Source : A paraitre DIABETES CARE, VOLUME 32, NUMBER 1, JANUARY 2009
Texte complet : [Lire] (pdf)
TITRATION OF METFORMIN
Begin with low-dose metformin (500 mg) taken once or twice per day with
meals (breakfast and/or dinner) or 850 mg once per day.
After 5–7 days, if gastrointestinal side effects have not occurred, advance dose
to 850, or two 500 mg tablets, twice per day (medication to be taken before
breakfast and/or dinner).
If gastrointestinal side effects appear as doses advanced, decrease to previous
lower dose and try to advance the dose at a later time.
The maximum effective dose can be up to 1,000 mg twice per day but is often
850 mg twice per day. Modestly greater effectiveness has been observed with
doses up to about 2,500 mg/day. Gastrointestinal side effects may limit the dose
that can be used.
Based on cost considerations, generic metformin is the first choice of therapy.
A longer-acting formulation is available in some countries and can be given once per day
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