Metformindosage

Adult Dosage for RIOMET:

Starting dose: 500 mg (5 mL) orally twice a day or 850 mg (8.5 mL) once a day, with meals

Increase the dose in increments of 500 mg (5 mL) weekly or 850 mg (8.5 mL) every 2 weeks, up to a maximum dose of 2,550 mg (25.5 mL) per day, given in divided doses

Doses above 2,000 mg (20 mL) may be better tolerated given in divided doses 3 times a day with meals Pediatric Dosage for RIOMET:

Starting dose: 500 mg (5 mL) orally twice a day, with meals

Increase dosage in increments of 500 mg (5 mL) weekly up to a maximum of 2,000 mg (20 mL) per day, given in divided doses twice daily Renal Impairment:

Prior to initiation, assess renal function with estimated glomerular filtration rate (eGFR)

Do not use in patients with eGFR below 30 mL/minute/1.73 m 2

Initiation is not recommended in patients with eGFR between 30 to 45 mL/minute/1.73 m 2

Assess risk/benefit of continuing RIOMET if eGFR falls below 45 mL/minute/1.73 m 2

Discontinue if eGFR falls below 30 mL/minute/1.73 m 2 Discontinuation for Iodinated Contrast Imaging Procedures:

RIOMET may need to be discontinued at time of, or prior to, iodinated contrast imaging procedures

2.1 Adult Dosage •

Measure the RIOMET dose in the RIOMET specific dosing cup.

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.

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.

Doses above 2,000 mg (20 mL) may be better tolerated given in divided doses 3 times a day with meals.

2.2 Pediatric

Dosage

Measure the RIOMET dose in the RIOMET specific dosing cup.

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.

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.

2.3 Recommendations for

Use in Renal Impairment

Assess renal function prior to initiation of RIOMET and periodically thereafter.

RIOMET is contraindicated in patients with an estimated glomerular filtration rate (eGFR) below 30 mL/minute/1.73 m 2.

Initiation of RIOMET in patients with an eGFR between 30 to 45 mL/minute/1.73 m 2 is not recommended.

In patients taking RIOMET whose eGFR later falls below 45 mL/min/1.73 m 2, assess the benefit risk of continuing therapy.

Discontinue RIOMET if the patient’s eGFR later falls below 30 mL/minute/1.73 m 2.

2.4 Discontinuation for

Iodinated Contrast Imaging Procedures

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 m 2; 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.