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Metformin Gi Side Effects

Relief For Diabetes Stomach Pain

Relief For Diabetes Stomach Pain

Managing diabetes often brings changes in what we eat and the medications we take. You may also notice some changes in how your gut, or gastrointestinal (GI) tract, feels, sounds, and responds. Changes in eating You are likely making changes in eating habits, including more foods rich in fiber, such as fruits, vegetables, and beans. Fiber can be filling without adding unwanted calories, and it can help improve abnormal cholesterol levels. But there may be a few uh-ohs if you rapidly increase the amount you eat. "Gas and bloating are a side effect of fiber," says Judith Wylie-Rosett, Ed.D., R.D., professor of health promotion and nutrition research at Albert Einstein College of Medicine in Bronx, New York. "Increasing your intake gradually may help." She suggests adding legumes, such as beans and lentils, to increase dietary fiber. "Throwing out the water you soak them in and giving them an extra rinse before cooking may also help decrease the gas and bloating," she says. Glucose-lowering meds Several prescription medications used to lower blood glucose levels in type 2 diabetes can stir up your gut. Experts tend to suggest that you start with a low dose and slowly increase it based on your provider's instructions. Metformin Metformin, the typical starting medication in type 2 diabetes to bring blood glucose levels in range, can lead to heartburn, nausea, or diarrhea. Ralph DeFronzo, M.D., professor of medicine and chief of the diabetes division at the University of Texas Health Science Center at San Antonio, says, "I try to use metformin in all of my patients who have type 2 diabetes. When there is a problem, it is diarrhea and abdominal discomfort. There are 5-10 percent of people who just can't tolerate it." Typically, metformin is started at a low dose and increased Continue reading >>

How To Prevent And Manage Metformin Side Effects

How To Prevent And Manage Metformin Side Effects

Metformin is the oral drug of choice for type 2 diabetics who do not respond well to diet and lifestyle changes alone unless contraindicated due to kidney problems. It has a long safety record. Scientific research has proven that metformin is just as good or even better at controlling blood sugar levels than other oral antidiabetic drugs and it causes less weight gain, less low blood sugar, and less cardiovascular events. Metformin is sold under the brand names Glucophage, Glucophage XR, Riomet, Fortamet and is also found in other combination diabetes medications. Metformin comes in the immediate release and extended release formulations. The immediate release formulation releases the medication all at once while the extended release formulations release medication over time. The extended release formulation has fewer gastrointestinal (GI) side effects, increases adherence to medications due to its once daily dosing, and has proven to be safer, more effective, and better tolerated than the Immediate release formulation. Some of the side effects to expect from metformin include: diarrhea nausea vomiting abdominal pain the passing of gas loss of appetite Some patients may experience other side effects such as: change in taste sensation weight loss indigestion heartburn stomach upset abnormal stool headache rhinitis infection discoloration of the nails hives (rash) itching plaques (scalp, elbows, and knees) low blood sugar (hypoglycemia) Serious side effects may occur in some patients under certain circumstances. These serious side effects are rare and include: chest pain lactic acidosis vitamin B12 deficiency hepatitis Continue Prevention and Treatment of Metformin Side Effects Gastrointestinal Discomfort Gastrointestinal discomfort includes abdominal pain, flatus (gas), Continue reading >>

Side Effects Of Metformin: What You Should Know

Side Effects Of Metformin: What You Should Know

Metformin is a prescription drug used to treat type 2 diabetes. It belongs to a class of medications called biguanides. People with type 2 diabetes have blood sugar (glucose) levels that rise higher than normal. Metformin doesn’t cure diabetes. Instead, it helps lower your blood sugar levels to a safe range. Metformin needs to be taken long-term. This may make you wonder what side effects it can cause. Metformin can cause mild and serious side effects, which are the same in men and women. Here’s what you need to know about these side effects and when you should call your doctor. Find out: Can metformin be used to treat type 1 diabetes? » Metformin causes some common side effects. These can occur when you first start taking metformin, but usually go away over time. Tell your doctor if any of these symptoms are severe or cause a problem for you. The more common side effects of metformin include: heartburn stomach pain nausea or vomiting bloating gas diarrhea constipation weight loss headache unpleasant metallic taste in mouth Lactic acidosis The most serious side effect metformin can cause is lactic acidosis. In fact, metformin has a boxed warning about this risk. A boxed warning is the most severe warning from the Food and Drug Administration (FDA). Lactic acidosis is a rare but serious problem that can occur due to a buildup of metformin in your body. It’s a medical emergency that must be treated right away in the hospital. See Precautions for factors that raise your risk of lactic acidosis. Call your doctor right away if you have any of the following symptoms of lactic acidosis. If you have trouble breathing, call 911 right away or go to the nearest emergency room. extreme tiredness weakness decreased appetite nausea vomiting trouble breathing dizziness lighthea Continue reading >>

Metformin (glucophage) Side Effects & Complications

Metformin (glucophage) Side Effects & Complications

The fascinating compound called metformin was discovered nearly a century ago. Scientists realized that it could lower blood sugar in an animal model (rabbits) as early as 1929, but it wasn’t until the late 1950s that a French researcher came up with the name Glucophage (roughly translated as glucose eater). The FDA gave metformin (Glucophage) the green light for the treatment of type 2 diabetes in 1994, 36 years after it had been approved for this use in Britain. Uses of Generic Metformin: Glucophage lost its patent protection in the U.S. in 2002 and now most prescriptions are filled with generic metformin. This drug is recognized as a first line treatment to control blood sugar by improving the cells’ response to insulin and reducing the amount of sugar that the liver makes. Unlike some other oral diabetes drugs, it doesn’t lead to weight gain and may even help people get their weight under control. Starting early in 2000, sales of metformin (Glucophage) were challenged by a new class of diabetes drugs. First Avandia and then Actos challenged metformin for leadership in diabetes treatment. Avandia later lost its luster because it was linked to heart attacks and strokes. Sales of this drug are now miniscule because of tight FDA regulations. Actos is coming under increasing scrutiny as well. The drug has been banned in France and Germany because of a link to bladder cancer. The FDA has also required Actos to carry its strictest black box warning about an increased risk of congestive heart failure brought on by the drug. Newer diabetes drugs like liraglutide (Victoza), saxagliptin (Onglyza) and sitagliptin (Januvia) have become very successful. But metformin remains a mainstay of diabetes treatment. It is prescribed on its own or sometimes combined with the newer d Continue reading >>

Metaglip Side Effects Center

Metaglip Side Effects Center

Metaglip (glipizide and metformin HCl) is a combination of two oral diabetes medicines for people with type 2 diabetes who do not use daily insulin injections. Metaglip is not for treating type 1 diabetes. The brand name Metaglip is discontinued, but generic versions may be available. Common side effects of Metaglip (glipizide and metformin HCl) include nausea, vomiting, diarrhea, stomach pain or upset, joint or muscle aches pain, headache, dizziness, or cold symptoms (stuffy nose, sneezing, or sore throat). Dosage of Metaglip is individualized on the basis of both effectiveness and tolerance while not exceeding the maximum recommended daily dose of 20 mg glipizide/2000 mg metformin. Metaglip may interact with furosemide, nifedipine, cimetidine, ranitidine, amiloride, triamterene, digoxin, morphine, procainamide, quinidine, trimethoprim, vancomycin, or ketoconazole, or itraconazole. Hyperglycemia (high blood sugar) may result if you take Metaglip with isoniazid, diuretics, steroids, heart or blood pressure medications, niacin, phenothiazines, thyroid medicines, birth control pills and other hormones, seizure medicines, and diet pills or medicines to treat asthma, colds or allergies. Hypoglycemia (low blood sugar) may result if you take Metaglip with exenatide, probenecid, nonsteroidal anti-inflammatory drugs (NSAIDs), aspirin or other salicylates, sulfa drugs, monoamine oxidase inhibitors (MAOIs), beta-blockers, or other diabetes medications. Tell your doctor all medications and supplements you use. During pregnancy, Metaglip should be used only when prescribed. Insulin treatment may be preferred during pregnancy. If you are using this drug during your pregnancy, your doctor may switch you to insulin at least 1 month before the expected delivery date because of Metaglip Continue reading >>

Metformin Side Effects

Metformin Side Effects

For the Consumer Applies to metformin: oral solution, oral tablet, oral tablet extended release Along with its needed effects, metformin may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention. Check with your doctor immediately if any of the following side effects occur while taking metformin: More common Abdominal or stomach discomfort cough or hoarseness decreased appetite diarrhea fast or shallow breathing fever or chills general feeling of discomfort lower back or side pain muscle pain or cramping painful or difficult urination sleepiness Less common Anxiety blurred vision chest discomfort cold sweats coma confusion cool, pale skin depression difficult or labored breathing dizziness fast, irregular, pounding, or racing heartbeat or pulse feeling of warmth headache increased hunger increased sweating nausea nervousness nightmares redness of the face, neck, arms, and occasionally, upper chest seizures shakiness shortness of breath slurred speech tightness in the chest unusual tiredness or weakness Rare Behavior change similar to being drunk difficulty with concentrating drowsiness lack or loss of strength restless sleep unusual sleepiness Some side effects of metformin may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them: More common Acid or sour stomach belching bloated excess air or gas in the stomach or intestines full feeling heartburn indiges Continue reading >>

Side Effects Of Metformin 500 Mg Tablets

Side Effects Of Metformin 500 Mg Tablets

Metformin is a prescription medication used primarily in the management of type 2 diabetes. This pill is sold under brand names such as Glucophage and Riomet. A member of the drug group known as biguanides, this drug’s 500 mg tablet is the smallest available pill -- and a common starting dose for this first-line diabetes medication. This widely used medication is an effective tool to help lower blood glucose levels, used alone or in conjunction with other pills or insulin. However, metformin can also produce adverse effects. Video of the Day The most common side effects from metformin use include gastrointestinal (GI) discomfort, including diarrhea, nausea, vomiting, gas and abdominal pain. A diabetes prevention trial, published in the April 2012 issue of “Diabetes Care,” noted that over a 4-year period, 9.8 percent of metformin users reported GI side effects, while only 1.1 percent of those using placebo had these adverse effects. These side effects usually occur at the beginning of metformin therapy and go away as the body becomes adjusted to the medication. Taking the metformin with food and having the dose gradually increased also helps minimize these adverse effects. Extended-release tablets, such as metformin XR (Glucophage XR, Glumetza or Fortamet) may be easier on the stomach -- and an option for anyone who has these common metformin side effects. Other Less Common Side Effects As with most medications, the potential list of side effects is lengthy. Insight into the adverse reactions experienced by metformin users was noted in an analysis of multiple studies published in the February 2012 issue of “Diabetes Care.” While less common than GI discomfort, other potential metformin side effects include dizziness, headache, palpitations, urinary tract infect Continue reading >>

Spencer Develops Metformin For Diabetics Without Gi Side Effects

Spencer Develops Metformin For Diabetics Without Gi Side Effects

Spencer develops metformin for diabetics without GI side effects Those who suffer from Type 2 diabetes know that the treatment can feel worse than the disease. The most debilitating side-effect, and one that often presents a major barrier to patient compliance, is the nausea associated with metformin, the most popular anti-diabetic drug for glycemia control. The solution, according to Boston-based Spencer Pharmaceutical, is a better controlled-release product that does not "swell" inside the GI tract, causinggastrointestinal issues. Spencer partners with the University of Quebec at Montreal to develop what they're calling an "intelligent vehicle" to deliver metformin. By "intelligent," the drug developers mean that the specially treated metformin is able to recognize harsh environments like gastric acid and change its configuration to a more stable structure to protect the bioactive agents while it's making its way through the GI tract, then release them in a controlled way at absorption sites. Also, according to the company, the drug delivery vehicle "can hang for a while on the intestinal walls and promote significantly the transport of the drug into the bloodstream." According to In-PharmaTechnologist, the vehicle is a succinyl-chitosan-based extended release form of metformin, and it appears to have the potential to outperform the most popular brand of metformin, Glucophage XR from Bristol-Myers Squibb. The result, according to Spencer, was a release time of around 12 hours, or 50 percent longer than that of the Glucophage XR. The next stage, Spencer CEO Max Arella tells In-PharmaTechnologist, is further study of the chitosan technology in animal models. If successful, Arella adds, chitosan could potentially be used in delivery of other prescription or over-the-cou Continue reading >>

Coping With The Side Effects Of Metformin

Coping With The Side Effects Of Metformin

Metformin is prescribed for some people with diabetes to help keep their blood sugar levels under control. Metformin works by encouraging the body to burn energy, leading to lower blood glucose levels. If you take metformin it is usually more effective at lowering blood glucose levels than if you are just careful about what you eat. Nausea Metformin has a number of side effects, the most common of which are gastrointestinal. More than one in 10 people who take metformin experience side effects including nausea, vomiting, diarrhoea, stomach pain, increased flatulence or loss of appetite. More than one in 100 patients who take the medication experience changes to their sense of taste - usually a metallic taste. A number of other very rare symptoms have also been reported. Fewer than one in 10,000 people who take metformin may experience: What to do about side effects All medications take some getting used to. The NHS advises that patients can avoid the more common gastrointestinal side effects by taking the medication during or after a meal. In order to guard against vitamin B12 deficiency - which in rare cases becomes apparent in patients who have taken the medication for a long time - the charity Diabetes UK recommends eating a healthy, balanced diet including foods rich in vitamin B12 such as meat, dairy products and eggs. However, it is not recommended for those prescribed metformin to also take vitamin B12 supplements unless advised to by their doctor. Patients who feel unwell or who are concerned about a side effect should talk to their GP, pharmacist or practice nurse. Immediate medical attention should be sought in cases of breathing difficulties, muscle cramps, stomach pain, weakness or hypothermia, which can be symptoms of lactic acidosis. Continue reading >>

Gastritis Tied To Metformin-related Gastrointestinal Side Effects In Type 2 Diabetes

Gastritis Tied To Metformin-related Gastrointestinal Side Effects In Type 2 Diabetes

Gastritis tied to metformin-related gastrointestinal side effects in type 2 diabetes Gastritis tied to metformin-related gastrointestinal side effects in type 2 diabetes Gastritis tied to metformin-related gastrointestinal side effects in T2D HealthDay News For patients with type 2 diabetes , asymptomatic gastritis is associated with metformin-related gastrointestinal side effects, according to a study published in the Journal of Clinical Pharmacy and Therapeutics. Digestive disorders represent the most common metformin side effects for type 2 diabetes. The mechanism of these metformin side effects is unclear, noted Yuxin Huang, M.D., from the Shanghai Huadong Hospital affiliated to Fudan University, and colleagues. To examine whether asymptomatic chronic gastritis could influence metformin tolerance with patients with type 2 diabetes, the investigators culled data from 144 metformin-naive patients. All subjects started metformin at 500 mg/day and increased progressively to 1,500 mg/day over four weeks. Each week a score of gastrointestinal side effects was assessed, and metformin dose was adjusted as appropriate. Of the patients, 64 were categorized as non-gastritis subjects and 80 as chronic gastritis subjects based on endoscopy. No statistical difference was seen between the groups for gastrointestinal symptoms at baseline. With metformin, the mean scores for abdominal pain, nausea, vomiting, and bloating were 1.02 versus 2.18 (P=0.001), 0.20 versus 0.50 (P=0.022), 0 versus 0.06 (P=0.024), and 1.08 versus 1.71 (P=0.028), respectively, for non-gastritis versus gastritis subjects, over four weeks. The mean final metformin doses were 706.24 and 1,101.56 mg for gastritis and non-gastritis subjects, respectively (P=0.001). "Our data show for the first time that asymptoma Continue reading >>

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

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 >>

Managing The Metformin Side Effect Of Diarrhea

Managing The Metformin Side Effect Of Diarrhea

In working with patients, the metformin side effect of diarrhea can be a real challenge. As a healthcare professional, I understand how beneficial it can be for some patients to be on metformin. It has a lot of great attributes for a diabetes medication. It can help with weight loss as well as not cause hypoglycemia like some other agents. It also comes at a low cost compared to some of the newer agents for diabetes. The major downside with metformin is that it can have a substantial incidence of diarrhea and/or other GI side effects. Managing these appropriately can help keep your patients on metformin and avoid the use of agents that cause weight gain, hypoglycemia, or cost a lot of money. Here’s a few thoughts on how to manage the metformin side effect of diarrhea. Take with food. If patients aren’t doing this and are having GI side effects, I encourage patients to give this a shot prior to calling it quits with metformin. Try the extended release product. The extended release product has a much lower incidence of GI side effects. Reduce the dose. Reducing the total daily dose is a potential option here. We may have to add an additional medication in this situation, but remaining on some metformin can help reduce the need for other medications. Change the timing. If patients are having trouble at a specific time of day, make sure the metformin dose and timing is reviewed. Maybe shifting 500-750 mg to a different time of day could help reduce adverse effects. Change medication. For those patients who continue to have diarrhea despite some of the above changes, sometimes the only thing we can do is change to another medication altogether. Do you have any tips or strategies for helping your patients remain on metformin? Love the blog? Get a free gift simply for foll Continue reading >>

Metformin And The Gastrointestinal Tract

Metformin And The Gastrointestinal Tract

Go to: Introduction Metformin—dimethylbiguanide—is an oral glucose-lowering agent. Its origins can be traced to Galega officinalis, also known as French lilac or goat’s rue [1]. In the early 20th century it was noted to lower blood glucose concentrations in animals, but it was not until the 1950s that Jean Sterne studied dimethylbiguanide and subsequently developed ‘Glucophage’ [2]. Over the last 15 years, metformin has become the first-line agent for the treatment of type 2 diabetes, as noted in several international guidelines, including the ADA-EASD guidelines [3]. Metformin has had a chequered history—it was initially eclipsed by phenformin, which was withdrawn in the late 1970s after it was discovered to be associated with lactic acidosis [4]. The lower propensity of metformin for hyperlactataemia [5] and success in several large randomised controlled clinical trials, such as the UK Prospective Diabetes Study (UKPDS) [6], confirmed its clinical benefit. It is widely recognised that metformin improves glycaemic control with a good safety profile, weight neutrality or weight loss, lack of associated hypoglycaemia, reduced cardiovascular mortality and low cost [3]. However, a large proportion of patients cannot tolerate the medication in adequate amounts because of its associated side effects. Up to 25% of patients suffer metformin-associated gastrointestinal (GI) side-effects, with approximately 5% unable to tolerate metformin at all [7]. In addition to this interindividual variation in side effects, there is variability in the efficacy of metformin. There are likely to be a number of factors to account for this variability in efficacy, for example, our group (Zhou et al) recently established that the glycaemic response to metformin is moderately heritabl Continue reading >>

Diabetes Drugs: Metformin

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 >>

Metformin

Metformin

Metformin, marketed under the trade name Glucophage among others, is the first-line medication for the treatment of type 2 diabetes,[4][5] particularly in people who are overweight.[6] It is also used in the treatment of polycystic ovary syndrome.[4] Limited evidence suggests metformin may prevent the cardiovascular disease and cancer complications of diabetes.[7][8] It is not associated with weight gain.[8] It is taken by mouth.[4] Metformin is generally well tolerated.[9] Common side effects include diarrhea, nausea and abdominal pain.[4] It has a low risk of causing low blood sugar.[4] High blood lactic acid level is a concern if the medication is prescribed inappropriately and in overly large doses.[10] It should not be used in those with significant liver disease or kidney problems.[4] While no clear harm comes from use during pregnancy, insulin is generally preferred for gestational diabetes.[4][11] Metformin is in the biguanide class.[4] It works by decreasing glucose production by the liver and increasing the insulin sensitivity of body tissues.[4] Metformin was discovered in 1922.[12] French physician Jean Sterne began study in humans in the 1950s.[12] It was introduced as a medication in France in 1957 and the United States in 1995.[4][13] It is on the World Health Organization's List of Essential Medicines, the most effective and safe medicines needed in a health system.[14] Metformin is believed to be the most widely used medication for diabetes which is taken by mouth.[12] It is available as a generic medication.[4] The wholesale price in the developed world is between 0.21 and 5.55 USD per month as of 2014.[15] In the United States, it costs 5 to 25 USD per month.[4] Medical uses[edit] Metformin is primarily used for type 2 diabetes, but is increasingly be Continue reading >>

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