Compositions and methods of treating metabolic disorders
Methods for improving the gastrointestinal tolerability of biguanide compounds and for treating metabolic disorders and/or inducing weight loss in patients in need thereof, particularly in individuals having a contraindication for treatment with biguanide compounds, are provided comprising administering delayed release formulations of such biguanide compounds, including metformin, targeted to the small intestine.
1. A method of treating a renally impaired subject having diabetes, comprising administering a therapeutically effective amount of metformin or a salt thereof to said subject in a formulation targeted for delivery to the distal small intestine, wherein said formulation comprises an oral dosage form enterically coated at a pH at or above 6.0 or 6.5, and wherein the metformin has a reduced relative average bioavailability of about 40, 50 or 60% in said formulation in comparison with an immediate-release formulation having the same amount of metformin or salt thereof.
2. The method according to claim 1 , wherein the administration produces a mean plasma AUC 0-36 less than about 14,000, 13,000 or 12,000 ng*h/mL when said formulation is administered at 500 mg twice daily.
3. The method according to claim 1 , wherein the administration produces a mean C max less than about 800, 700 or 600 ng/mL when said formulation is administered at 500 mg twice daily.
4. The method according to claim 1 , wherein said oral dosage form further comprises a modified release component for at least a portion of said metformin or a salt thereof.
5. The method according to claim 1 , wherein the oral dosage form comprises less than 500 mg of metformin or a salt thereof.
6. A method according to claim 1 , further comprising administration of a DPP-IV inhibitor.
7. A method according to claim 1 , further comprising administration of an anti-obesity or anti-diabetes agent.
8. The method according to claim 1 , wherein said metformin or a salt thereof is metformin hydrochloride.