOS where they give a dosage for the condition, then later on state that Metformin is not licenced for PCOS treatment

However, the manufacturer you identified does indeed give 3 g as their max dose.
https://www.medicines.org.uk/emc/medicine/23244/SPC
They quote the EMC which is the European Medical Council. i.e. Europe's equivalent to NICE.

I'm afraid I need to correct something:
EMC = Electronic Medicines Compendium.

https://www.medicines.org.uk/emc/about-the-emc

 

[Oldvatr]

I'm afraid I need to correct something:
EMC = Electronic Medicines Compendium.

https://www.medicines.org.uk/emc/about-the-emc

I was close. I was thnking it was the EMA. My Bad

One of the 3 main sources of info comes from.
"The UK or European medicines licensing agency - the Medicines and Healthcare products Regulatory Agency (MHRA) or the European Medicines Agency (EMA) - then checks and approves the information"

The other 2 main sources of its info identified in the EMC document are the Pharma companies themselves. (1) Initial characteristics on profuct release, and (2) marketing feedback to follow on.

Definitely European database since the FDA soes not get a mention. Not sure who accesses or uses EMC since GP's , and pharmacies seem to use the BNF and NICE.