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Metformin extended release

  • Adis Drug Profile
  • Published:
American Journal of Drug Delivery

Abstract

  • ▲ Metformin extended release (metformin ER) is a novel gastric-retentive formulation of the antihyperglycemic agent that can be administered once daily. The polymer matrix of the metformin ER 500mg tablet swells in gastric fluid, causing it to be retained in the stomach in the fed state. Over a period of ≈8 hours, the drug dissolves and diffuses through the matrix to be absorbed in the upper gastrointestinal tract.

  • ▲ Systemic exposure to the drug (assessed by the area under the plasma concentration-time curve) with oral metformin ER 1000mg once daily did not differ from that of immediate-release metformin (metformin IR) 1000 mg/day administered as a divided dose. However, the time to maximum plasma concentration was 7.5 hours with metformin ER versus 4.2 hours with metformin IR.

  • ▲ Glycemic control, measured by change from baseline in mean glycosylated hemoglobin (HbA1c) levels at study endpoint, with metformin ER 1500 mg/day (once daily or as divided doses morning and night) or 2000 mg/day (once daily) did not differ from that with metformin IR 1500 mg/day as a divided dose in a 24-week, double-blind, randomized trial in 706 patients with type 2 diabetes mellitus.

  • ▲ In the same study, the American Diabetes Association-recommended HbA1c level of <7% was achieved in significantly more metformin ER 2000 mg/day than metformin IR 1500 mg/day recipients.

  • ▲ Greater glycemic control was seen with metformin ER 1500–2000 mg/day plus glyburide (glibenclamide) than with glyburide plus placebo in a 24-week, double-blind, randomized trial in 575 patients with type 2 diabetes.

  • ▲ Metformin ER is generally well tolerated, with an adverse event profile similar to that of metformin IR. Of interest, the incidence of nausea was significantly lower with metformin ER than with metformin IR in the first week of treatment, suggesting that more rapid dose titration may be possible with metformin ER. The incidence of adverse events with metformin ER 2000 mg/day did not differ from that with metformin IR 1500 mg/day.

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Notes

  1. The use of trade names is for product identification purposes only and does not imply endorsement.

References

  1. American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care 2006 Jan; 29Suppl. 1: S43–8

    Google Scholar 

  2. DeFronzo RA. Pathogenesis of type 2 diabetes: implications for metformin. Drugs 1999; 58Suppl. 1: 29–30

    Article  PubMed  CAS  Google Scholar 

  3. Wild S, Roglic G, Green A, et al. Global prevalence of diabetes: estimates for the year 2000 and projections for 2030. Diabetes Care 2004 May; 27(5): 1047–53

    Article  PubMed  Google Scholar 

  4. Centers for Disease Control and Prevention. National diabetes fact sheet: general information and national estimates on diabetes in the United States, 2005. Atlanta (GA): US Department of Health and Human Services, Centers for Disease Control and Prevention, 2005

  5. American Diabetes Association. Standards of medical care in diabetes. Diabetes Care 2006 Jan; 29Suppl. 1: S4–S42

    Google Scholar 

  6. Mcintosh A, Hutchinson A, Home PD, et al. Clinical guidelines and evidence review for type 2 diabetes: management of blood glucose. Sheffield: ScHARR, University of Sheffield, 2001 [online]. Available from URL: http://www.shef.ac.uk/guidelines/ [Accessed 2006 Jul 28]

  7. The American Association of Clinical Endocrinologists medical guidelines for the management of diabetes mellitus: the AACE system of intensive diabetes self-management–2002 update. Endocr Pract 2002; 8Suppl. 1: 40–82

  8. Effect of intensive blood-glucose control with metformin on complications in overweight patients with type 2 diabetes (UKPDS 34). UK Prospective Diabetes Study (UKPDS) Group. Lancet 1998 Sep 12; 352(9131): 854–65

    Article  Google Scholar 

  9. Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). UK Prospective Diabetes Study (UKPDS) Group. Lancet 1998 Sep 12; 352(9131): 837–53

    Article  PubMed  Google Scholar 

  10. Resnick HE, Foster GL, Bardsley J, et al. Achievement of American Diabetes Association clinical practice recommendations among U.S. adults with diabetes, 1999–2002: the National Health and Nutrition Examination Survey. Diabetes Care 2006 Mar; 29 (3): 531–7

  11. Guillausseau PJ. Impact of compliance with oral antihyperglycemic agents on health outcomes in type 2 diabetes mellitus: a focus on frequency of administration. Treat Endocrinol 2005; 4(3): 167–75

    Article  PubMed  CAS  Google Scholar 

  12. Hundal RS, Inzucchi SE. Metformin: new understandings, new uses. Drugs 2003; 63(18): 1879–94

    Article  PubMed  CAS  Google Scholar 

  13. Nathan DM, Buse JB, Davidson MB, et al. Management of hyperglycemia in type 2 diabetes: a consensus algorithm for the initiation and adjustment of therapy. A consensus statement from the American Diabetes Association and the European Association for the Study of Diabetes. Diabetes Care 2006 Aug; 29(8): 1963–72

    Article  PubMed  Google Scholar 

  14. Bristol-Myers Squibb Company. Glucophage® (metformin hydrochloride tablets) and Glucophage® XR (metformin hydrochloride extended release tablets) prescribing information. Princeton (NJ): Bristol-Myers Squibb Company, 2004

    Google Scholar 

  15. Blonde L, Dailey GE, Jabbour SA, et al. Gastrointestinal tolerability of ER metformin tablets compared to immediate-release metformin tablets: results of a retrospective cohort study. Curr Med Res Opin 2004 Apr; 20(4): 565–72

    Article  PubMed  CAS  Google Scholar 

  16. Scheen AJ. Clinical pharmacokinetics of metformin. Clin Pharmacokinet 1996 May; 30(5): 359–71

    Article  PubMed  CAS  Google Scholar 

  17. Hou SY, Cowles VE, Berner B. Gastric retentive dosage forms: a review. Crit Rev Ther Drug Carrier Syst 2003; 20(6): 459–97

    Article  PubMed  Google Scholar 

  18. Talukder R, Fassihi R. Gastroretentive delivery systems: a mini review. Drug Dev Ind Pharm 2004; 30(10): 1019–28

    Article  PubMed  CAS  Google Scholar 

  19. Gusler G, Gorsline J, Levy G, et al. Pharmacokinetics of metformin gastric-retentive tablets in healthy volunteers. J Clin Pharmacol 2001 Jun; 41(6): 655–61

    Article  PubMed  CAS  Google Scholar 

  20. Dunn CJ, Peters DH. Metformin: a review of its pharmacological properties and therapeutic use in non-insulin-dependent diabetes mellitus. Drugs 1995 May; 49(5): 721–49

    Article  PubMed  CAS  Google Scholar 

  21. Schwartz S, Fonseca V, Berner B, et al. Efficacy, tolerability, and safety of a novel once-daily ER metformin in patients with type 2 diabetes. Diabetes Care 2006 Apr; 29(4): 759–64

    Article  PubMed  CAS  Google Scholar 

  22. Klausner EA, Lavy E, Friedman M, et al. Expandable gastroretentive dosage forms. J Controlled Release 2003; 90(2): 143–62

    Article  CAS  Google Scholar 

  23. Wu J. Gastric retentive dosage forms. Drug Delivery Supplement. Cambridge: PJB Publications, 2005: 18–9

    Google Scholar 

  24. Foster RH, Keam SJ. Prolonged-release ciprofloxacin. Am J Drug Delivery 2006; 4(2): 113–20

    Article  CAS  Google Scholar 

  25. Depomed, Inc. Technology: overview [online]. Available from URL: http://www.depomedinc.com/products_overview.htm [Accessed 2006 Jul 3]

  26. Depomed, Inc. Technology: diffusional [online]. Available from URL: http://www.depomedinc.com/technology_diffusional.htm [Accessed 2006 Jul 3]

  27. Depomed, Inc. Technology: erosional [online]. Available from URL: http://www.depomedinc.com/technology_erosional.htm [Accessed 2006 Jul 3]

  28. Wagstaff AJ, Figgitt DP. ER metformin hydrochloride: single-composition osmotic tablet formulation. Treat Endocrinol 2004; 3(5): 327–32

    Article  PubMed  CAS  Google Scholar 

  29. Depomed, Inc. Glumetza™ (metformin hydrochloride ER tablets). Prescribing information. Menlo Park (CA): Depomed, Inc., 2006 Apr

    Google Scholar 

  30. Biovail Pharmaceuticals Canada. Once-daily Glumetza™ (metformin hydrochloride 500mg tablets). Summary product information. Mississauga (ON): Biovail Pharmaceuticals Canada, 2005

    Google Scholar 

  31. Biovail Corporation. Biovail launches Glumetza to Canadian physicians [media release]. Available from URL: http://www.biovail.com [Accessed 2006 Apr 19]

  32. Shell JW, Louie-Helm J, Markey M. Extending the duration of drug release within the stomach during the fed mode. United States Patent 6,635,280 B2. [online]. Available from URL: http://www.uspto.gov/patft/index.html [Accessed 2006 Mar 28]

  33. Berner B, Louie-Helm J. Tablet shapes to enhance gastric retention of swellable controlled-release oral dosage forms. United States Patent 6,488,962 B2 [online]. Available from URL: http://patft.uspto.gov [Accessed 2006 Mar 28]

  34. Gusler G, Berner B, Chau M. Optimal polymer mixtures for gastric retentive tablets. United States Patent 6,723,340 B2 [online]. Available from URL: http://www.uspto.gov/patft/index.html [Accessed 2006 Mar 28]

  35. Hou S, Gusler GM, Wilding IR, et al. Gastric retention and pharmacokinetics of a novel ER metformin formulation [abstract no. 905]. The Endocrine Society’s 88th Annual Meeting; 2006 Jun 24–27; Boston (MA)

  36. Gusler G, Hou SYE, Connor AL, et al. Pharmacoscintigraphic evaluation of metformin ER in healthy volunteers [abstract R6054]. Pharm Sci 2003; 5 Suppl. 1 [online]. Available from URL: http://www.aapspharmsci.org/ [Accessed 2006 Jul 28]

    Google Scholar 

  37. Schwartz S, Wu J, Berner B. ER metformin for the treatment of type 2 diabetes mellitus. Expert Opin Pharmacother 2006 Apr; 7(6): 803–9

    Article  PubMed  CAS  Google Scholar 

  38. Wiernsperger NF, Bailey CJ. The antihyperglycaemic effect of metformin: therapeutic and cellular mechanisms. Drugs 1999; 58 Suppl. 1: 31–9; discussion 75-82

    Article  PubMed  CAS  Google Scholar 

  39. Biovail Laboratories, Inc.. NDA 21-748. Glumetza™ (metformin hydrochloride) extended release tablets 500mg and 1000mg. 2.7.1 Summary of biopharmaceutic studies and associated analytical methods. (Data on file). Mississauga (ON): Biovail Laboratories, Inc., 2005

    Google Scholar 

  40. Berner B, Cramer M, Chiang Y, et al. Addition of once-daily ER metformin to sulfonylurea treatment significantly improves glycemic control in patients with type 2 diabetes mellitus. (Data on file). Menlo Park (CA): Depomed, Inc., 2006

    Google Scholar 

  41. Schwartz S, Berner B, Cramer M, et al. Addition of once-daily ER metformin to sulfonylurea significantly improves glycemic control in patients with type 2 diabetes [abstract no. 1999-PO]. Diabetes 2006 Jun; 55 Suppl. 1: A463

    Google Scholar 

  42. Biovail Pharmaceuticals Canada. Product monograph Glumetza™ (metformin hydrochloride) ER tablets 500 mg and 1000 mg. Mississauga (ON): Biovail Pharmaceuticals Canada, 2005 May 31 Available from URL: http://www.biovail.com [Accessed 2006 Jul 27]

    Google Scholar 

  43. Depomed, Inc.. Depomed study 81-0013. (Data on file). Menlo Park (CA): Depomed, Inc., 2006

    Google Scholar 

  44. Depomed, Inc. Glumetza™ clinical and pharmacokinetic data. (Data on file). Menlo Park (CA): Depomed, Inc., 2006

    Google Scholar 

  45. Protocol 81-0003: final report. (Data on file). Menlo Park (CA): Depomed, Inc., 2003 Jul 11

  46. Depomed, Inc. Depomed study 81-0014. (Data on file). Menlo Park (CA): Depomed, Inc., 2006

    Google Scholar 

  47. Fujioka K, Brazg RL, Raz I, et al. Efficacy, dose-response relationship and safety of once-daily ER metformin (Glucophage XR) in type 2 diabetic patients with inadequate glycaemic control despite prior treatment with diet and exercise: results from two double-blind, placebo-controlled studies. Diabetes Obes Metab 2005 Jan; 7(1): 28–39

    Article  PubMed  CAS  Google Scholar 

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Correspondence to Rachel H. Foster.

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Foster, R.H., Keam, S.J. Metformin extended release. Am J Drug Deliv 4, 177–186 (2006). https://doi.org/10.2165/00137696-200604030-00005

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