Metformin Hydrochloride and Palladone

• Generic Name: metformin
• Dosage Forms: n.a.
• Other Brand Names: Fortamet, Glucophage, Glucophage XR, Glumetza, Riomet, Glumetza. Riomet

Used as an adjunct to diet and exercise for the management of type 2 diabetes mellitus.

May be used in combination with a sulfonylurea, repaglinide, a thiazolidinedione antidiabetic agent, a dipeptidyl peptidase-4 [DPP-4] inhibitor, a glucagon-like peptide-1 (GLP-1) agonist, or a sodium-glucose cotransporter-2 [SGLT2] inhibitor for the management of type 2 diabetes mellitus in patients who do not achieve adequate glycemic control on monotherapy with metformin or any of these drugs. Also used concomitantly with nateglinide.

May be used with insulin to improve glycemic control and/or decrease the required dosage of insulin.

Commercially available in fixed combination with glyburide or glipizide for use as an adjunct to diet and exercise in adults with type 2 diabetes mellitus. May add a thiazolidinedione antidiabetic agent if patient has inadequate glycemic control with fixed-combination metformin/glyburide therapy.

Commercially available in fixed combination with rosiglitazone for use when treatment with both rosiglitazone and metformin is appropriate.

Commercially available in fixed combination with pioglitazone (as immediate- or extended-release tablets) for use as an adjunct to diet and exercise in patients with type 2 diabetes mellitus who have inadequate glycemic control with pioglitazone or metformin monotherapy or in those who are already receiving pioglitazone and metformin concurrently as separate components.

Commercially available in fixed combination with repaglinide for use as an adjunct to diet and exercise in patients with type 2 diabetes mellitus who are already receiving repaglinide and metformin concurrently as separate components or in those who have inadequate glycemic control with repaglinide or metformin monotherapy.

Commercially available in fixed combination with the DPP-4 inhibitors alogliptin, linagliptin, saxagliptin, or sitagliptin for use as an adjunct to diet and exercise when treatment with both drug components is appropriate.

Commercially available in fixed combinations with the SGLT2 inhibitors canagliflozin, dapagliflozin, empagliflozin, or ertugliflozin for use when treatment with both drugs components is appropriate.

Metformin generally is the preferred initial oral antidiabetic agent for patients with type 2 diabetes mellitus. Potential advantages of metformin compared with sulfonylureas or insulin include minimal risk of hypoglycemia, more favorable effects on serum lipids, reduction of hyperinsulinemia, and weight loss or lack of weight gain.

Not effective as sole therapy in patients with diabetes mellitus complicated by acidosis, ketosis, or coma.

Has been used in the management of metabolic and reproductive abnormalities associated with polycystic ovary syndrome.

• Generic Name: hydromorphone
• Dosage Forms: capsule, extended release
• Other Brand Names: Dilaudid, Exalgo, Hydrostat IR, Dilaudid-HP

Hydromorphone oral liquid and tablets are used to relieve pain. The hydromorphone extended-release capsules and extended-release tablets are used to relieve pain in opioid-tolerant patients severe enough to require around-the-clock pain relief for a long period of time.

Hydromorphone extended-release capsules and extended-release tablets should not be used if you need pain medicine for just a short time, such as when recovering from surgery. Do not use this medicine to relieve mild pain. This medicine should not be used to treat pain that you only have once in a while or "as needed".

Hydromorphone belongs to the group of medicines called narcotic analgesics (pain medicines). It acts on the central nervous system (CNS) to relieve pain.

When a narcotic medicine is used for a long time, it may become habit-forming, causing mental or physical dependence. However, people who have continuing pain should not let the fear of dependence keep them from using narcotics to relieve their pain. Mental dependence (addiction) is not likely to occur when narcotics are used for this purpose. Physical dependence may lead to withdrawal side effects if treatment is stopped suddenly. However, severe withdrawal side effects can usually be prevented by gradually reducing the dose over a period of time before treatment is stopped completely.

This medicine is available only under a restricted distribution program called the Opioid Analgesic REMS (Risk Evaluation and Mitigation Strategy) program.