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Combination with insulin:
Metformin and insulin may be used in combination therapy to achieve better blood glucose control. Metformin hydrochloride is given at the usual starting dose of 500 mg or 850 mg 2 or 3 times daily, while insulin dosage is adjusted on the basis of blood glucose measurements.
It is important that the tablets are taken in divided doses with meals. Your doctor will tell you if you need to increase the dose. 500 mg three times a day is often sufficient to obtain diabetic control. The maximum recommended daily dose is 1 g three times per day. Once control has been obtained, the dosage should be reviewed and reduced to the lowest maintenance level consistent with good diabetic control.
Monotherapy and combination with other oral antidiabetic agents:
The usual starting dose for adults is 500 mg or 850 mg metformin hydrochloride 2 or 3 times daily given during or after meals. After 10 to 15 days the dose should be adjusted on the basis of blood glucose measurements. A slow increase of dose may improve gastrointestinal tolerability. In patients receiving a high metformin hydrochloride dose (2 to 3 grams per day), it is possible to replace two Glucophage 500 mg doses with one Glucophage 1000 mg dose. The maximum recommended dose of metformin hydrochloride is 3 g daily, taken as 3 divided doses.
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