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Metvis SR is a sustained-release formulation of metformin, an oral biguanide antihyperglycemic agent developed and marketed by V.S. International (V.S. Pharma). It is primarily indicated for the management of type 2 diabetes mellitus. Metformin works by decreasing hepatic glucose production, decreasing intestinal absorption of glucose, and improving insulin sensitivity by increasing peripheral glucose uptake and utilization. At the molecular level, metformin inhibits mitochondrial complex I of the electron transport chain, leading to an increase in the AMP:ATP ratio and subsequent activation of AMP-activated protein kinase (AMPK). It also directly binds to presenilin enhancer protein 2 (PEN2), forming a complex that inhibits lysosomal v-ATPase and activates AMPK in an AMP-independent manner.
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