Metta SR Dosage/Direction for Use

Monotherapy and Combination with Other Oral Antidiabetic Agents: The usual starting dose is one tablet of Metformin SR 500 mg once daily.
After 10 to 15 days the dose should be adjusted on the basis of blood glucose measurements. A slow increase of dose may improve gastro-intestinal tolerability. The maximum recommended dose is 4 tablets of Metformin SR 500 mg daily.
Dosage increases should be made in increments of 500 mg every 10-15 days, up to a maximum of 2000 mg once daily with the evening meal. If glycaemic control is not achieved on Metformin SR 2000 mg once daily, Metformin SR 1000 mg twice daily should be considered, with both doses being given with food. If glycaemic control is still not achieved, patients may be switched to standard metformin tablets to a maximum dose of 3000 mg daily.
In patients already treated with metformin tablets, the starting dose of Metformin SR should be equivalent to the daily dose of metformin immediate release tablets. In patients treated with metformin at a dose above 2000 mg daily, switching to Metformin SR is not recommended.
If transfer from another oral antidiabetic agent is intended: discontinue the other agent and initiate Metformin SR at the dose indicated above.
Metformin SR 750 mg is intended for patients who are already treated with metformin tablets (prolonged or immediate release).
The dose of Metformin SR 750 mg should be equivalent to the daily dose of metformin tablets (prolonged or immediate release), up to a maximum dose of 1500 mg, given with the evening meal.
Combination with Insulin: Metformin and insulin may be used in combination therapy to achieve better blood glucose control. The usual starting dose of Metformin SR is one 500 mg tablet once daily, while insulin dosage is adjusted on the basis of blood glucose measurements.
For patients already treated with metformin and insulin in combination therapy, the dose of Metformin SR 750 mg should be equivalent to the daily dose of metformin tablets up to a maximum of 1500 mg, given with the evening meal, while insulin dosage is adjusted on the basis of blood glucose measurements.
Elderly: due to the potential for decreased renal function in elderly subjects, the metformin dosage should be adjusted based on renal function. Regular assessment of renal function is necessary.
Children: In the absence of available data, Metformin SR should not be used in children.