diabetestalk.net

Metformin Patient Teaching

Glucophage, Glucophage Xr (metformin) Dosing, Indications, Interactions, Adverse Effects, And More

Glucophage, Glucophage Xr (metformin) Dosing, Indications, Interactions, Adverse Effects, And More

Initial: 500 mg PO q12hr or 850 mg PO qDay with meals; increase q2Weeks Maintenance: 1500-2550 mg/day PO divided q8-12hr with meal Glucophage XR: 500 mg PO qDay with dinner; titrate by 500 mg/day qWeek; not to exceed 2000 mg/day Fortamet: 500-1000 mg PO qDay; titrate by 500 mg/day qWeek; not to exceed 2500 mg/day Glumetza: 1000 mg PO qDay; titrate by 500 mg/day qWeek; not to exceed 2000 mg/day Hepatic impairment: Avoid use; risk of lactic acidosis eGFR 30-45 mL/min/1.73 m: Not recommended to initiate treatment Monitor eGFR at least annually or more often for those at risk for renal impairment (eg, elderly) If eGFR falls below 45mL/min/1.73 m while taking metformin, risks and benefits of continuing therapy should be evaluated If eGFR falls below 30 mL/min/1.73 m: while taking metformin, discontinue the drug Orphan designation for treatment of pediatric polycystic ovary syndrome EffRx Pharmaceuticals SA; Wolleraustrass 41 B; 8807 Freienbach (SZ); SWITZERLAND Orphan designation for treatment of progressive myoclonus epilepsy type 2 (Lafora disease) Consorcio Centro de Investigacin Biomdica en Red, M.P. (CIBER); Monforte de Lemos, 3-5 Pabellon 11; Madrid, Spain Maintenance: Titrate qWeek by 500 mg; no more than 2000 mg/day in divided doses Initial: 500 mg PO q12hr or 850 mg PO qDay with meals; increase q2Weeks Maintenance: 1500-2550 mg/day PO divided q8-12hr with meal Glucophage XR: 500 mg PO qDay with dinner; titrate by 500 mg/day qWeek; not to exceed 2000 mg/day Fortamet: 500-1000 mg PO qDay; titrate by 500 mg/day qWeek; not to exceed 2500 mg/day eGFR 30-45 mL/min/1.73 m: Initiating not recommended Obtain GFR at least annually in all patients taking metformin; assess eGFR more frequently in patients at increased risk for renal impairment (eg, elderly) If eGFR falls to <4 Continue reading >>

Metformin. What Do You Need To Know?

Metformin. What Do You Need To Know?

What is type 2 diabetes? People with diabetes are not able to make enough insulin and/or respond normally to the insulin their body does make. When this happens, sugar (glucose) builds up in the blood. This can lead to serious medical problems including kidney damage, amputations and blindness. Diabetes is also closely linked to heart disease. The main goal of treating diabetes is to lower the level of your blood sugar as close to normal as possible. How is type 2 diabetes usually controlled? High blood sugar can be lowered by diet and exercise, by a number of oral medications and by insulin injections. Before taking biguanidas (metformin hydrochloride tablets) you should first try to control your diabetes by exercise and weight loss. Even if you are taking biguanidas, you should still exercise and follow the diet recommended for your diabetes. Does Metformin work differently from other glucose-control medications? Yes it does. Until Metformin was introduced, al¡ the available oral glucose-control medications were from the same chemical group called sulfonylureas. These drugs lower blood sugar primarily by causing more of the body's own insulin to be released. Metformin lowers the amount of sugar in your blood by helping your body respond better to its own insulin. Metformin (metformin hydrochloride tablets) does not cause your body to produce more insulin. Therefore, Metformin rarely causes hypoglycemia (low blood sugar) and it doesn't usually cause weight gain. What happens if my blood sugar is still too high? When blood sugar cannot be lowered enough by either Metformin or a sulfonylurea, the two medications may be effective taken together. However, if you are unable to maintain your blood sugar with diet, exercise and glucose-control medication taken orally, then y Continue reading >>

Oral Hypoglycemic Drugs

Oral Hypoglycemic Drugs

Oral hypoglycemic drugs are used only in the treatment of type 2 diabetes which is a disorder involving resistance to secreted insulin. Type 1 diabetes involves a lack of insulin and requires insulin for treatment. There are now four classes of hypoglycemic drugs: Sulfonylureas Metformin Thiazolidinediones Alpha-glucosidase inhibitors. These drugs are approved for use only in patients with type 2 diabetes and are used in patients who have not responded to diet, weight reduction, and exercise. They are not approved for the treatment of women who are pregnant with diabetes. SULFONYLUREAS – Sulfonylureas are the most widely used drugs for the treatment of type 2 diabetes and appear to function by stimulating insulin secretion. The net effect is increased responsiveness of ß-cells (insulin secreting cells located in the pancreas) to both glucose and non-glucose secretagogues, resulting in more insulin being released at all blood glucose concentrations. Sulfonylureas may also have extra-pancreatic effects, one of which is to increase tissue sensitivity to insulin, but the clinical importance of these effects is minimal. Pharmacokinetics – Sulfonylureas differ mainly in their potency & their duration of action. Glipizide, glyburide (glibenclamide), and glimepiride are so-called second-generation sulfonylureas. They have a potency that allows them to be given in much lower doses. Those drugs with longer half-lives (particularly chlorpropamide, glyburide, and glimepiride) can be given once daily. This benefit may be counterbalanced by a substantially increased risk of hypoglycemia. Side effects – Sulfonylureas are usually well tolerated. Hypoglycemia is the most common side effect and is more common with long-acting sulfonylureas. Patients recently discharged from hospit Continue reading >>

Metformin Oral : Uses, Side Effects, Interactions, Pictures, Warnings & Dosing - Webmd

Metformin Oral : Uses, Side Effects, Interactions, Pictures, Warnings & Dosing - Webmd

Nausea , vomiting , stomach upset, diarrhea , weakness , or a metallic taste in the mouth may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly. If stomach symptoms return later (after taking the same dose for several days or weeks), tell your doctor right away. Stomach symptoms that occur after the first days of your treatment may be signs of lactic acidosis . Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects. Metformin does not usually cause low blood sugar ( hypoglycemia ). Low blood sugar may occur if this drug is prescribed with other diabetes medications . Talk with your doctor or pharmacist about whether the dose of your other diabetes medication(s) needs to be lowered. Symptoms of low blood sugar include sudden sweating , shaking, fast heartbeat, hunger , blurred vision , dizziness , or tingling hands/feet. It is a good habit to carry glucose tablets or gel to treat low blood sugar . If you don't have these reliable forms of glucose, rapidly raise your blood sugar by eating a quick source of sugar such as table sugar, honey, or candy, or drink fruit juice or non-diet soda. Tell your doctor about the reaction right away. Low blood sugar is more likely if you drink large amounts of alcohol, do unusually heavy exercise , or do not consume enough calories from food. To help prevent low blood sugar, eat meals on a regular schedule, and do not skip meals. Check with your doctor or pharmacist to find out what you should do if you miss a meal. Symptoms of high blood sugar ( hyperglycemia ) include thirst, increased urination, confusion, drowsiness, flushing, rapid Continue reading >>

Metformin For Diabetes

Metformin For Diabetes

Metformin for diabetes This leaflet is about the use of metformin for diabetes. This leaflet has been written specifically about the use of this medicine in children. Our information sometimes differs from that provided by the manufacturers, because their information is usually aimed at adult patients. Please read this leaflet carefully. Keep it somewhere safe so that you can read it again. If your child starts to breathe very fast and deeply and becomes dizzy, drowsy (sleepy) and confused, stop giving this medicine and take your child to hospital or call an ambulance straight away, as they may be suffering from a rare reaction to metformin called lactic acidosis. Name of drug Metformin hydrochloride Brand names: Glucophage®, Metsol® Why is it important for my child to take this medicine? Your child has been prescribed metformin because their diabetes is not fully controlled even when eating a strict diet. Metformin should help to control your child’s blood sugar levels, in combination with a controlled diet. What is metformin available as? Tablets: 500 mg, 850 mg Liquid medicine: 500 mg in 5 mL Oral powder: 500 mg per sachet, 1g per sachet; these contain aspartame When should I give metformin? Metformin is usually given once each day with or straight after a meal. This is usually in the morning. If your child needs a higher dose of metformin, they may need to take it two – three times each day, with or straight after a meal. Ideally these times are six hours apart. Give the medicine at about the same time each day so that this becomes part of your child’s daily routine, which will help you to remember. How much should I give? Your doctor will work out the amount of metformin (the dose) that is right for your child. The dose will be shown on the medicine label. Continue reading >>

Important Safety Information For Invokana®, Invokamet® (canagliflozin/metformin Hcl), And Invokamet® Xr (canagliflozin/metformin Hcl Extended-release)

Important Safety Information For Invokana®, Invokamet® (canagliflozin/metformin Hcl), And Invokamet® Xr (canagliflozin/metformin Hcl Extended-release)

WARNING: LACTIC ACIDOSIS AND LOWER-LIMB AMPUTATION Lactic Acidosis Postmarketing cases of metformin-associated lactic acidosis have resulted in death, hypothermia, hypotension, and resistant bradyarrhythmias. The onset of metformin-associated lactic acidosis is often subtle, accompanied only by nonspecific symptoms such as malaise, myalgias, respiratory distress, somnolence, and abdominal pain. Metformin-associated lactic acidosis was characterized by elevated blood lactate levels (>5 mmol/L); anion gap acidosis (without evidence of ketonuria or ketonemia); an increased lactate:pyruvate ratio; and metformin plasma levels generally >5 mcg/mL. Risk factors for metformin-associated lactic acidosis include renal impairment, concomitant use of certain drugs (eg, carbonic anhydrase inhibitors such as topiramate), age 65 years old or greater, having a radiological study with contrast, surgery and other procedures, hypoxic states (eg, acute congestive heart failure), excessive alcohol intake, and hepatic impairment. Steps to reduce the risk of and manage metformin-associated lactic acidosis in these high-risk groups are provided in the full prescribing information. If metformin-associated lactic acidosis is suspected, immediately discontinue INVOKAMET®/ INVOKAMET® XR and institute general supportive measures in a hospital setting. Prompt hemodialysis is recommended. Risk of Lower-Limb Amputation An approximately 2-fold increased risk of lower-limb amputations associated with canagliflozin, a component of INVOKAMET®/INVOKAMET® XR, was observed in CANVAS and CANVAS-R, two large, randomized, placebo-controlled trials in patients with type 2 diabetes who had established cardiovascular disease (CVD) or were at risk for CVD. Amputations of the toe and midfoot were most frequent; Continue reading >>

Fortamet Patient Information Including Side Effects

Fortamet Patient Information Including Side Effects

Brand Names: Fortamet, Glucophage, Glucophage XR, Glumetza, Riomet Generic Name: metformin (Pronunciation: met FOR min) What are the possible side effects of metformin (Fortamet, Glucophage, Glucophage XR, Glumetza, Riomet)? What is the most important information I should know about metformin (Fortamet, Glucophage, Glucophage XR, Glumetza, Riomet)? What should I discuss with my healthcare provider before taking metformin (Fortamet, Glucophage, Glucophage XR, Glumetza, Riomet)? What is metformin (Fortamet, Glucophage, Glucophage XR, Glumetza, Riomet)? Metformin is an oral diabetes medicine that helps control blood sugar levels. Metformin is for people with type 2 diabetes. Metformin is sometimes used in combination with insulin or other medications, but it is not for treating type 1 diabetes. Metformin may also be used for purposes not listed in this medication guide. What are the possible side effects of metformin (Fortamet, Glucophage, Glucophage XR, Glumetza, Riomet)? Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat. This medication may cause lactic acidosis (a build-up of lactic acid in the body, which can be fatal). Lactic acidosis can start slowly and get worse over time. Get emergency medical help if you have even mild symptoms of lactic acidosis, such as: muscle pain or weakness; numb or cold feeling in your arms and legs; trouble breathing; feeling dizzy, light-headed, tired, or very weak; stomach pain, nausea with vomiting; or slow or uneven heart rate. Call your doctor at once if you have any other serious side effect such as: feeling short of breath, even with mild exertion; swelling or rapid weight gain; or fever, chills, body aches, flu symptoms. Les Continue reading >>

Metformin: Current Knowledge

Metformin: Current Knowledge

Go to: Abstract Diabetes mellitus is a group of metabolic disorders in which the blood glucose is higher than normal levels, due to insufficiency of insulin release or improper response of cells to insulin, resulting in high blood pressure. The resultant hyperglycemia produces sever complications. Metformin drug has been shown to prevent diabetes in people who are at high risk and decrease most of the diabetic complications. Recent reports on metformin, not only indicate some implications such as renoprotective properties have been suggested for metformin, but some reports indicate its adverse effects as well that are negligible when its benefits are brought into account. We aimed here to review the new implications of metformin and discuss about the concerns in the use of metformin, referring to the recently published papers. Keywords: Diabetes, diabetes mellitus, diabetic nephropathy, glucose, metformin, new applications, polycystic ovary syndrome, renoprotection Go to: INTRODUCTION Diabetes mellitus is a group of metabolic disorders in which the blood glucose is higher than normal levels, due to insufficiency of insulin release or improper response of cells to insulin, resulting in high blood pressure. The resultant hyperglycemia produces the classical symptoms of polyuria, polydipsia and polyphagia. It may also cause nerve problems, kidney problems, and blindness, loss of limbs, and sexual dysfunction, increase in heart attack or stroke.[1] Metformin (a biguanide derivative), by controlling blood glucose level decreases these complications. Metformin works by helping to restore the body's response to insulin. It decreases the amount of blood sugar that the liver produces and that the intestines or stomach absorb.[2] Metformin, other than hypoglycemic activity, has b Continue reading >>

Metformin

Metformin

Metformin may rarely cause a serious, life-threatening condition called lactic acidosis. Tell your doctor if you have kidney disease. Your doctor will probably tell you not to take metformin. Also, tell your doctor if you are over 65 years old and if you have ever had a heart attack; stroke; diabetic ketoacidosis (blood sugar that is high enough to cause severe symptoms and requires emergency medical treatment); a coma; or heart or liver disease. Taking certain other medications with metformin may increase the risk of lactic acidosis. Tell your doctor if you are taking acetazolamide (Diamox), dichlorphenamide (Keveyis), methazolamide, topiramate (Topamax, in Qsymia), or zonisamide (Zonegran). Tell your doctor if you have recently had any of the following conditions, or if you develop them during treatment: serious infection; severe diarrhea, vomiting, or fever; or if you drink much less fluid than usual for any reason. You may have to stop taking metformin until you recover. If you are having surgery, including dental surgery, or any major medical procedure, tell the doctor that you are taking metformin. Also, tell your doctor if you plan to have any x-ray procedure in which dye is injected, especially if you drink or have ever drunk large amounts of alcohol or have or have had liver disease or heart failure. You may need to stop taking metformin before the procedure and wait 48 hours to restart treatment. Your doctor will tell you exactly when you should stop taking metformin and when you should start taking it again. If you experience any of the following symptoms, stop taking metformin and call your doctor immediately: extreme tiredness, weakness, or discomfort; nausea; vomiting; stomach pain; decreased appetite; deep and rapid breathing or shortness of breath; dizzi Continue reading >>

Nursing Drug Guide Online

Nursing Drug Guide Online

Nursing Consideration Patient Teaching - Metformin Fortamet Glucophage Glucophage XR Glumetza, Riomet Give metformin tablets with food, which decreases and slightly delays absorption, thus reducing risk of adverse GI reactions. Give E.R. tablets with evening meal; dont Expect prescriber to alter dosage if patient gastric emptying, such as diarrhea, gastroparesis, Expect to assess BUN and serum creatinine therapy in those at increased risk for lactic ordered, because impaired hepatic function ability to clear lactate, predisposing the Monitor patients blood glucose level to during times of increased stress, such as Iodinated contrast media used in radiographic failure and lactic acidosis during metformin Instruct patient to take metformin tablet at breakfast if taking drug once a day or at breakfast and dinner if taking drug twice a day. Instruct him to take E.R. tablets once Direct patient to take drug exactly as prescribed Stress importance of following prescribed weight, and checking blood glucose level. Teach patient how to measure blood glucose and hypoglycemia. Urge him to notify prescriber Caution patient to avoid alcohol, which Instruct patient to report early signs of lactic acidosis, including drowsiness, hyperventilation, Advise patient to expect laboratory testing 3 months until blood glucose is controlled. Continue reading >>

Glucophage (metformin) And Diabetes

Glucophage (metformin) And Diabetes

Tweet Glucophage and Metformin are often mentioned in relation to diabetes treatment. But what exactly is Glucophage and how does Glucophage help control type 2 diabetes? The following guide to Glucophage should help you to understand more about this medication, its side effects and its value. What is Glucophage? Glucophage tablets (and Glucophage SR tablets) each have an active ingredient called Metformin hydrochloride. Metformin is widely used to aid in the control of blood glucose levels amongst people with type 2 diabetes. How does Glucophage help people with type 2 diabetes? Amongst people with type 2 diabetes, the pancreas fails to produce sufficient levels of insulin. Furthermore, the cells in the body may be resistant to any insulin that is present. Normally, insulin would instruct cells to remove sugar from the blood, but in people with diabetes blood sugar levels can climb too high. As we said before, Glucophage contains the ingredient Metformin. Metformin (Metformin hydrochloride) is a type of medicine known as a biguanide. This works to lower the amount of sugar in the blood of people with diabetes. It does this by lowering the amount of sugar produced in the liver, and also increasing the sensitivity of muscle cells to insulin. The cells are therefore more able to remove sugar from the blood. Metformin also slows the absorption of sugars from the intestines. Metformin lowers blood sugar levels between and after meals. Who is Glucophage prescribed to? Glucophage is usually prescribed as a treatment for people with type 2 diabetes who are overweight or obese. When diet and exercise fail to adequately control blood glucose levels, Glucophage is prescribed. Sometimes, this medicine is used in conjunction with other anti-diabetic medication. How often do people Continue reading >>

Metformin (oral Route)

Metformin (oral Route)

met-FOR-min hye-droe-KLOR-ide Oral route(Tablet;Tablet, Extended Release;Solution) Death, hypothermia, hypotension, and resistant bradyarrhythmias have been reported due to metformin-associated lactic acidosis. Onset may be subtle and include nonspecific symptoms such as malaise, myalgia, respiratory distress, somnolence, and abdominal distress; laboratory abnormalities include low pH, increased anion gap and elevated blood lactate. The risk of lactic acidosis increases with renal or hepatic impairment, aged 65 years or older, having a radiological study with contrast, surgery, or other procedures, hypoxic states, and excessive alcohol intake. If lactic acidosis is suspected, metformin hydrochloride should be discontinued, supportive measures started in a hospital setting. Prompt hemodialysis is recommended . Commonly used brand name(s) In the U.S. Fortamet Glucophage Glucophage XR Glumetza Riomet Available Dosage Forms: Tablet Tablet, Extended Release Solution Therapeutic Class: Hypoglycemic Chemical Class: Metformin Uses For metformin Metformin is used to treat high blood sugar levels that are caused by a type of diabetes mellitus or sugar diabetes called type 2 diabetes. With this type of diabetes, insulin produced by the pancreas is not able to get sugar into the cells of the body where it can work properly. Using metformin alone, with a type of oral antidiabetic medicine called a sulfonylurea, or with insulin, will help to lower blood sugar when it is too high and help restore the way you use food to make energy. Many people can control type 2 diabetes with diet and exercise. Following a specially planned diet and exercise will always be important when you have diabetes, even when you are taking medicines. To work properly, the amount of metformin you take must be Continue reading >>

Diabetes Medication Metformin: Why Patients Stop Taking It

Diabetes Medication Metformin: Why Patients Stop Taking It

Gretchen Becker, author of The First Year: Type 2 Diabetes: An Essential Guide for the Newly Diagnosed , has been taking metformin for more than 20 years after receiving a diagnosis of type 2 diabetes in 1996. I never had any problems with metformin until I took a pill that I thought was the extended-release version, but it wasnt, Becker told Healthline. Beckers doctor had accidentally prescribed the regular form of metformin. I had very loose bowels for several months until I figured out what the problem was, Becker said. After getting the proper prescription, it took several months for Beckers digestive system to recover. Corinna Cornejo, who received a diagnosis of type 2 diabetes in 2009, told Healthline that her digestive woes didnt start until shed been taking metformin for more than a year. At first, I thought it was a response to dairy, but my doctor eventually switched my prescription to the extended-release version, Cornejo recalled. That has helped, but the side effect has not gone away completely. For some people, however, metformins unpleasant side effect of loose stools provides a much-needed balance to the side effects that can result from other diabetes drugs theyre taking. GLP-1 drugs, like Victoza or Byetta, can cause constipation, explained Robinson. Taking metformin with a GLP-1 drug means they actually complement each other, balancing out those side effects. And for some, metformin simply isnt the right drug. No matter what you do, some patients just dont tolerate the side effects well, said Robinson. Although there are many diabetes drugs on the market today, doctors will likely push metformin first. There has never been as many diabetes treatment options available as there are now, explained Robinson. But doctors look at cost, and metformin is th Continue reading >>

Metformin And Repaglinide

Metformin And Repaglinide

What is the most important information I should know about metformin and repaglinide? You should not use this medication if you are allergic to metformin (Glucophage) or repaglinide (Prandin), if you have kidney disease or type 1 diabetes, or if you are in a state of diabetic ketoacidosis (call your doctor for treatment with insulin). You should not use metformin and repaglinide together with gemfibrozil (Lopid) or NPH insulin (such as isophane insulin). If you need to have any type of x-ray or CT scan using a dye that is injected into your veins, you will need to temporarily stop taking metformin and repaglinide. Some people develop lactic acidosis while taking metformin. Early symptoms may get worse over time and this condition can be fatal. Get emergency medical help if you have even mild symptoms such as: muscle pain or weakness, numb or cold feeling in your arms and legs, trouble breathing, stomach pain, nausea with vomiting, slow or uneven heart rate, dizziness, or feeling very weak or tired. Take care not to let your blood sugar get too low. Low blood sugar (hypoglycemia) can occur if you skip a meal, exercise too long, drink alcohol, or are under stress. Symptoms include headache, hunger, weakness, sweating, tremors, irritability, or trouble concentrating. Carry hard candy or glucose tablets with you in case you have low blood sugar. Other sugar sources include orange juice and milk. Be sure your family and close friends know how to help you in an emergency. Metformin and repaglinide are oral diabetes medications that help control blood sugar levels. Repaglinide works by causing the pancreas to produce insulin. Metformin works by decreasing glucose (sugar) production in the liver and decreasing absorption of glucose by the intestines. The combination of metform Continue reading >>

Glucophage Advanced Patient Information - Drugs.com

Glucophage Advanced Patient Information - Drugs.com

For oral dosage form (extended-release tablets): Metformin alone (Fortamet): At first, 1000 milligrams (mg) once a day taken with the evening meal. Your doctor may increase your dose if needed until your blood sugar is controlled. However, the dose is usually not more than 2500 mg per day. Metformin alone (Glucophage XR): At first, 500 mg once daily with the evening meal. Your doctor may increase your dose if needed until your blood sugar is controlled. However, the dose is usually not more than 2000 mg per day. Metformin alone (Glumetza): At first, 500 mg once a day taken with the evening meal. Then, your doctor may increase your dose if needed until your blood sugar is controlled. However, the dose is usually not more than 2000 mg per day. Metformin with a sulfonylurea: Your doctor will determine the dose of each medicine. Metformin with insulin: At first, 500 mg once a day. Then, your doctor may increase your dose by 500 mg every week if needed until your blood sugar is controlled. However, the dose is usually not more than 2500 mg per day. ChildrenUse and dose must be determined by your doctor. Metformin alone: At first, 5 milliliters (mL) two times a day, or 8.5 mL once a day with meals. Your doctor may increase your dose if needed until your blood sugar is controlled. However, the dose is usually not more than 25.5 mL per day. Metformin with a sulfonylurea: Your doctor will determine the dose of each medicine. Metformin with insulin: At first, 5 mL once a day. Your doctor may increase your dose if needed until your blood sugar is controlled. However, the dose is usually not more than 25 mL per day. Children 10 to 16 years of ageAt first, 5 mL two times a day with meals. Your doctor may increase your dose if needed until your blood sugar is controlled. However, th Continue reading >>

More in diabetes