DIANBEN 850 mg FILM-COATED TABLETS

Introduction

Package Leaflet: Information for the User

Dianben 850 mg Film-Coated Tablets

Metformin Hydrochloride

Read all of this leaflet carefully before you start taking this medicine because it contains important information for you.

• Keep this leaflet, you may need to read it again.
• If you have any further questions, ask your doctor or pharmacist.
• This medicine has been prescribed for you only. Do not pass it on to others. It may harm them, even if their signs of illness are the same as yours.
• If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. See section 4.

Contents of the pack and other information

1. What is Dianben and what is it used for
2. What you need to know before you take Dianben
3. How to take Dianben
4. Possible side effects
5. Storing Dianben
6. Contents of the pack and further information

1. What is Dianben and what is it used for

Dianben 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 your body take in glucose (sugar) from the blood. Your body uses glucose to produce energy or stores it for future use.

If you have diabetes, your pancreas does not produce enough insulin or your body cannot use the insulin it produces properly. This causes high blood glucose levels. Dianben helps reduce your blood glucose to as normal a level as possible.

If you are an adult with overweight, taking Dianben for a long time also helps reduce the risk of complications associated with diabetes. Dianben is associated with maintaining body weight or a slight decrease in body weight.

Dianben is used to treat patients with type 2 diabetes (also called "non-insulin-dependent diabetes") when diet and exercise alone are not enough to control their blood glucose levels. It is especially used in patients with overweight.

Adults can take Dianben alone or with other medicines to treat diabetes (medicines taken by mouth or insulin).

Children aged 10 years and older, and adolescents can take Dianben alone or with insulin.

2. What you need to know before you take Dianben

Do not take Dianben

• If you are allergic (hypersensitive) to metformin or any of the other ingredients of this medicine (listed in section 6).
• If you have liver problems
• If you have a severe reduction in kidney function;
• If you have uncontrolled diabetes with, for example, severe hyperglycemia (high blood sugar), nausea, vomiting, diarrhea, rapid weight loss, lactic acidosis (see "Risk of lactic acidosis" below) or ketoacidosis. Ketoacidosis is a disorder in which substances called "ketone bodies" accumulate in the blood, which can lead to a pre-diabetic coma. Symptoms include stomach pain, rapid and deep breathing, drowsiness or an unusual fruity odor in your breath.
• If you have lost a lot of water from your body (dehydration), for example due to prolonged or severe diarrhea, or if you have vomited several times in a row. Dehydration can trigger kidney problems, which can put you at risk of developing lactic acidosis (see "Warnings and precautions").
• If you have a severe infection, for example an infection that affects your lungs, bronchi or kidneys. Severe infections can trigger kidney problems, which can put you at risk of developing lactic acidosis (see "Warnings and precautions").
• If you are receiving treatment for acute heart failure or if you have recently had a heart attack, if you have severe circulation problems (such as shock) or if you have difficulty breathing. This can lead to a lack of oxygen in the tissues, which can put you at risk of developing lactic acidosis (see below "Warnings and precautions").
• If you drink a lot of alcohol.

If any of the above circumstances apply to you, consult your doctor before starting to take this medicine.

Make sure to consult your doctor if

• you need an examination such as an X-ray or a scan that involves injecting a contrast medium into your blood that contains iodine.
• you need major surgery.

You should stop taking Dianben for a certain period of time before and after the examination or surgery. Your doctor will decide if you need any other treatment during this time. It is important that you follow your doctor's instructions precisely.

Warnings and precautions

Stop taking Dianben and contact a doctor or the nearest hospital immediately if you experience any of the symptoms that lactic acidosis produces, as this disorder can lead to a coma.

The symptoms of lactic acidosis include:

• vomiting
• stomach pain (abdominal pain)
• muscle cramps
• general feeling of discomfort, with intense fatigue
• difficulty breathing
• decrease in body temperature and heart rate

Lactic acidosis is a medical emergency and should be treated in a hospital.

Consult your doctor quickly if:

• You know you have a genetic disorder that affects the mitochondria (the energy-producing components within cells), such as MELAS syndrome (mitochondrial encephalomyopathy, myopathy, lactic acidosis, and stroke-like episodes) or maternally inherited diabetes and deafness (MIDD).
• You experience any of the following symptoms after starting treatment with metformin: seizure, cognitive impairment, difficulty with body movements, symptoms indicative of nerve damage (e.g., pain or numbness), migraine, and hearing loss.

If you need to undergo major surgery, you should stop taking Dianben during the procedure and for a period of time after it. Your doctor will decide when you should stop taking Dianben and when you can restart it.

Dianben alone does not cause hypoglycemia (a blood glucose concentration that is too low). However, if you take Dianben with other diabetes medicines that can cause hypoglycemia (such as sulfonylureas, insulin, meglitinides), there is a risk of hypoglycemia. If you experience symptoms of hypoglycemia, such as weakness, dizziness, increased sweating, increased heart rate, vision disorders, or difficulty concentrating, it is usually helpful to eat or drink something that contains sugar.

During treatment with Dianben, your doctor will check your kidney function regularly, at least once a year or more frequently if you are an elderly person and/or if your kidney function is worsening.

Other medicines and Dianben

If you need to be given an injection of a contrast medium that contains iodine into your bloodstream, for example in the context of an X-ray or scan, you should stop taking Dianben before the injection or at the time of the injection. Your doctor will decide when you should stop taking Dianben and when you can restart it.

Tell your doctor if you are taking, have recently taken, or might take any other medicines. You may need more frequent blood glucose and kidney function tests, or your doctor may need to adjust the dose of Dianben. It is especially important to mention the following:

• medicines that increase urine production (diuretics)
• medicines used to treat pain and inflammation (NSAIDs and COX-2 inhibitors, such as ibuprofen and celecoxib)
• certain medicines to treat high blood pressure (ACE inhibitors and angiotensin II receptor antagonists)
• beta-2 agonists, such as salbutamol or terbutaline (used to treat asthma)
• corticosteroids (used to treat various conditions, such as severe skin inflammation or asthma)
• medicines that may alter the amount of Dianben in your blood, especially if you have reduced kidney function (such as verapamil, rifampicin, cimetidine, dolutegravir, ranolazine, trimethoprim, vandetanib, isavuconazole, crizotinib, olaparib).
• other medicines used to treat diabetes.

Taking Dianben with alcohol

Avoid excessive alcohol consumption while taking Dianben, as this can increase the risk of lactic acidosis (see section "Warnings and precautions").

Pregnancy and breastfeeding

If you are pregnant, think you may be pregnant, or are planning to have a baby, talk to your doctor, as it may be necessary to change your treatment or monitor your blood glucose levels.

It is not recommended to take this medicine if you are breastfeeding or planning to breastfeed your baby.

Driving and using machines

Dianben alone does not cause hypoglycemia (a blood glucose concentration that is too low). This means it will not affect your ability to drive or use machines.

However, be especially careful if you take Dianben with other diabetes medicines that can cause hypoglycemia (such as sulfonylureas, insulin, meglitinides). The symptoms of hypoglycemia include weakness, dizziness, increased sweating, increased heart rate, vision disorders, or difficulty concentrating. Do not drive or use machines if you start to feel these symptoms.

3. How to take Dianben

Follow exactly the administration instructions of this medicine given by your doctor. In case of doubt, consult your doctor or pharmacist.

Dianben cannot replace the benefits of a healthy lifestyle. Continue to follow any dietary advice your doctor has given you and exercise regularly.

Recommended dose

Children aged 10 years and older, and adolescents usually start with 500 mg or 850 mg of Dianben once a day. The maximum daily dose is 2000 mg divided into 2 or 3 doses. Treatment of children between 10 and 12 years is only recommended under specific advice from your doctor, as clinical experience in this patient group is limited.

Adults usually start with 500 mg or 850 mg of Dianben, two or three times a day. The maximum daily dose is 3000 mg divided into 3 doses.

If you have reduced kidney function, your doctor may prescribe a lower dose.

If insulin is also administered, your doctor will indicate how to start taking Dianben.

Monitoring

• Your doctor will regularly perform blood glucose tests and adjust your dose of Dianben according to your blood glucose levels. Make sure to talk to your doctor regularly. This is particularly important for children, adolescents, or if you are an elderly person.
• Your doctor will also check how well your kidneys are working, at least once a year. You may need more frequent checks if you are an elderly person or if your kidneys are not working normally.

How to take Dianben

Take Dianben with meals or after meals. This will prevent you from suffering from side effects that affect your digestion. Do not chew or crush the tablets. Swallow each tablet with a glass of water.

• If you take one dose a day, take it in the morning (at breakfast).
• If you take two doses a day, take them in the morning (at breakfast) and at night (at dinner).
• If you take three doses a day, take them in the morning (at breakfast), at noon (at lunch), and at night (at dinner).

If, after some time, you think the effect of Dianben is too strong or too weak, consult your doctor or pharmacist.

If you take more Dianben than you should

If you have taken more Dianben than you should, you may suffer from lactic acidosis. The symptoms of lactic acidosis are non-specific, such as vomiting, stomach pain (abdominal pain) with cramps, a general feeling of discomfort with intense fatigue, and difficulty breathing. Additional symptoms may include a decrease in body temperature and heart rate. If you experience any of these symptoms, you should seek medical attention immediatelyas lactic acidosis can lead to a coma. Stop taking Dianben immediately and contact your doctor or the nearest hospital as soon as possible.

In case of overdose or accidental ingestion, consult your doctor or pharmacist immediately or call the Toxicology Information Service. Phone: 91 562 04 20, indicating the medicine and the amount ingested.

If you forget to take Dianben

Do not take a double dose to make up for forgotten doses. Take the next dose at the usual time.

If you have any other questions about the use of this medicine, ask your doctor or pharmacist.

4. Possible side effects

Like all medicines, this medicine can cause side effects, although not everybody gets them. The following side effects may occur:

Dianben can cause a very rare but very serious side effect called lactic acidosis (see section "Warnings and precautions"). If this happens to you, you should stop taking Dianben and contact a doctor or the nearest hospital immediately, as lactic acidosis can lead to a coma.

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

• digestive problems, such as nausea, vomiting, diarrhea, stomach pain (abdominal pain), and loss of appetite. These side effects occur more frequently at the beginning of treatment with Dianben. Spreading the doses throughout the day and taking Dianben during or immediately after a meal can help reduce these side effects. If the symptoms persist, stop takingDianbenand consult your doctor.

Common side effects (may affect up to 1 in 10 people):

• changes in taste.
• low or decreased vitamin B12 levels in the blood (symptoms may include extreme fatigue, red and painful tongue, numbness or pale or yellowish skin). Your doctor may schedule some tests to find the reason for your symptoms because some of them may be caused by diabetes or other health problems unrelated to the medicine.

Very rare side effects (may affect up to 1 in 10,000 people):

• lactic acidosis. It is a very rare but serious complication, especially if your kidneys are not working properly. The symptoms of lactic acidosis are non-specific (see section "Warnings and precautions").
• liver function test changes or hepatitis (inflammation of the liver; this can cause fatigue, loss of appetite, weight loss, with or without a yellowish tint to the skin or the whites of the eyes). If this happens to you, stop taking Dianben and talk to your doctor.
• skin reactions such as skin redness (erythema), itching, or an itchy rash (urticaria).

Children and adolescents

Limited data in children and adolescents showed that the side effects were similar in nature and severity to those observed in adults.

Reporting of side effects

If you experience any side effects, talk to your doctor or pharmacist, even if it is possible side effects not listed in this leaflet. You can also report them directly through the Spanish Pharmacovigilance System for Human Use Medicines: www.notificaRAM.es. By reporting side effects, you can help provide more information on the safety of this medicine.

5. Storing Dianben

Keep this medicine out of the sight and reach of children. If a child is being treated with Dianben, it is recommended that parents and caregivers supervise how this medicine is used.

No special storage conditions are required.

Do not use this medicine after the expiry date which is stated on the carton after "EXP". The expiry date is the last day of the month indicated.

Medicines should not be disposed of via wastewater or household waste. Place the cartons and any remaining medicine in the SIGRE collection point at your pharmacy. If you have any further questions, ask your pharmacist how to dispose of the cartons and any remaining medicine. This will help protect the environment.

6. Packaging Contents and Additional Information

Dianben Composition

• The active ingredient is metformin hydrochloride. One Dianben 850 mg film-coated tablet contains 850 mg of metformin hydrochloride, equivalent to 662.9 mg of metformin base.
• The other ingredients are povidone K 30, magnesium stearate, and hypromellose.

Product Appearance and Packaging Contents

Dianben 850 mg film-coated tablets are white, circular, and convex.

The tablets are supplied in blister packs of 1 (x100), 8, 9, 10, 14, 20, 21, 30, 40, 50, 56, 60, 84, 90, 100, 120, 300, 600, or 1000 tablets, and in plastic bottles with child-resistant caps of 30, 60, 200, 300, or 600 tablets.

Only some pack sizes may be marketed.

Marketing Authorization Holder and Manufacturer

Marketing Authorization Holder

Merck Santé s.a.s.

37 Rue Saint Romain

F-69008 Lyon

France

Manufacturer

Merck Santé s.a.s.

2 rue du Pressoir Vert

45400 Semoy

France

or

Merck Healthcare KGaA

Frankfurter Str. 250

64293 Darmstadt

Germany

or

Merck, S.L.

Polígono Merck

08100 Mollet del Vallés

(Barcelona)

Spain

or (only for Greece)

• Petsiavas S.A.

Agion Anargiron 21, Kaliftaki

Kato Kifisia Attiki 14564

Greece

Further information about this medicinal product can be obtained from the local representative of the marketing authorization holder:

Merck, S.L.

María de Molina, 40

28006 Madrid

Spain

This medicinal product is authorized in the Member States of the European Economic Area and in the United Kingdom (Northern Ireland) under the following names:

Spain: Dianben

Austria, Belgium, Bulgaria, Cyprus, Czech Republic, France, Germany, Greece, Iceland, Ireland, Italy, Luxembourg, Norway, Poland, Romania, Slovakia, Slovenia, Sweden, United Kingdom (Northern Ireland): Glucophage

Hungary: Merckformin

Portugal: Risidon

Date of last revision of this leaflet:03/2025.

Other sources of information

Detailed and up-to-date information on this medicinal product is available on the website of the Spanish Agency for Medicines and Health Products (AEMPS) http://www.aemps.gob.es/