Iruka

Metformin, the active ingredient in Iruka, is a biguanide presented as an oral tablet for oral use. It is used to improve blood glucose control in adults with type 2 diabetes mellitus. GNH USA supplies Iruka as a licensed, GDP‑compliant international pharmaceutical supplier serving hospitals, pharmacies and clinics worldwide.

Metformin is an oral antidiabetic that acts on glucose metabolism in type 2 diabetes and related insulin‑resistant conditions. - Type 2 diabetes mellitus: lowers fasting and post‑prandial blood glucose levels. - Prediabetes (impaired glucose tolerance): helps delay progression to overt diabetes. - Polycystic ovary syndrome (PCOS): improves insulin sensitivity and may regularise menstrual cycles.

Metformin is generally well tolerated, but a range of adverse reactions have been reported.

Common Side Effects: - Gastrointestinal upset: nausea, abdominal discomfort, and loss of appetite. - Diarrhea: frequent loose stools, especially during treatment initiation. - Metallic taste: transient alteration of taste perception. - Vitamin B12 deficiency: gradual reduction in serum B12 levels with long‑term use.

Serious or Rare Side Effects: - Lactic acidosis: a rare but life‑threatening accumulation of lactate. - Severe skin reactions: such as Stevens‑Johnson syndrome or toxic epidermal necrolysis. - Hepatic dysfunction: marked elevation of liver enzymes or hepatitis.

Metformin requires careful monitoring in several clinical situations. - Renal function: assess creatinine clearance before initiation and periodically thereafter. - Hepatic function: evaluate liver enzymes as impaired liver may increase lactic acidosis risk. - Heart failure: avoid in decompensated heart failure due to reduced perfusion. - Vitamin B12 status: monitor levels during long‑term therapy. - Pregnancy and lactation: use only if clearly needed after risk‑benefit assessment. - Store at room temperature: keep in the original container, protect from moisture and heat.

Metformin may interact with several medicines, altering its efficacy or safety.

Major Interactions (Avoid): - Alcohol: potentiates risk of lactic acidosis. - Iodinated contrast agents: can cause acute renal impairment, increasing metformin exposure. - Cimetidine: may raise plasma metformin concentrations.

Moderate Interactions (Monitor Closely): - Sulfonylureas: additive hypoglycaemic effect, monitor blood glucose. - Beta‑blockers: may mask hypoglycaemia symptoms. - Diuretics (especially thiazides): can affect renal clearance of metformin. - ACE inhibitors/ARBs: monitor renal function when combined.