Metformin Dosage 250mg Is Too Low?
Friend Thin super-active but rising FBG; Mom T2 I felt nothing after one week on 250mg glucostage. Maybe the dosage is too low and too soon to share experience. I read someone saying met needs at least 1000mg to start working, is it true? I am considering raising it to 850mg XR after 90days, when I will do a blood testing At first metformin 500 mg worked but eventually needed more and that is when i couldnt handle the side effects. Also you have to eat low carb with it to work good D.D. Family Getting much harder to control A lot depends on what your eating. Met can not counter act what carbs do. Also it could take 6 weeks to fully work most likely they started you low dose to prevent stomach issues. I started 500mg for first week and then upped to 1000mg. As furball says the initial lower dose is so your body adjusts. 250 does sound a bit low though. I am also taking 2.5mg of glipizide once a day. Friend Thin super-active but rising FBG; Mom T2 I work hard to persuade dr. for even 250mg dosage because in their book the patient is normal unless FBG is 7+ or HBA1c is 6.5%+ After 3 months, I will have the battle to get 850mg XR ... I truely believe Met needs more dosage to work.. 250mg, which is too low, is wasting my kidney and my time.... D.D. Family Getting much harder to control Friend Thin super-active but rising FBG; Mom T2 it's like eating much salt while I am not a salty dinner fan... Met is dumped by my kidney, right? My lovely organ should not "in vain" function, my opinion... D.D. Family Getting much harder to control Met works in the liver and reduces insulin resistance and you been on it only one week it's not like a pancreas stimulating med. D.D. Family diabetic since 1997, on insulin 2000 When I first started metformin, I had to raise it to 2550 mg before Continue reading >>
Metformin, Oral Tablet
Metformin oral tablet is available as both a generic and brand-name drug. Brand names: Glucophage, Glucophage XR, Fortamet, and Glumetza. Metformin is also available as an oral solution but only in the brand-name drug Riomet. Metformin is used to treat high blood sugar levels caused by type 2 diabetes. FDA warning: Lactic acidosis warning This drug has a Black Box Warning. This is the most serious warning from the Food and Drug Administration (FDA). A black box warning alerts doctors and patients to potentially dangerous effects. Lactic acidosis is a rare but serious side effect of this drug. In this condition, lactic acid builds up in your blood. This is a medical emergency that requires treatment in the hospital. Lactic acidosis is fatal in about half of people who develop it. You should stop taking this drug and call your doctor right away or go to the emergency room if you have signs of lactic acidosis. Symptoms include tiredness, weakness, unusual muscle pain, trouble breathing, unusual sleepiness, stomach pains, nausea (or vomiting), dizziness (or lightheadedness), and slow or irregular heart rate. Alcohol use warning: You shouldn’t drink alcohol while taking this drug. Alcohol can affect your blood sugar levels unpredictably and increase your risk of lactic acidosis. Kidney problems warning: If you have moderate to severe kidney problems, you have a higher risk of lactic acidosis. You shouldn’t take this drug. Liver problems warning: Liver disease is a risk factor for lactic acidosis. You shouldn’t take this drug if you have liver problems. Metformin oral tablet is a prescription drug that’s available as the brand name drugs Glucophage, Glucophage XR, Fortamet, and Glumetza. Glucophage is an immediate-release tablet. All of the other brands are extended-r Continue reading >>
About Metformin
Metformin is a medicine used to treat type 2 diabetes and sometimes polycystic ovary syndrome (PCOS). Type 2 diabetes is an illness where the body doesn't make enough insulin, or the insulin that it makes doesn't work properly. This can cause high blood sugar levels (hyperglycemia). PCOS is a condition that affects how the ovaries work. Metformin lowers your blood sugar levels by improving the way your body handles insulin. It's usually prescribed for diabetes when diet and exercise alone have not been enough to control your blood sugar levels. For women with PCOS, metformin stimulates ovulation even if they don't have diabetes. It does this by lowering insulin and blood sugar levels. Metformin is available on prescription as tablets and as a liquid that you drink. Key facts Metformin works by reducing the amount of sugar your liver releases into your blood. It also makes your body respond better to insulin. Insulin is the hormone that controls the level of sugar in your blood. It's best to take metformin with a meal to reduce the side effects. The most common side effects are feeling sick, vomiting, diarrhoea, stomach ache and going off your food. Metformin does not cause weight gain (unlike some other diabetes medicines). Metformin may also be called by the brand names Bolamyn, Diagemet, Glucient, Glucophage, and Metabet. Who can and can't take metformin Metformin can be taken by adults. It can also be taken by children from 10 years of age on the advice of a doctor. Metformin isn't suitable for some people. Tell your doctor before starting the medicine if you: have had an allergic reaction to metformin or other medicines in the past have uncontrolled diabetes have liver or kidney problems have a severe infection are being treated for heart failure or you have recentl Continue reading >>
Weekly Dose: Metformin, The Diabetes Drug Developed From French Lilac
Metformin is the most widely used drug to treat type 2 diabetes globally. In Australia, approximately two-thirds of patients with type 2 diabetes are prescribed metformin, either alone or in combination with other pills, or with insulin injections. Alongside diet and exercise, metformin is considered the first-choice drug to improve glucose control in type 2 diabetes. Metformin hydrochloride is the scientific or generic name for the active ingredient in tablets sold in Australia under 40 different proprietary or brand names. History Metformin was originally developed from natural compounds found in the plant Galega officinalis, known as French lilac or goat’s rue. Synthetic biguanides were developed in the 1920s in Germany, but their use was limited due to side effects. During the 1940s, however, French physician Jean Sterne examined a new biguanide called dimethylbiguanide or metformin. At the time, it was being studied for the treatment of influenza, but Sterne recognised it had glucose-lowering properties. He proposed calling it glucophage, meaning glucose eater, a name with which it is still commercially associated today. Metformin has been used to treat diabetes since the late 1950s. It is now on the World Health Organisation’s List of Essential Medicines needed for a basic health care system. How does it work? Insulin suppresses the production of glucose by the liver. One reason glucose levels remain high in those with type 2 diabetes is due to insufficient insulin. The liver continues to inappropriately make large amounts of glucose, even when glucose levels are already high. Metformin is able to reduce glucose production by the liver by approximately one-third, through mechanisms that remain to be fully understood. When taken as directed, it will reduce the Continue reading >>
A Comprehensive Guide To Metformin
Metformin is the top of the line medication option for Pre-Diabetes and Type 2 Diabetes. If you must start taking medication for your newly diagnosed condition, it is then likely that your healthcare provider will prescribe this medication. Taking care of beta cells is an important thing. If you help to shield them from demise, they will keep your blood sugar down. This medication is important for your beta cell safety if you have Type 2 Diabetes. Not only does Metformin lower blood sugar and decrease resistance of insulin at the cellular level, it improves cell functioning, lipids, and how fat is distributed in our bodies. Increasing evidence in research points to Metformin’s effects on decreasing the replication of cancer cells, and providing a protective action for the neurological system. Let’s find out why Lori didn’t want to take Metformin. After learning about the benefits of going on Metformin, she changed her mind. Lori’s Story Lori came in worrying. Her doctor had placed her on Metformin, but she didn’t want to get the prescription filled. “I don’t want to go on diabetes medicine,” said Lori. “If I go on pills, next it will be shots. I don’t want to end up like my dad who took four shots a day.” “The doctor wants you on Metformin now to protect cells in your pancreas, so they can make more insulin. With diet and exercise, at your age, you can reverse the diagnosis. Would you like to talk about how we can work together to accomplish that?” “Reverse?” she asked. “What do you mean reverse? Will I not have Type 2 Diabetes anymore?” “You will always have it, but if you want to put it in remission, you are certainly young enough to do so. Your doctor wants to protect your beta cells in the pancreas. If you take the new medication, Continue reading >>
Metformin Dosage
Metformin Dosage There have been no human studies to identify the optimal dose of metformin that is needed to duplicate the beneficial gene expression effects that are described in the June 2003 issue of Life Extension magazine. For people who want to derive the many proven health benefits of metformin, it might be prudent to follow the dosage schedule used by Type II diabetics. According to the Physician's Desk Reference, the starting dose should be 500 mg of metformin twice a day. (An alternative option is 850 mg of metformin once a day). After one week, increase the dose of metformin to 1000 mg as the first dose of the day and 500 mg as the second dose. After another week, increase to 1000 mg of metformin two times a day. The maximum safe dose described in the Physician's Desk Reference is 2550 mg a day (which should be taken as 850 mg three times a day). According to the Physician's Desk Reference, clinically significant responses in Type II diabetics are not seen at doses below 1500 mg a day of metformin. Anti-aging doctors, on the other hand, have recommended doses as low as 500 mg twice a day to healthy non-diabetics who are seeking to obtain metformin's other proven benefits such as enhancing insulin sensitivity and reducing excess levels of insulin, glucose, cholesterol and triglycerides in the blood. It could be the dosage range is highly individualistic in healthy people, meaning some may benefit from 500 mg twice a day, while others may need 1000 mg twice a day for optimal effects. Blood tests to ascertain if the dose of metformin you are taking is improving glucose/insulin metabolism would be: Hemoglobin A1c Fasting insulin CBC/Chemistry panel that includes glucose, cholesterol triglycerides and indicators of liver and kidney function A hemoglobin A1c test Continue reading >>
Metformin In The Treatment Of Adults With Type 2 Diabetes Mellitus
INTRODUCTION Two classes of oral hypoglycemic drugs directly improve insulin action: biguanides (only metformin is currently available) and thiazolidinediones (TZDs). In the absence of contraindications, metformin is considered the first choice for oral treatment of type 2 diabetes (table 1). A 2006 consensus statement from the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD), updated regularly, proposed that metformin therapy (in the absence of contraindications) be initiated, concurrent with lifestyle intervention, at the time of diabetes diagnosis [1-3]. The pharmacology, efficacy, and side effects of metformin for the treatment of diabetes will be reviewed here. A general discussion of initial treatment of type 2 diabetes and the role of metformin in the prevention of diabetes, in the treatment of polycystic ovary syndrome, and in gestational diabetes are reviewed separately. Continue reading >>
- Type 1 diabetes as common in adults as children, but many adults misdiagnosed
- ADA: Cardiovascular Benefits seen with Long-Term Metformin Use in Adults with Type 1 Diabetes
- Is It Time to Change the Type 2 Diabetes Treatment Paradigm? No! Metformin Should Remain the Foundation Therapy for Type 2 Diabetes
Metformin
Adult Dosing . Dosage forms: TAB: 500 mg, 850 mg, 1000 mg; ER TAB: 500 mg, 750 mg, 1000 mg diabetes mellitus, type 2 [immediate-release form] Dose: 850-1000 mg PO bid; Start: 850 mg PO qd or 500 mg PO bid, incr. 500 mg qwk or 850 mg q2wk; Max: 2550 mg/day; Info: give w/ meals; D/C for iodinated contrast study if eGFR 30-60, hepatic dz hx, alcoholism hx, heart failure hx, or receiving contrast intra-arterially; restart after 48h if stable renal fxn [extended-release form] Dose: 1000-2000 mg ER PO qpm; Start: 500 mg ER PO qpm, incr. 500 mg/day qwk; Max: 2000 mg/day ER; Alt: 1000 mg ER PO bid; Info: may add 500 mg regular form if inadequate response; give w/ meals; do not cut/crush/chew ER tab; D/C for iodinated contrast study if eGFR 30-60, hepatic dz hx, alcoholism hx, heart failure hx, or receiving contrast intra-arterially; restart after 48h if stable renal fxn *polycystic ovary syndrome [immediate-release form] Dose: 500 mg PO tid; Max: 2550 mg/day; Alt: 850-1000 mg PO bid; Info: may incr. dose if inadequate response; give w/ meals; D/C for iodinated contrast study if eGFR 30-60, hepatic dz hx, alcoholism hx, heart failure hx, or receiving contrast intra-arterially; restart after 48h if stable renal fxn [extended-release form] Dose: 1500-2000 mg ER PO qpm; Info: give w/ meals; do not cut/crush/chew ER tab; D/C for iodinated contrast study if eGFR 30-60, hepatic dz hx, alcoholism hx, heart failure hx, or receiving contrast intra-arterially; restart after 48h if stable renal fxn renal dosing [see below] eGFR 30-45: avoid use; eGFR <30: contraindicated hepatic dosing [see below] hepatic impairment: avoid use Continue reading >>
Glucophage
GLUCOPHAGE® (metformin hydrochloride) Tablets GLUCOPHAGE® XR (metformin hydrochloride) Extended-Release Tablets DESCRIPTION GLUCOPHAGE® (metformin hydrochloride) Tablets and GLUCOPHAGE® XR (metformin hydrochloride) Extended-Release Tablets are oral antihyperglycemic drugs used in the management of type 2 diabetes. Metformin hydrochloride (N,N-dimethylimidodicarbonimidic diamide hydrochloride) is not chemically or pharmacologically related to any other classes of oral antihyperglycemic agents. The structural formula is as shown: Metformin hydrochloride is a white to off-white crystalline compound with a molecular formula of C4H11N5 HCl and a molecular weight of 165.63. Metformin hydrochloride is freely soluble in water and is practically insoluble in acetone, ether, and chloroform. The pK of metformin is 12.4. The pH of a 1% aqueous solution of metformin hydrochloride is 6.68. GLUCOPHAGE tablets contain 500 mg, 850 mg, or 1000 mg of metformin hydrochloride. Each tablet contains the inactive ingredients povidone and magnesium stearate. In addition, the coating for the 500 mg and 850 mg tablets contains hypromellose and the coating for the 1000 mg tablet contains hypromellose and polyethylene glycol. GLUCOPHAGE XR contains 500 mg or 750 mg of metformin hydrochloride as the active ingredient. GLUCOPHAGE XR 500 mg tablets contain the inactive ingredients sodium carboxymethyl cellulose, hypromellose, microcrystalline cellulose, and magnesium stearate. GLUCOPHAGE XR 750 mg tablets contain the inactive ingredients sodium carboxymethyl cellulose, hypromellose, and magnesium stearate. System Components And Performance GLUCOPHAGE XR comprises a dual hydrophilic polymer matrix system. Metformin hydrochloride is combined with a drug release controlling polymer to form an “inne Continue reading >>
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 Dosage
Usual Adult Dose for Diabetes Type 2 Immediate-release: Initial dose: 500 mg orally twice a day or 850 mg orally once a day Dose titration: Increase in 500 mg weekly increments or 850 mg every 2 weeks as tolerated Maintenance dose: 2000 mg daily in divided doses Maximum dose: 2550 mg/day Extended-release: Initial dose: 500 to 1000 mg orally once a day Dose titration: Increase in 500 mg weekly increments as tolerated Maintenance dose: 2000 mg daily Maximum dose: 2500 mg daily Comments: -Metformin, if not contraindicated, is the preferred initial pharmacologic agent for treatment of type 2 diabetes mellitus. -Immediate-release: Take in divided doses 2 to 3 times a day with meals; titrate slowly to minimize gastrointestinal side effects. In general, significant responses are not observed with doses less than 1500 mg/day. -Extended-release: Take with the evening meal; if glycemic control is not achieved with 2000 mg once a day, may consider 1000 mg of extended-release product twice a day; if glycemic control is still not achieve, may switch to immediate-release product. Use: To improve glycemic control in adults with type 2 diabetes mellitus as an adjunct to diet and exercise. Usual Pediatric Dose for Diabetes Type 2 10 years or older: Immediate-release: Initial dose: 500 mg orally twice a day Dose titration: Increase in 500 mg weekly increments as tolerated Maintenance dose: 2000 mg daily Maximum dose: 2000 mg daily Comments: Take in divided doses 2 to 3 times a day with meals. Titrate slowly to minimize gastrointestinal side effects. Safety and effectiveness of metformin extended-release has not been established in pediatric patients less than 18 years of age. Use: To improve glycemic control in children with type 2 diabetes mellitus as an adjunct to diet and exercise. Le Continue reading >>
Proper Use
Drug information provided by: Micromedex This medicine usually comes with a patient information insert. Read the information carefully and make sure you understand it before taking this medicine. If you have any questions, ask your doctor. Carefully follow the special meal plan your doctor gave you. This is a very important part of controlling your condition, and is necessary if the medicine is to work properly. Also, exercise regularly and test for sugar in your blood or urine as directed. Metformin should be taken with meals to help reduce stomach or bowel side effects that may occur during the first few weeks of treatment. Swallow the extended-release tablet whole with a full glass of water. Do not crush, break, or chew it. While taking the extended-release tablet, part of the tablet may pass into your stool after your body has absorbed the medicine. This is normal and nothing to worry about. Measure the oral liquid with a marked measuring spoon, oral syringe, or medicine cup. The average household teaspoon may not hold the right amount of liquid. Use only the brand of this medicine that your doctor prescribed. Different brands may not work the same way. You may notice improvement in your blood glucose control in 1 to 2 weeks, but the full effect of blood glucose control may take up to 2 to 3 months. Ask your doctor if you have any questions about this. Dosing The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so. The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the Continue reading >>
Therapeutic Use Of Metformin In Prediabetes And Diabetes Prevention
Go to: Pathophysiology and Diagnosis of Prediabetes The defects in glucose metabolism that underlie type 2 diabetes begin many years before the diagnosis of diabetes is made [6, 7]. The development of insulin resistance, in which the action of insulin on glucose metabolism is blunted, occurs early in the pathogenesis of dysglycaemia. Increased secretion of insulin initially compensates for the presence of insulin resistance; however, a simultaneous and progressive loss of β-cell mass and β-cell function limits the ability of the pancreas to maintain euglycaemia by increasing insulin secretion [8]. The early manifestations of prediabetic dysglycaemia represent one or both of [9]: impaired glucose tolerance (IGT), in which postprandial glucose control is impaired but fasting plasma glucose (FPG) is normal; impaired fasting glucose (IFG), in which a chronic elevation of FPG occurs in the absence of a deterioration in postprandial glucose control. Table 1 shows the usually accepted diagnostic criteria for the diagnosis of prediabetes based on measurements of glycaemia [4, 8–10]. A simple blood test is sufficient to diagnose IFG, while a 75 g oral glucose tolerance test (OGTT) is required for the diagnosis of IGT. The originally used cutoff level for IFG (110 mg/dL [6.1 mmol/L]) was reduced to that shown in Table 1 (100 mg/dL [5.6 mmol/L]) by an Expert Committee of the American Diabetes Association in 2003, in order to equalise the prognostic impact of diagnosis of IFG or IGT, in terms of the future risk of diabetes in a subject with either condition [11]. It should be noted that the World Health Organization (WHO) diagnostic criteria for IFG retains the 110 mg/dL (6.1 mmol/L) cutoff value for diagnosing IFG [12]. Diagnostic criteria from the American Diabetes Associatio Continue reading >>
Safe Prescribing Of Metformin In Diabetes
Metformin is the first-line pharmacological therapy for type 2 diabetes. It is the only glucose-lowering oral drug that has been shown to reduce mortality in patients with diabetes. The most common adverse effect is gastrointestinal upset. Starting at a low dose and increasing it slowly reduces this risk. Taking metformin with food also helps. Numerous contraindications to the use of metformin are listed in the product information, including reduced renal function. Strict adherence to these recommendations may deny a valuable drug to many patients. Introduction Metformin lowers both fasting and postprandial blood glucose. It reduces hepatic glucose output 1 and increases peripheral glucose uptake, and may delay intestinal glucose absorption. Its use is not associated with weight gain and hypoglycaemia is extremely rare when metformin is used on its own. It lowers triglyceride concentrations and has small but beneficial effects on total and high-density lipoprotein cholesterol. In the UK Prospective Diabetes Study metformin reduced diabetes-related and all-cause mortality, and reduced the risk of myocardial infarction in obese patients with type 2 diabetes when used as first-line therapy. It also reduced the risk of microvascular complications, but was no more effective than insulin or sulfonylureas. 2 A retrospective cohort study from the USA found a lower rate of hospitalisations for myocardial infarction and stroke and a reduced death rate when metformin was used first-line in type 2 diabetes in comparison with a sulfonylurea. 3 Metformin is effective when used with other glucose-lowering drugs. A standard-release (3000 mg/day maximum dose) and an extended-release preparation of metformin (2000 mg/day maximum dose) are available. The extended-release preparation can b Continue reading >>
What Are The Possible Side Effects Of Glyburide And Metformin (glucovance)?
GLUCOVANCE® (glyburide and metformin hcl) Tablets, 1.25 mg/250 mg, 2.5 mg/500 mg, 5 mg/500 mg DESCRIPTION GLUCOVANCE® (Glyburide and Metformin HCl) Tablets contain 2 oral antihyperglycemic drugs used in the management of type 2 diabetes, glyburide and metformin hydrochloride. Glyburide is an oral antihyperglycemic drug of the sulfonylurea class. The chemical name for glyburide is 1-[[p-[2-(5-chloro-o-anisamido)ethyl]phenyl]sulfonyl]-3-cyclo-hexylurea. Glyburide is a white to off-white crystalline compound with a molecular formula of C23H28ClN3O5S and a molecular weight of 494.01. The glyburide used in GLUCOVANCE has a particle size distribution of 25% undersize value not more than 6 μm, 50% undersize value not more than 7 to 10 μm, and 75% undersize value not more than 21 μm. The structural formula is represented below. Metformin hydrochloride is an oral antihyperglycemic drug used in the management of type 2 diabetes. Metformin hydrochloride (N,N-dimethylimidodicarbonimidic diamide monohydrochloride) is not chemically or pharmacologically related to sulfonylureas, thiazolidinediones, or α-glucosidase inhibitors. It is a white to off-white crystalline compound with a molecular formula of C4H12ClN5 (monohydrochloride) and a molecular weight of 165.63. Metformin hydrochloride is freely soluble in water and is practically insoluble in acetone, ether, and chloroform. The pKa of metformin is 12.4. The pH of a 1% aqueous solution of metformin hydrochloride is 6.68. The structural formula is as shown: GLUCOVANCE is available for oral administration in tablets containing 1.25 mg glyburide with 250 mg metformin hydrochloride, 2.5 mg glyburide with 500 mg metformin hydrochloride, and 5 mg glyburide with 500 mg metformin hydrochloride. In addition, each tablet contains the f Continue reading >>
