Not reported

Treatment of Type II diabetes with metamorfmin

With metmorfin- Tremor, headache, dizziness, nausea, hypoglycemia With sulfonyl urea- Tremor, headache, dizziness, asthenia, hypoglycemia With glitazone- Weight gain, peripheral odema

Moderate or severe renal impairment Dialysis patients with end stage renal disease, hepatic impairment Congestive heart failure ( NYHA class III- IV ) Diabetic ketoacidosis Pregnancy, Lactation

Special Precautions-

Measure liver enzymes before treatment, every 3 months during first year and then periodically If tranaminase levels increased , monitor frequently until return to normal.

Withdraw and do not re- start, if persistent incrrease in ALT or AST equals or over 3 times ULN, or if the patient develops jaundice or other suggestive of liver dysfunction. Congestive heart failure ( NYHA - Class I -II ) Elderly

Dosage-

100mg daily (50mg morning and evening)

With a sulfonylurea- 50mg once daily in the morning Patients under 18 years not recommended 9 (

Contraindicated for use during pregnancy and lactation Observe caution