Adult Initially 500 mg bid or tid or 850 mg once daily or bid, gradually increased of at least 1 wk interval to 2-3 g daily. To reduce GI effects in the beginning of therapy, start dose of 500 mg for at least 1 wk is recommended, then increased gradually to 500 mg bid & can be further increased as necessary up to a max of 2 g daily. Childn ≥10 yr Initially 500 or 850 mg once daily or 500 mg bid. May gradually increased of at least 1-wk interval to a max of 2 g daily in 2 or 3 divided doses.
Diabetic coma & ketoacidosis, severe infection, trauma or other severe conditions. Conditions associated w/ hypoxia eg, acute heart failure, recent MI or shock. Avoid excessive alcohol intake. May increase risk of lactic acidosis. Temporarily stop therapy 48 hr before & after exam using contrast media. Annual monitoring of vit B2 conc during long-term treatment. Renal & hepatic impairment.
Increased risk of hypoglycemia w/ other drugs that lower blood glucose conc. May reduce effect of therapy w/ drugs that increase blood glucose. Increased risk of lactic acidosis & hypoglycemia w/ alcohol. Concomitant use w/ other drugs that may impair renal function.
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