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Hiv & Aids Information :: A To Z Of Other Drugs - Metformin Hydrochoride (glucophage / Glucophage Sr)

Metformin hydrochoride (Glucophage / Glucophage SR) Metformin hydrochoride (Glucophage / Glucophage SR) Metformin hydrochoride (Glucophage / Glucophage SR) is an anti-diabetes drug. It is particularly useful in treating diabetes in patients with insulin resistance and obesity. Metformin can be taken alone, or if this is not effective, in combination with other drugs such as rosiglitazone (Avandia). Metformin and rosiglitazone are available in a combination tablet called Avandamet, manufactured by GlaxoSmithKline. The way in which metformin works is uncertain, although it is thought to reduce the bodys rate of glucose production in the liver. It also reduces the rate of glucose absorption from the gut. Metformin can reduce the insulin resistance that can occur as a side-effect of HIV treatment, notably with protease inhibitors. The drug can also improve perturbations of blood fat and sugar levels that can occur with HIV treatment, particularly by reducing triglyceride levels. These improvements can reduce the chance that a patient will suffer a stroke or heart attack. Metformin also reduces fat accumulation around the internal organs. However, it can worsen fat loss from under the skin, a more worrying aspect of fat redistribution for most HIV-positive patients. 1 2 3 4 5 Side-effects of metformin include diarrhoea, stomach pain, nausea and vomiting. These can be reduced by taking the drug with or after food. Metformin can also cause elevated levels of lactic acid in the blood, although this is usually only seen in patients with liver, heart or kidney problems. However, lactic acidosis is also a side-effect of some nucleoside reverse transcriptase inhibitors (NRTIs), notably ddI (didanosine, Videx / VidexEC) and d4T (stavudine, Zerit). Patients taking these drugs with m Continue reading >>

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Diabetes Drugs: Metformin

Editor’s Note: This is the second post in our miniseries about diabetes drugs. Tune in on August 21 for the next installment. Metformin (brand names Glucophage, Glucophage XR, Riomet, Fortamet, Glumetza) is a member of a class of medicines known as biguanides. This type of medicine was first introduced into clinical practice in the 1950’s with a drug called phenformin. Unfortunately, phenformin was found to be associated with lactic acidosis, a serious and often fatal condition, and was removed from the U.S. market in 1977. This situation most likely slowed the approval of metformin, which was not used in the U.S. until 1995. (By comparison, metformin has been used in Europe since the 1960’s.) The U.S. Food and Drug Administration (FDA) required large safety studies of metformin, the results of which demonstrated that the development of lactic acidosis as a result of metformin therapy is very rare. (A finding that has been confirmed in many other clinical trials to date.) Of note, the FDA officer involved in removing phenformin from the market recently wrote an article highlighting the safety of metformin. Metformin works primarily by decreasing the amount of glucose made by the liver. It does this by activating a protein known as AMP-activated protein kinase, or AMPK. This protein acts much like an “energy sensor,” setting off cellular activities that result in glucose storage, enhanced entry of glucose into cells, and decreased creation of fatty acids and cholesterol. A secondary effect of the enhanced entry of glucose into cells is improved glucose uptake and increased storage of glycogen (a form of glucose) by the muscles. Additionally, the decrease in fatty acid levels brought about by metformin may indirectly improve insulin resistance and beta cell func Continue reading >>

Medication - Japan Message Board - Tripadvisor

First of all, why don't you ask your MD to change Metformin Hydrochloride oral solution to pills? That way you can carry them in your carryon bag without worrying about the liquid limitation. You should never put your Rx meds in checkin luggage in case they lose your luggage, so I recommend putting Metformin and Propranolol in your carry on. Antacid and anti-diarrhea meds can be easily obtained in a pharmacy anywhere in Japan , so I'd put them in the checkin luggage. Anyway all medications you mentioned can be brought into Japan without a Dr's letter or Rx (I'm a physician.) I don't know anything about Dubai, though. Sorry to jump in...you require a Narcotic certificate for any codiene or morphia based products. Some other medications reqire a Yakkan for import an example is prefilled syringe medication. The Japanese Consultant website via the .com.uk will have all the information and forms. Most the meds you mention are okay but you need to double check for yourself. If you try to bring in any pain medication with a morphia base like codiene and morphine it is frowned upon by customs. You have three weeks, if you need a Yakkan then get the forms filled and email marked urgent. The same with a Narcotic Certificate mark as urgent and they will email you a copy of the certificate. Yakkan was done in 48hrs and NC was two weeks. It's my poor understanding that morphia based products are more difficult to obtain in Japan than at home. In Austraila I can buy either 8 mg or 15mg tablets x 40 from a pharmacy from the pharmacist...in Japan you'd need a prescription for Panadiene (8mg). There have been people held up in customs for not having a Yakkan or Narcotic Certificate. Even with the forms you are asked a few questions and about 6 custom officers will crowd around you...my Continue reading >>

Metformin Forever

Metformin controls the insulin resistance of people who have type 2 diabetes so well that, if possible, all of us should be taking it. That’s what Roderic Crist, M.D., told me at the annual convention of the American Society of Bariatric Physicians in Denver this weekend. Dr. Crist specializes in family medicine in Cape Girardeau, Missouri. “Not everybody can take every drug,” he added, when I followed up our conversation by calling him at his office after he returned home. “But most of the time people can take metformin if they take it carefully.” Doctors increasingly prescribe it not only for type 2 diabetes but also for insulin resistance, polycystic ovary syndrome, and non-alcoholic fatty liver disease. Roughly one-third of Dr. Crist’s patients have diabetes. Well over half, if not two-thirds of the people he sees are insulin resistant. “I treat insulin resistance with that drug even if they aren’t fully diabetic.” he says. “If they have high triglyceride levels and low HDL levels, particularly if they are centrally obese, they should probably be on metformin. It helps slow the progression of the disease from one thing to the next.” But he goes further. He prescribes metformin to almost all of his patients who have type 2 diabetes — no matter how low their A1C level is. And he tells his patients that their levels should be 5.0 or less — not the American Diabetes Association’s less stringent recommendation of 7.0 or less. “If their A1C is at 5, their diabetes is in complete remission. So I have that as a goal.” And he still prescribes metformin to them after they reach that goal. “The two important issues are that it will prevent progression and it should be used in the earliest phases of insulin resistance. We vastly underutilize me Continue reading >>

Tips On Taking Metformin

For women trying to conceive with PCOS (Polycystic Ovarian Syndrome). Welcome to the JustMommies Message Boards. We pride ourselves on having the friendliest and most welcoming forums for moms and moms to be! Please take a moment and register for free so you can be a part of our growing community of mothers. If you have any problems registering please drop an email to [emailprotected] . Our community is moderated by our moderation team so you won't see spam or offensive messages posted on our forums. Each of our message boards is hosted by JustMommies hosts, whose names are listed at the top each board. We hope you find our message boards friendly, helpful, and fun to be on! Does anyone have any tips on taking metformin? I started my metformin, half a pill, and it has been awful. Lots of stomach upset, which I was told to expect, but I was wondering if there was any way I could stop those symptoms. I'm only on 1/2 a pill and at this rate, I will be 80 by the time I get up to the four pills per day that my doctor wants. Did anything work for you in preventing the side effects? My first book will be coming out in 2010, hopefully just in time for baby #3. There's really no way to make the side effects stop but there are things you can do to help alleviate them some. Some ladies have had good results by taking Imodium. I've never used it but when I was taking met I found it easier to take my met in the MIDDLE of my meals. I took it at lunch so I would eat half of my lunch, take my pill then eat the rest of my lunch. It really helped with the bathroom runs. And rest assured the side effects do ease up as your body gets used to the met. It took me about a month but other ladies see results within a couple weeks. Thanks. I will have to try mid meal. No problem yet with the ba Continue reading >>

Is Diarrhea A Symptom Of Diabetes?

Diabetes occurs when your body is unable to produce or use insulin. Insulin is a hormone that your pancreas releases when you eat. It allows your cells to absorb sugar. Your cells use this sugar to make energy. If your body isn’t able to use or absorb this sugar, it builds up in your blood. This causes your blood sugar levels to increase. The two types of diabetes are type 1 and type 2. People with either form of diabetes experience many of the same symptoms and complications. One such complication is diarrhea. About 22 percent of people with diabetes experience frequent diarrhea. Researchers are unsure whether this is related to issues in the small bowel or the colon. It’s unclear what causes persistent diarrhea in people who have diabetes. Most people have experienced diarrhea at one point in their lives. People with diabetes may often need to pass a significant amount of loose stool at night. Being unable to control a bowel movement, or having incontinence, is also common in people who have diabetes. Diarrhea may be regular, or it may alternate with periods of regular bowel movements. It may also alternate with constipation. Learn more: Diabetes and constipation: What’s the connection? » The cause for the connection between diabetes and diarrhea isn’t clear, but research suggests that neuropathy may be a factor. Neuropathy refers to numbness or pain resulting from nerve damage. If you have diabetes, high blood sugar levels can damage your nerve fibers. This generally occurs in the hands or feet. Issues with neuropathy are common causes for many of the complications that accompany diabetes. Another possible cause is sorbitol. People often use this sweetener in diabetic foods. Sorbitol has proven to be a potent laxative in amounts as small as 10 grams. An imba Continue reading >>

Metformin Side Effects

Metformin is the generic name of the prescription medications Glucophage, Glumetza, and Fortamet, used to control blood sugar in people with type 2 diabetes. Type 2 diabetes is a disease that occurs when the body does not produce or use insulin normally, which results in high blood sugar (glucose). Metformin works by decreasing the amount of sugar you absorb from food and reducing the amount of glucose your liver makes. It also increases your body's response to insulin. Metformin is in a class of medications called biguanides. It's sometimes used along with diet, exercise, and other medications to control blood glucose levels. It's also used to prevent the development of diabetes in people at high risk for the disease, treat polycystic ovary syndrome (PCOS), and control weight gain that occurs from taking certain drugs. The Food and Drug Administration (FDA) approved the medication in 1994. Metformin and PCOS (Polycystic Ovary Syndrome) Polycystic ovary syndrome (PCOS) is a common endocrine disorder that affects about one in 10 women of reproductive age. Women with PCOS may have enlarged ovaries containing fluid, or follicles. These fluids may cause infrequent or prolonged menstrual periods, excess hair growth, acne, and weight gain. The exact cause of PCOS is unknown, but the disorder has been linked to insulin resistance and excess insulin in the body. If you have insulin resistance, your body cannot use insulin effectively. As a result, your pancreas has to secrete more insulin to make glucose available to cells and tissues, including those that compose the ovaries. Researchers believe excess insulin may affect the ovaries by increasing androgen production, which may interfere with the ovaries' ability to ovulate. Because metformin can increase your body’s response Continue reading >>

Lactose In Pills Caused Distress

Q. I have had stomach pain and diarrhea for years, but over the last few months it reached a crisis. The pain was so bad I couldnt get comfortable sitting or even lying down. My stomach swelled up like a beach ball. My doctor didnt know what was wrong. I finally asked my pharmacist if any of my pills had milk sugar (lactose). Every single one of the half dozen pills I take contains lactose. Even though I am extremely careful about my diet (no dairy), I had no idea that my pills were poisoning me. Once I found out, I added lactase enzyme pills to my regimen. Ill be asking my doctor to find substitutes without lactose. Someone else may benefit from my nightmare. A. Lactose is a common filler in many medications. For those who are highly sensitive to milk sugar, this can cause bloating, pain, gas and diarrhea. Others may need to enlist the help of a pharmacist to discover whether their drugs could be causing digestive distress. Sometimes diarrhea, gas or cramps may be a reaction to the medication rather than to lactose in the filler. Heres one readers story: Both medicines I was given for type 2 diabetes, Metformin and Glipizide, caused bad diarrhea. I went to the internet to find out whether others were troubled with this problem and found it was a common side effect controlled by taking Immodium with each dose of those medicines. Get The Graedons' Favorite Home Remedies Health Guide for FREE Join our daily email newsletter with breaking health news, prescription drug information, home remedies AND you'll get a copy of our brand new full-length health guide for FREE! Continue reading >>

Mixing Alcohol With Metformin

In this article, we answer a reader question regarding whether or not you can drink alcohol while taking metformin. Are there any interactions between Metformin and alcohol that might cause memory loss while drinking? Lately, I barely have to drink anything (2 or 3 beers) and my memory of the time is significantly impaired. I recently stopped taking Topiramate for migraines, but began taking Metformin to manage my PCOS symptoms. I've looked up information but the only harmful interactions I could find were lactic acidosis and low blood sugar. Answer It is recommended to either limit or avoid drinking alcohol while taking the diabetes medication metformin. As you mentioned in your question, metformin raises the risk of a condition known as lactic acidosis. Lactic acidosis is the accumulation of lactate in the blood, which lowers the pH (i.e.increases the acidity) of the bloodstream. Left untreated, it is a potentially fatal condition. Blood lactate concentrations are known increase when combining alcohol with metformin. At onset, the symptoms of lactic acidosis are often subtle, accompanied mostly by nonspecific symptoms such as fatigue and muscle pain. These can quickly be followed by more serious symptoms such as respiratory distress. Lactic acidosis is a medical emergency which must be treated immediately. In addition, metformin is well known to cause nausea and GI distress. Mixing alcohol with metformin can potentiate these adverse reactions leading to extreme nausea, vomiting and diarrhea. In regards to memory loss when mixing alcohol with metformin, there is no data regarding that specific interaction. Having said that, metformin has conflicting information in regard to how it may affect memory by itself. Early studies with metformin actually showed potential promi Continue reading >>

Will Metformin Cause Gastrointestinal Problems?

The most common side affect of Metformin is diarrhea. Metformin may also cause nausea, upset stomach and gas. These side effects usually only occur during the first few weeks of taking Metformin. Of course, a few weeks can feel like an eternity to someone suffering from serious diarrhea and may cause many to stop using Metformin before realizing its benefits. If you can make it through these first few uncomfortable weeks, Metformin can help reduce the risk of developing type 2 diabetes, increase fertility and help women with PCOS and/or insulin resistance lose weight. There are several steps you can take to reduce or eliminate the likelihood that you will suffer from diarrhea when you first begin taking Metformin. Easy Methods to Prevent or Minimize Diarrhea Sometimes Caused by Metformin Diarrhea is the most common side effect of Metformin. In one study, diarrhea occurred in 41% of the patients studied and caused 6% of those patients to drop out of the study. If you are one of the people who suffer from diarrhea or gastrointestinal problems related to Metformin, there are ways you can reduce or eliminate those problems. Your health care professional will determine the dosage and timing of Metformin that is right for you. However, the gastrointestinal side effects suffered by many people are shown to be much reduced where Metformin is started at the lowest dose, usually 500 mg a day, and then slowly increased to the recommended dosage. An extended release version of Metformin, Glucophage XR, is also now available and may help reduce gastrointestinal problems through a slow release process. Diarrhea, nausea and upset stomach are also greatly reduced when Metformin is taken with a meal. This slows the release of the drug into your system. It is important to reduce the amou Continue reading >>

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Does Anyone In The Rg Community Know The Mechanism Of Diarrhea Caused By Metformin?

So, apparently Metformin induced diarrhea has a complex but at the same time simple mechanism. It resembles, on a small scale, what we gastroenterologists know as "after bypass surgery dumping syndrome", in which you have a simultaneous osmotic/hipermotility condition. Would it be too much to ask you to provide me w/a reference list in which I could read up on this topic as much as possible? It would be greatly appreciated. As a researcher and clinical gastroenterologist I work w/Metmorfin tolerability, especially diarhrea, that is present between 5-10% of the cases in patients beginning Metformin treatment or in those who are increasing their daily dose. There are also some susceptible ethnic populations such as the mestizo group, which are highly prevalent in most Latin American countries, (Mexico, CA and Pacific Andean Region) who are relatively intolerant to Metformin. As clinicians we usually deal w/this problem by progressively escalating the dose on a weekly basis and in more severe cases by adding on loperamide/psyllum as rescue medication. Now, in order to provide a better and tolerable metformin, first we need to understand what we are dealing with, and second, to work on a different improved delivery system such as NERF "novel extended release fotrmulations" and/or drug combinations. Continue reading >>

Diabetic Diarrhea - Causes, Symptoms And Management

Diabetic diarrhea is a type of diarrhea caused by nerve damage which disrupts the functioning of the bowel. People suffering from diabetes are also more prone to diarrhea caused by other things. Coping with diabetes is hard on its own but is made even more difficult with this complication. People don't always know that diabetes and diarrhea can go together. Read on to find out about this distressing symptom, the causes, its symptoms and management. Diabetic Diarrhea Caused by Nerve Damage Autonomic neuropathy is the medical term for damage to the nerves that carry information from your brain to your glands and organs. These nerves normally work to control organs like your bowel, bladder, heart and sexual organs without you being aware of it. When diabetic diarrhea strikes it is because the nerves controlling your bowel have been damaged. During the night our nervous system normally ensures that our bowels are quiet so that we can sleep but if the nerves are damaged then this does not happen and night time diarrhea can be the result. Nerves which control the sphincters allowing the passage of feces can also be damaged leading to incontinence. This type of nerve damage is usually associated with type 1 diabetes and is more common if the diabetes is long standing and has been poorly controlled. It is very rare in type 2 diabetes but it can happen especially if the person is an insulin dependent diabetic. The incidence of this type of diarrhea is difficult to estimate as it is often confused with other types of diarrhea. Figures of 4-22% for people with type 1 diabetes but only 0.4% for type 2 have been given. Diabetic Diarrhea Symptoms Watery painless diarrhea Night time diarrhea (nocturnal diarrhea) Episodes of diarrhea along with periods of normal bowel movements or even Continue reading >>

How To Ease The Diarrhea Effects Of Metformin

Metformin is the most effective drug used to treat conditions such as polycystic ovarian syndrome and insulin resistance. It is also used to prevent and treat type 2 diabetes. Metformin works by regulating blood-sugar levels. Because of that, it promotes weight loss and can improve fertility. As with most prescription medications, metformin can have problematic side effects. But there is a marked decrease in side effects after the first month of taking metformin. The most common side effect of taking metformin is diarrhea. Instructions Reduce your dose, with the approval of a health-care professional. While diarrhea is most common in the initial weeks of taking metformin, reducing the dose may reduce the frequency, as it allows the body to adjust to the medication. The lowest dosage given is generally 500 mg. If you have started at a higher dose, the doctor may reduce the dosage to lessen side effects. Consider switching to the extended-release version of metformin. Talk to your health-care provider about doing so. As it is a slow-release medication, it may reduce diarrhea, because smaller amounts are absorbed over the day rather than hitting your system all at once. Keep in mind that the extended-release version is more expensive. Reduce consumption of carbohydrates and fat. People who follow a reduced–carbohydrate diet experience less diarrhea than those that do not. A diet that is rich in low-fat protein and low in carbohydrates, fats and sugar is optimal. Take metformin with a meal. It should never be taken on an empty stomach. When metformin is taken on an empty stomach, it reacts with stomach acid and can cause an increase in diarrhea and other gastrointestinal issues. Use over-the-counter medications to treat diarrhea. One such medication is Imodium. The relief Continue reading >>