Drug Detail:Riomet (Metformin [ met-for-min ])
Generic Name: METFORMIN HYDROCHLORIDE 500mg in 5mL
Dosage Form: oral solution
Drug Class: Non-sulfonylureas
Adult Dosage
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- Measure the RIOMET dose in the RIOMET specific dosing cup.
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- The recommended starting dose of RIOMET is 500 mg (5 mL) orally twice a day or 850 mg (8.5 mL) once a day, given with meals.
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- Increase the dose in increments of 500 mg (5 mL) weekly or 850 mg (8.5 mL) every 2 weeks on the basis of glycemic control and tolerability, up to a maximum dose of 2,550 mg (25.5 mL) per day, given in divided doses.
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- Doses above 2,000 mg (20 mL) may be better tolerated given in divided doses 3 times a day with meals.
Pediatric Dosage
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- Measure the RIOMET dose in the RIOMET specific dosing cup.
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- The recommended starting dose of RIOMET for pediatric patients 10 years of age and older is 500 mg (5 mL) orally twice a day, given with meals.
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- Increase dosage in increments of 500 mg (5 mL) weekly on the basis of glycemic control and tolerability, up to a maximum of 2,000 mg (20 mL) per day, given in divided doses twice daily.
Recommendations for Use in Renal Impairment
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- Assess renal function prior to initiation of RIOMET and periodically thereafter.
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- RIOMET is contraindicated in patients with an estimated glomerular filtration rate (eGFR) below 30 mL/minute/1.73 m2.
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- Initiation of RIOMET in patients with an eGFR between 30 to 45 mL/minute/1.73 m2 is not recommended.
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- In patients taking RIOMET whose eGFR later falls below 45 mL/min/1.73 m2, assess the benefit risk of continuing therapy.
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- Discontinue RIOMET if the patient’s eGFR later falls below 30 mL/minute/1.73 m2 [see Warnings and Precautions (5.1)].
Discontinuation for Iodinated Contrast Imaging Procedures
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- Discontinue RIOMET at the time of, or prior to, an iodinated contrast imaging procedure in patients with an eGFR between 30 and 60 mL/min/1.73 m2; in patients with a history of liver disease, alcoholism, or heart failure; or in patients who will be administered intra-arterial iodinated contrast. Re-evaluate eGFR 48 hours after the imaging procedure; restart RIOMET if renal function is stable.