Metformin Interactions

How Relevant Is The Interaction Between Dolutegravir And Metformin In Real Life?

Song et al 1 have reported recently the results of a phase I parallel-group study aimed to evaluate the effect of dolutegravir on the steady-state pharmacokinetics (PK) of metformin in healthy volunteers. They found that co-administration of dolutegravir dose-dependently (dolutegravir was in fact given at 50 mg q24h or 50 mg q12h) increased metformin area under the curve (AUC) and Cmax by 79%145% and 66%111%, respectively. Overall, combined treatment was well-tolerated, with 1 of 29 nondiabetic subjects experiencing clinical signs of hypoglycemia. According to these findings, the authors recommended that dose adjustments of metformin should be considered to maintain optimal glycemic control when HIV-infected patients are starting/stopping dolutegravir while taking metformin. Here, we intend to verify the clinical relevance of this drug-to-drug (DDI) pharmacokinetic interaction in a real-life setting. In this retrospective analysis, we considered all HIV-infected patients from our local database fulfilling the following mandatory criteria: (1) a diagnosis of type II diabetes from at least 1 year; (2) metformin therapy for at least 12 months; and (3) switch from any antiretroviral regimen to dolutegravir-based therapies from at least 6 months. Glycemic control was expressed both as fasting blood glucose concentrations (the last 3 measurements before the switch and the first 3 measurements after the switch to dolutegravir) and glycosylated hemoglobin (HbA1c) (the 2 most recent measurements for each observational period, with the third measurement taken at least 3 months after the switch to dolutegravir). Hypoglycemia was defined as fasting blood glucose concentrations less than 70 mg/dL, in agreement with the definition adopted by Song et al. 1 Dolutegravir plasma trough Continue reading >>

Glipizide And Metformin Overview

Glipizide/metformin is a prescription medication used in the management of type 2 diabetes mellitus. It is a single tablet containing 2 medications: glipizide and metformin. Glipizide belongs to a group of drugs called sulfonylureas. These work by stimulating the release of insulin from the pancreas. Metformin belongs to a group of drugs called biguanides. These work by decreasing the amount of glucose absorbed from food and decreasing the amount of glucose that is produced by the liver. This medication comes in tablet form and is taken once or twice daily with meals. Common side effects of glipizide/metformin include stomach pain, nausea or vomiting, diarrhea, and dizziness. Glipizide/metformin can also cause dizziness. Do not drive or operate heavy machinery until you know how glipizide/metformin affects you. Glipizide/metformin is a prescription medication used in the management of type 2 diabetes mellitus. It helps to lower the amount of glucose (sugar) in the blood. This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information. Continue reading >>

Metformin Hcl

Uses Metformin is used with a proper diet and exercise program and possibly with other medications to control high blood sugar. It is used in patients with type 2 diabetes. Controlling high blood sugar helps prevent kidney damage, blindness, nerve problems, loss of limbs, and sexual function problems. Proper control of diabetes may also lessen your risk of a heart attack or stroke. Metformin works by helping to restore your body's proper response to the insulin you naturally produce. It also decreases the amount of sugar that your liver makes and that your stomach/intestines absorb. How to use Metformin HCL Read the Patient Information Leaflet if available from your pharmacist before you start taking metformin and each time you get a refill. If you have any questions, consult your doctor or pharmacist. Take this medication by mouth as directed by your doctor, usually 1-3 times a day with meals. Drink plenty of fluids while taking this medication unless otherwise directed by your doctor. The dosage is based on your medical condition, response to treatment, and other medications you may be taking. Be sure to tell your doctor and pharmacist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products). To reduce your risk of side effects (such as upset stomach), your doctor may direct you to start this medication at a low dose and gradually increase your dose. Follow your doctor's instructions carefully. Take this medication regularly in order to get the most benefit from it. Remember to use it at the same times each day. If you are already taking another diabetes drug (such as chlorpropamide), follow your doctor's directions carefully for stopping/continuing the old drug and starting metformin. Check your blood sugar regularly a Continue reading >>

Metformin Viagra Interaction

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Metformin

Drug Information Metformin is a drug used to lower blood sugar levels in people with non-insulin-dependent (type 2) diabetes. The Drug-Nutrient Interactions table may not include every possible interaction. Taking medicines with meals, on an empty stomach, or with alcohol may influence their effects. For details, refer to the manufacturers’ package information as these are not covered in this table. If you take medications, always discuss the potential risks and benefits of adding a new supplement with your doctor or pharmacist. Copyright © 2017 Healthnotes, Inc. All rights reserved. www.healthnotes.com Please read the disclaimer about the limitations of the information provided here. Do NOT rely solely on the information in this article. The Healthnotes knowledgebase does not contain every possible interaction. The information presented by Healthnotes is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. For many of the conditions discussed, treatment with prescription or over-the-counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications. Information expires December 2017. Continue reading >>

Interaction Between Pharmaceutical Drugs And Cannabis

Patients being treated for certain conditions should be mindful of the possible interactions between cannabis and the pharmaceutical drugs they already take for their pathology. The effect of prescription drugs can be increased or weakened when combined with cannabinoids. In some cases, these interactions can simply prevent patients to deal with their normal daily activities requiring alertness. In others, the combined effects might lead to more serious conditions. The vast majority of patients can easily tolerate the combined effects between medical cannabis and the pharmaceutical prescriptions. Occasionally, cannabis can cause minor side effects, while sometimes these combined effects have to be taken more seriously. Cannabis alone has never caused death, and very few cases are reported of major diseases from acute cannabis use. Despite that, combining different drugs or substances can have unpredictable effects on any kind of patient. THE TRANQUILIZING EFFECT ADDS UP Cannabis' natural compounds add up their action on our nervous system to the one of many pain medications, resulting in a strengthening of these substances’ effects. This strong interaction is not completely predictable in its display. As an example, patients need to be cautious about the additive effect of cannabis and opiates pain medications, which can amplify the depression of our central nervous system. Since the central nervous system controls heart rate and respiration, a depressive effect can lead to death. Despite this adverse interaction, cannabis can help patients with chronic pain reducing their opiate use. Cannabis adds its effect to sedative drugs, such as sleeping pills in the class of cyclopyrrolones, or "Z-drugs", or other tranquilizers, like Valium. All these chemicals' compounds incr Continue reading >>

Drugs That May Interact With Cbd Oil | Learn More | Cbd Oil Review

Home Learn About CBD (cannabidiol) Drugs that May Interact with CBD Oil CBD and the Cytochrome P-450 Enzyme System Research has clearly shown that cannabidiol , or CBD, has the potential to effectively treat many different ailments by manipulating the endocannabinoid system with very few unintended effects. However, some of cannabidiol's side effects can be dangerous if they are not properly understood. One such effect is the inhibition of the cytochrome P-450 enzyme system. The cytochrome P-450 enzyme system is a system within the liver that is responsible for metabolizing 90 percent of the drugs you consume. According to Davis's Drug Guide , this system contains more than 50 enzymes that process and eliminate toxins. In order to determine appropriate dosages of medications, doctors make calculations using the average amount of time it takes for various drugs to be processed by this system. If only one drug is being processed and the system is generally healthy, these averages are usually correct. However, certain drugs have the ability to affect processing times within the cytochrome P-450 system, thus making other drugs metabolize faster or slower than they would have on their own. Similarly, if the system is unhealthy because of liver problems or other pre-existing conditions, drugs may not metabolize as they should. Cannabidiol in the Cytochrome P-450 System Cannabidiol can inhibit the cytochrome P-450 system's ability to metabolize certain drugs, which leads to an overall increase in processing times. This leads to higher levels of the drug in your system at one time, which can cause unwanted side effects and even overdose. Thus, if you are taking a drug affected by cannabidiol, you may need a dosage adjustment in order to take both drugs safely. Any drug metabol Continue reading >>

Can I Have Grapefruit While Taking Metformin?

Many medications, such as statins and some antihistamines, have a negative interaction with grapefruit. Metformin is used in treatment of type 2 diabetes. Does having grapefruit while taking metformin lead to adverse side effects? There’s limited research, but here’s what you need to know. Metformin is a drug that’s prescribed to treat type 2 diabetes. People with type 2 diabetes can’t use insulin normally. This means they can’t control the amount of sugar in their blood. Metformin helps people with type 2 diabetes control the level of sugar in their blood in several ways, including: decreasing the amount of sugar your body absorbs from food decreasing the amount of sugar produced by your liver increasing your body’s response to the insulin that it makes naturally Metformin can rarely cause a very serious and life-threatening condition called lactic acidosis. People with liver, kidney, or heart problems should avoid taking metformin. There are more than 85 drugs that are known to interact with grapefruit. Of these drugs, 43 of them can lead to serious adverse effects. All forms of grapefruit — including freshly squeezed juice, frozen concentrate, and the whole fruit — can lead to drug interaction. Some of the chemicals found in grapefruit can bind to and inactivate an enzyme in your body that’s found in your intestines and liver. This enzyme helps break down the medication you take. Normally when you take a drug orally, it’s broken down slightly by enzymes before it reaches your bloodstream. This means that you receive a little less of the drug in your bloodstream than the amount you initially consumed. But when the enzyme is inhibited — as it is when it interacts with the chemicals in grapefruit — there’s a dramatically larger amount of the dr Continue reading >>

Taking The Supplement Berberine? Look Out For These 3 Side Effects And 3 Great Stacks!

Berberine HCl is a relatively unknown health supplement, especially when you consider the powerful health benefits that it can generate. Berberine is extracted from the Berberis vulgaris plant and is used to help promote healthy blood sugar levels. It has a huge amount of research showing the its therapeutic potential. Berberine side effects are often overlooked because of the low Bereberine toxicity rating. However, there are definitely some side effects of Berberine to look out for, which is what we’ll explore in this article. We also look into three great Berberine stacks to boost the health benefits! What does Berberine Do? Berberine is one of the few dietary supplements available today with sufficient evidence to show that it is as effective as some pharmaceuticals. It is one of the best supplements available today to lower blood sugar. This is especially important in the Western world, where type 2 diabetes is so prevalent. In 2016, the percentage of Americans living with diabetes was estimated to be just under 10%. This equates to a staggering 29.1 million people living with diabetes in America.[1] Other potential benefits of Berberine include: anti-inflammatory effects, helps to destroy cholesterol, works as a powerful antioxidant, reduces fat in the liver, improves insulin sensitivity, and reduces triglycerides. For more information about Berberine’s great benefits, check out our article on the Top 6 Berberine benefits. Recommended Dosage The recommended daily Berberine dosage to lower blood sugar is around 1500mg. Researchers have found that this dosage may be equally effective in lowering blood sugar as 1500mg of metformin or 4mg glibenclamide. [2] You can take Berberine 500 mg, three times daily, to reach the correct recommended dosage. Using separate do Continue reading >>

What Happens If You Drink Alcohol While Taking Metformin

What is Metformin? It is an oral diabetes drug that is used to control blood glucose levels. Metformin can be used alone or in combination with other medications to treat people with type 2 diabetes. Type 2 diabetes refers to a chronic condition where the pancreas cannot produce enough insulin or use it properly. Insulin is a natural hormone which transports glucose from the blood stream to the body tissue to be stored or used for energy. Without insulin, glucose cannot enter the body’s cells and stays in the bloodstream. Too much glucose in the bloodstream can lead to serious health complications. People with type 2 diabetes can take this medicine to help them reduce their blood sugar levels. However, this medication should not be used to treat type 1 diabetes, a condition where the body produces little or no insulin at all. This is because the drug works by helping the body respond properly to the insulin it already makes. In addition, it reduces the amount of glucose produced by the liver and decreases the amount of glucose absorbed by the intestines. This helps to control high blood glucose levels. How to take this medication The dosage of metformin will vary depending on the patient’s medical condition and response to treatment. To reduce the risk of side effects such as stomach upset, your doctor may advise you to start on a lower dose then increase it gradually. Make sure you take this medication exactly as it is prescribed by your doctor. This medication is supposed to be taken by mouth, normally one to three times per day together with meals. Use this medication every day so that you can get the most benefit out of it. Your doctor may need to change your dose occasionally so that you can get the best results. Remember to use this drug at the same time every Continue reading >>

Glipizide/metformin Hcl Tablets Rx

Select the drug indication to add to your list Glipizide/metformin HCl; 2.5mg/250mg, 2.5mg/500mg, 5mg/500mg. Indications for Glipizide/Metformin HCl Tablets: Adjunct to diet and exercise in type 2 diabetes, as initial therapy or as second-line therapy when response to a sulfonylurea or metformin is inadequate. Take with meals. First-line: initially 2.5mg/250mg once daily; or, if fasting plasma glucose is 280320mg/dL, may start at 2.5mg/500mg twice daily. May increase by 1 tab/day every 2 weeks; max 10mg/1000mg or 10mg/2000mg per day in divided doses. Second-line: (previously treated with sulfonylurea or metformin only): 2.5mg/500mg or 5mg/500mg twice daily (AM & PM) (initial dose should not exceed previous daily doses of individual components); may increase by increments of 5mg/500mg up to minimum effective dose or max 20mg/2000mg per day. Previously treated with combination therapy (sulfonylurea plus metformin): may be switched to 2.5mg/500mg or 5mg/500mg (initial dose should not exceed previous daily doses of individual components). Elderly: avoid max doses. Renal disease or dysfunction. Metabolic acidosis, diabetic ketoacidosis with or without coma. Concomitant intravascular iodinated contrast agents (suspend during and for 48hrs). Increased risk of cardiovascular mortality. Discontinue if lactic acidosis, shock, acute CHF, acute MI, sepsis, or hypoxemia occurs. Confirm normal renal function before starting therapy (esp. in patients 80yrs); monitor renal function. Avoid in hepatic disease. G6PD deficiency. Suspend before surgery that requires fasting. Monitor hematology (esp. serum Vit. B12 in susceptible patients). Elderly, debilitated, uncompensated strenuous exercise, malnourished, or deficient caloric intake, adrenal or pituitary insufficiency, alcohol intoxicat Continue reading >>

Rosiglitazone/metformin Rx

Adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes. Limitations of use: not for treating type 1 diabetes or diabetic ketoacidosis. Not for use with insulin. Give in divided doses with meals. Drug-naive: initially 2mg/500mg once or twice daily; may increase by 2mg/500mg per day after 4 weeks; max 8mg/2000mg per day. If HbA1c >11% or fasting plasma glucose (FPG) >270mg/dL: consider starting at 2mg/500mg twice daily. Previously on metformin alone: add rosiglitazone 4mg/day to current metformin dose; may increase after 812 weeks. Previously on rosiglitazone alone: add metformin 1000mg/day to current rosiglitazone dose; may increase after 12 weeks. Previously on rosiglitazone + metformin: switch on a mg/mg basis; may increase by rosiglitazone 4mg and/or metformin 500mg per day; max 8mg/2000mg per day. NYHA Class III or IV heart failure. Severe renal impairment (eGFR <30mL/min/1.73m2). Metabolic acidosis, diabetic ketoacidosis. Symptomatic HF or acute coronary syndromes: not recommended; discontinue if occurs. CHF: NYHA Class I or II: increased risk of cardiovascular events (monitor); discontinue or reduce dose if develops. Edema. Monitor for signs/symptoms of heart failure. Increased risk of metformin-associated lactic acidosis in renal or hepatic impairment, concomitant use of certain drugs (eg, cationic drugs), 65yrs of age, undergoing radiological contrast study, surgery and other procedures, hypoxic states, and excessive alcohol intake; discontinue if lactic acidosis occurs. Discontinue at time of, or prior to intravascular iodinated contrast imaging in patients with eGFR 3060mL/min/1.73m2, history of hepatic impairment, alcoholism, heart failure, or will be given intra-arterial contrast; reevaluate eGFR 48hrs after procedure and res Continue reading >>

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 >>

How Does Metformin Interact With Other Medications Or Foods?

Medications that interact with metformin include digoxin, cimetidine, furosemide, nifedipine, amiloride, ranitidine, triamterene, morphine, quinidine, vancomycin, trimethoprim and procainamide. Taking metformin with other drugs that lower blood sugar can raise your risk of hypoglycemia (low blood sugar). This includes probenid, beta-blockers, sulfa drugs, salicylates, monoamine oxidase inhibitors and certain nonsteroidal anti-inflammatory drugs (NSAIDs). Alcohol can also lower your blood sugar and increase the chances of developing lactic acidosis. Your risk of hyperglycemia (high blood sugar) may be increased if you take metformin with other medications that increase blood sugar levels. Medications that raise your blood sugar are thyroid medications, steroids, isoniazid, diet pills, seizure medications, birth control pills, diuretics and phenothiazines. There may be other drugs, supplements or food that interact with metformin. People with diabetes should follow a diet and exercise plan. Because diabetes affects your blood sugar, diet is extremely important and you should discuss this with your doctor. Continue reading >>

Drug Interactions Of Medications Commonly Used In Diabetes

When patients are diagnosed with diabetes, a large number of medications become appropriate therapy. These include medications for dyslipidemia, hypertension, antiplatelet therapy, and glycemic control. So many medications can be overwhelming, and it is imperative that patients are thoroughly educated about their drug regimen. Patients have many concerns when multiple medications are started, including prescribing errors, the cost of medications, and possible adverse effects. Significantly, 58% of patients worry that they will be given medications that have drug interactions that will adversely affect their health.1 These worries are not unfounded given that several highly publicized drugs have been withdrawn from the U.S. market in the past several years because of adverse effects from drug interactions. Terfenadine, mibefradil, and cisapride have all been withdrawn from the market specifically because of drug-drug interactions. When terfenadine or cisapride were given with a strong inhibitor of their metabolism, torsades de pointes, a life-threatening drug-induced ventricular arrhythmia associated with QT prolongation, could occur.2 Cisapride, for gastroparesis or gastrointestinal reflux disease, and mibefradil, for hypertension, were prescribed for many patients with diabetes. An adverse drug interaction is defined as an interaction between one or more coadministered medications that results in the alteration of the effectiveness or toxicity of any of the coadministered medications. Drug interactions can be caused by prescription and over-the-counter medications, herbal products or vitamins, foods, diseases, and genetics (family history). The true incidence of drug interactions is unknown because many are not reported, do not result in significant harm to patients, o Continue reading >>