Metformax 1000

Leaflet attached to the packaging: patient information

Metformax 1000, 1000 mg, film-coated tablets

metformin hydrochloride

Read the leaflet carefully before taking the medicine, as it contains important information for the patient

• Keep this leaflet, so you can read it again if you need to.
• If you have any doubts, consult your doctor or pharmacist.
• This medicine has been prescribed specifically for you. Do not pass it on to others. The medicine may harm another person, even if their symptoms are the same as yours.
• If the patient experiences any side effects, including any not listed in this leaflet, they should tell their doctor or pharmacist. See section 4.

Table of contents of the leaflet:

• 1. What is Metformax 1000 and what is it used for
• 2. Important information before taking Metformax 1000
• 3. How to take Metformax 1000
• 4. Possible side effects
• 5. How to store Metformax 1000
• 6. Contents of the packaging and other information

1. What is Metformax 1000 and what is it used for

What is Metformax 1000

Metformax 1000 contains metformin, a medicine used to treat diabetes. It belongs to a group of medicines called biguanides.
Insulin is a hormone produced by the pancreas that makes the body take in glucose (sugar) from the blood. The body uses glucose to produce energy or stores it for future use.
If the patient has diabetes, the pancreas does not produce enough insulin or the body cannot use the insulin it produces properly. This leads to high blood sugar levels. Metformax 1000 helps lower blood sugar levels to near normal levels.
If the adult patient is overweight, long-term use of Metformax 1000 also helps reduce the risk of diabetes complications.
Taking metformin is associated with maintaining or slightly reducing body weight.

What is Metformax 1000 used for

Metformax 1000 is used to treat patients with type 2 diabetes (also called "non-insulin-dependent diabetes"), when diet and exercise alone have not controlled blood sugar levels properly. It is used especially in patients who are overweight.
Adult patients can take Metformax 1000 alone or in combination with other oral anti-diabetic medicines (medicines taken orally or insulin).
Children aged 10 years or older and adolescents can take Metformax 1000 alone or in combination with insulin.

2. Important information before taking Metformax 1000

When not to take Metformax 1000

If any of the above applies to the patient, they should consult their doctor before taking this medicine.
Make sure the doctor has explained all the doubts:

Warnings and precautions

Before taking Metformax 1000, the patient should discuss it with their doctor or pharmacist .

Risk of lactic acidosis

Metformax 1000 may rarely cause a very serious side effect called lactic acidosis, especially if the patient has kidney problems. The risk of lactic acidosis increases in cases of uncontrolled diabetes, severe infection, prolonged fasting or alcohol consumption, dehydration (see more information below), liver problems, and any conditions in which a part of the body is not getting enough oxygen (e.g. severe heart problems).
If any of the above applies to the patient, they should consult their doctor for more detailed instructions.

Temporarily stop taking Metformax 1000 if the patient has

a condition that may lead to dehydration(significant water loss),
such as severe vomiting, diarrhea, fever, exposure to high temperatures, or if the patient drinks less fluid than usual. The patient should consult their doctor for more detailed instructions.

Stop taking Metformax 1000 and contact a doctor or the nearest hospital immediately if the patient experiences any of the following symptoms

of lactic acidosis, as this condition can lead to coma.
Symptoms of lactic acidosis include:

• vomiting,
• abdominal pain,
• muscle cramps,
• general feeling of being unwell with severe fatigue,
• breathing difficulties,
• lowered body temperature and slowed heart rate.

Lactic acidosis is a life-threatening condition that requires immediate hospital treatment.

Consult a doctor for further instructions if:

• the patient has a genetically inherited disease affecting the mitochondria (energy-producing structures in cells), such as MELAS syndrome (mitochondrial encephalomyopathy, myopathy, lactic acidosis, and stroke-like episodes) or maternally inherited diabetes and deafness.
• the patient experiences any of the following symptoms after starting metformin: seizures, impaired cognitive function, difficulty moving, signs of nerve damage (e.g. pain or numbness), migraine, or hearing loss. If the patient is to have major surgery, they should not take Metformax 1000 during or for some time after the surgery. The doctor will decide when the patient should stop and restart Metformax 1000.

Metformax 1000 does not cause hypoglycemia (low blood sugar) on its own. However, if Metformax 1000 is taken with other anti-diabetic medicines that can cause hypoglycemia (such as sulfonylurea, insulin, meglitinides), there is a risk of hypoglycemia. If the patient experiences symptoms of hypoglycemia, such as fatigue, dizziness, increased sweating, rapid heartbeat, vision disturbances, or difficulty concentrating, they should usually eat or drink something containing sugar.
During treatment with Metformax 1000, the doctor will check the patient's kidney function at least once a year or more often if the patient is elderly and/or has impaired kidney function.

Metformax 1000 with other medicines

If the patient is to have an iodine-containing contrast medium injected into their bloodstream, e.g. for an X-ray or CT scan, they should stop taking Metformax 1000 before or at the latest at the time of the injection. The doctor will decide when the patient should stop and restart Metformax 1000.
The patient should tell their doctor or pharmacist about all medicines they are currently taking or have recently taken, as well as any medicines they plan to take. The patient may need more frequent blood sugar checks and kidney function tests or a dose adjustment of Metformax 1000 by their doctor. It is especially important to inform about the following medicines:

• diuretics (medicines that increase urine production),
• medicines used to treat pain and inflammation (NSAIDs and COX-2 inhibitors, such as ibuprofen and celecoxib),
• certain medicines used to treat high blood pressure (ACE inhibitors and angiotensin II receptor antagonists).
• beta-2 adrenergic receptor agonists, such as salbutamol or terbutaline (used to treat asthma).
• corticosteroids (used to treat a range of conditions, such as severe skin infections or asthma).
• medicines that may change metformin levels in the blood, especially if the patient has kidney problems (such as verapamil, rifampicin, cimetidine, dolutegravir, ranolazine, trimethoprim, vandetanib, isavuconazole, crizotinib, olaparib),
• other medicines used to treat diabetes.

Metformax 1000 with alcohol

The patient should avoid consuming excessive amounts of alcohol while taking Metformax 1000, as this may increase the risk of lactic acidosis (see "Warnings and precautions").

Pregnancy and breastfeeding

• If the patient is pregnant, thinks they may be pregnant, or plans to have a baby, they should consult their doctor, as changes in treatment or blood sugar monitoring may be necessary.
• This medicine is not recommended if the patient is breastfeeding or plans to breastfeed.

Driving and using machines

Metformax 1000 does not cause hypoglycemia (low blood sugar). This means that the medicine will not affect the patient's ability to drive or use machines. However, the patient should be careful when taking Metformax 1000 in combination with other anti-diabetic medicines that can cause hypoglycemia (such as sulfonylurea, insulin, meglitinides). Symptoms of hypoglycemia include fatigue, dizziness, increased sweating, rapid heartbeat, vision disturbances, or difficulty concentrating. The patient should not drive or use machines if they experience any of these symptoms.

3. How to take Metformax 1000

This medicine should always be taken exactly as prescribed by the doctor or pharmacist. If the patient has any doubts, they should consult their doctor or pharmacist.
Metformax 1000 will not replace the benefits of a healthy lifestyle. The patient should follow their doctor's advice on diet and exercise regularly.
Recommended dose:
Usual starting dose for children over 10 years and adolescents is one 500 mg or 850 mg metformin hydrochloride tablet once daily. The maximum dose of metformin is 2000 mg per day, given in 2 or 3 divided doses. Treatment of children aged 10 to 12 years is only recommended after careful consideration by the doctor, as experience in this age group is limited.
Usual starting dose for adults is one 500 mg or 850 mg metformin hydrochloride tablet, 2 or 3 times a day. The maximum dose of metformin is 3000 mg per day, given in 3 divided doses.
If the patient has kidney problems, the doctor may prescribe a lower dose.
If the patient is also taking insulin, the doctor will inform them how to start taking Metformax 1000.
Monitoring

• The doctor will recommend regular blood sugar checks and adjust the dose of Metformax 1000 according to the patient's blood sugar levels. The patient should regularly consult their doctor. This is especially important for children and adolescents, as well as elderly patients.
• The doctor will also check the patient's kidney function at least once a year. More frequent checks may be necessary if the patient is elderly or if their kidneys are not working properly.

How to take Metformax 1000
The patient should take the tablet with or after a meal. This will help avoid gastrointestinal side effects.
The patient should not crush or chew the tablets. They should swallow each tablet with a glass of water.

• If the patient takes one dose per day, they should take it in the morning (breakfast).
• If the patient takes 2 divided doses, they should take them in the morning (breakfast) and evening (dinner).
• If the patient takes 3 divided doses, they should take them in the morning (breakfast), at noon (lunch), and evening (dinner).

The score line on the tablet is only to facilitate breaking the tablet, if the patient has difficulty swallowing it whole.
If, after some time, the patient feels that the effect of Metformax 1000 is too strong or too weak, they should consult their doctor or pharmacist.

Taking a higher dose of Metformax 1000 than recommended

If the patient takes more Metformax 1000 than they should, they may experience lactic acidosis. Symptoms of lactic acidosis are non-specific and include: vomiting, abdominal pain with muscle cramps, general feeling of being unwell, severe fatigue, and shortness of breath. Other symptoms include lowered body temperature and slowed heart rate. If the patient experiences any of these symptoms, they should immediately seek medical help, as lactic acidosis can lead to coma. They should stop taking Metformax 1000 and consult their doctor or go to the nearest hospital.

Missing a dose of Metformax 1000

The patient should not take a double dose to make up for a missed dose. They should take the next dose at the usual time.
If the patient has any doubts about taking this medicine, they should consult their doctor or pharmacist.

4. Possible side effects

Like all medicines, Metformax 1000 can cause side effects, although not everybody gets them.
The following side effects are very serious and the patient should contact their doctor immediately if they experience any of these symptoms:
Very rare: may affect up to 1 in 10,000 people

• Metformax 1000 may very rarely cause a very serious side effect called lactic acidosis, especially if the patient has kidney problems. Symptoms of lactic acidosis are non-specific (see "Warnings and precautions"). If the patient experiences it, they should stop taking Metformax 1000 and contact their doctor or the nearest hospital immediately, as lactic acidosis can lead to coma.
• Abnormal liver function test results or symptoms of liver inflammation (liver inflammation with fatigue, loss of appetite, and weight loss, with or without yellowing of the skin and whites of the eyes). If such symptoms occur, the patient should stop taking Metformax 1000 and tell their doctor.

Other side effects:
Very common: may affect more than 1 in 10 people

• Gastrointestinal problems such as nausea (feeling sick), vomiting, diarrhea, abdominal pain, and loss of appetite. These side effects are more common at the start of treatment with Metformax 1000. It is helpful to take the doses with intervals during the day and to take the tablets with food or immediately after food. If the symptoms do not go away, the patient should stop taking Metformax 1000 and consult their doctor.

Common: may affect up to 1 in 10 people

• Taste disturbances.
• Decreased or low levels of vitamin B12 in the blood (symptoms may include extreme fatigue, pain, and redness of the tongue, numbness or tingling, or pale or yellowish skin. The doctor may order several tests to find the cause of the symptoms, as some of them may also be caused by diabetes or other non-diabetes-related health problems).

Very rare: may affect up to 1 in 10,000 people

• Skin reactions such as redness, itching, or itchy rash.
• Decreased levels of vitamin B in the blood.

Children and adolescents
Limited data in children and adolescents showed that side effects were similar in nature and severity to those in adult patients.
Reporting side effects
If the patient experiences any side effects, including any not listed in this leaflet, they should tell their doctor or pharmacist.
Side effects can be reported directly to the Department of Post-Marketing Surveillance of Adverse Reactions to Medicinal Products, Medical Devices, and Biocidal Products, Al. Jerozolimskie 181C, 02-222 Warsaw, Tel.: +48 22 49 21 301, Fax: +48 22 49 21 309, website: https://smz.ezdrowie.gov.pl.
By reporting side effects, more information can be collected on the safety of this medicine.

5. How to store Metformax 1000

The medicine should be stored out of the sight and reach of children. If Metformax 1000 is used in children, treatment should be supervised by parents or caregivers.
Do not use Metformax 1000 after the expiry date stated on the blister and carton after "Expiry date" or "EXP". The expiry date refers to the last day of that month.
There are no special storage instructions for this medicine.
Medicines should not be disposed of via wastewater or household waste. The patient should ask their pharmacist how to dispose of medicines they no longer use. This will help protect the environment.

6. Contents of the packaging and other information

What Metformax 1000 contains

• The active substance of Metformax 1000 is metformin hydrochloride. Each tablet contains 1000 mg of metformin hydrochloride, equivalent to 780 mg of metformin.
• Other ingredients: Core: povidone K30, colloidal anhydrous silica, magnesium stearate; Coating: hypromellose, macrogol 400, and coloring agent - titanium dioxide (E171).

What Metformax 1000 looks like and contents of the pack

White or almost white, oval tablet, with a score line, with the inscription "9/3" on one side and "72/14" on the other side.
Metformax 1000 is available in blisters containing 30, 60, 90, or 120 film-coated tablets and in bottles containing 60, 100, or 180 film-coated tablets.
Not all pack sizes may be marketed.

Marketing authorization holder and manufacturer

Marketing authorization holder

Teva Pharmaceuticals Polska Sp. z o.o., ul. Emilii Plater 53, 00-113 Warsaw, Poland

Manufacturer

Teva Pharmaceutical Works Private Limited Company, Pallagi út 13, 4042 Debrecen, Hungary
Pharmachemie B.V., Swensweg 5, Postbus 552, 2003 RN Haarlem, Netherlands
Teva Santé SA, Rue Bellocier, 89107 Sens, France
Teva Operations Poland Sp. z o.o., ul. Mogilska 80, 31-546 Kraków
Teva Czech Industries s.r.o., Ostravská 305/29, Opava, Komárov, Czech Republic

This medicinal product is authorized in the Member States of the European Economic Area under the following names:

France

Metformine TEVA PHARMA 1000 mg, film-coated tablet

Czech Republic

Metformin Teva

Germany

Metformin-ratiopharm 1.000 mg film-coated tablets

Denmark

Metformin Teva

Hungary

Adimet 1000 mg film-coated tablet

Poland

Metformax 1000

Portugal

Metformina Teva

Date of last revision of the leaflet: March 2025