Timing Your Metformin Dose
The biggest problem many people have with Metformin is that it causes such misery when it hits their stomachs that they can't keep taking it even though they know it is the safest and most effective of all the oral diabetes drugs. In many cases all that is needed is some patience. After a rocky first few days many people's bodies calm down and metformin becomes quite tolerable. If you are taking the regular form of Metformin with meals and still having serious stomach issues after a week of taking metformin, ask your doctor to prescribe the extended release form--metformin ER or Glucophage XR. The extended release form is much gentler in its action. If that still doesn't solve your problem, there is one last strategy that quite a few of us have found helpful. It is to take your metformin later in the day, after you have eaten a meal or two. My experience with metformin--and this has been confirmed by other people--is that it can irritate an empty stomach, but if you take it when the stomach contains food it will behave. There are some drugs where it matters greatly what time of day you take the drug. Metformin in its extended release form is not one of them. As the name suggests, the ER version of the pill slowly releases the drug into your body over a period that, from my observations, appears to last 8 to 12 hours. Though it is supposed to release over a full 24 hours, this does not appear to be the case, at least not with the generic forms my insurer will pay for. Because there seems to be a span of hours when these extended release forms of metformin release the most drug into your blood stream, when you take your dose may affect how much impact the drug has on your blood sugars after meals or when you wake up. For example, the version I take, made by Teva, releases Continue reading >>
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Metformin Side Effects
Generic Name: metformin (met FOR min) Brand Names: Fortamet, Glucophage, Glucophage XR, Glumetza, Riomet What is metformin? Metformin is an oral diabetes medicine that helps control blood sugar levels. Metformin is used together with diet and exercise to improve blood sugar control in adults with type 2 diabetes mellitus. Metformin is sometimes used together with insulin or other medications, but it is not for treating type 1 diabetes. Important information You should not use metformin if you have severe kidney disease or diabetic ketoacidosis (call your doctor for treatment). 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. This medicine may cause a serious condition called lactic acidosis. 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. Get emergency medical help if you have signs of an allergic reaction to metformin: hives; difficult breathing; swelling of your face, lips, tongue, or throat. Some people develop lactic acidosis while taking this medicine. 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; feeling dizzy, light-headed, tired, or very weak; stomach pain, nausea with vomiting; or slow or uneven heart rate. Common metformin side effects may include: low blood sugar; nausea, upset stomach; or diarrhea. This is not a complete list of side effects and others may occur. Call your doc 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 >>
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 >>
Glimepiride Side Effects
What Is Glimepiride (Amaryl)? Glimepiride is the generic name of the prescription drug Amaryl, used to treat patients with type 2 diabetes. Glimepiride belongs to a class of drugs known as sulfonylureas. It stimulates the pancreas to produce insulin and helps the body use insulin more efficiently. The drug can also decrease the chances that someone will develop life-threatening complications of type 2 diabetes. The drug was approved by the FDA in 1995 and is manufactured by Sanofi-Aventis. Glimepiride comes in tablet form and is usually taken once a day. It may be used alone, or in combination with insulin or another oral medication such as metformin. Your doctor will probably start you on a low dose of the medication and gradually increase your dose if needed. If you've taken glimepiride for a long period of time, the drug may not control blood sugar as well as it did when you first started the treatment. Your doctor will adjust the dosage as needed. Glimepiride Warnings Glimepiride helps control blood sugar, but it will not cure your diabetes. You should continue to take glimepiride even if you feel well. This medication should not be used to treat patients with type 1 diabetes, a disease in which the body does not produce insulin. Glimepiride will only help lower blood sugar if your body produces insulin naturally. In one study, patients who took a medication similar to glimepiride to treat diabetes were more likely to die of heart problems than those who were treated with diet changes and insulin. Talk to your doctor about the risks of this treatment. While taking glimepiride, you should tell your doctor if you: Are pregnant, plan to become pregnant, or are breastfeeding Are having surgery, including dental surgery Have ever had G6PD deficiency (a genetic blood diso Continue reading >>
Metformin Extended Release Tablets
Generic Name: metformin hydrochloride Dosage Form: tablet, extended release Metformin Extended Release Tablets Description Metformin hydrochloride extended release tablets USP are an oral antihyperglycemic drug 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 pKa of metformin is 12.4. The pH of a 1% aqueous solution of metformin hydrochloride is 6.68. Metformin hydrochloride extended release tablets USP contain 500 mg of metformin hydrochloride USP as the active ingredient. Metformin hydrochloride extended release tablets USP 500 mg contain the inactive ingredients sodium carboxymethyl cellulose, hypromellose and magnesium stearate. Metformin hydrochloride extended release tablets USP 500 mg meets USP dissolution Test 3. System Components and Performance- Metformin hydrochloride extended release tablets USP comprises a swellable matrix system. In the aqueous gastrointestinal (GI) environment, the dosage form swells remarkably thereby increasing in size and geometry from where drug is released slowly by a process of diffusion through the gel matrix that is essentially independent of pH. The hydrated polymer system is not rigid and is expected to be broken up by normal peristalsis in the GI tract. The biologically inert components of the tablet may occasionally remain intact during GI transit and will be Continue reading >>
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Efficacy, Tolerability, And Safety Of A Novel Once-daily Extended-release Metformin In Patients With Type 2 Diabetes
OBJECTIVE—The purpose of this study was to determine the efficacy and safety of a novel extended-release metformin in patients with type 2 diabetes. RESEARCH DESIGN AND METHODS—Adults with type 2 diabetes (newly diagnosed, treated with diet and exercise only, or previously treated with oral diabetic medications) were randomly assigned to receive one of three extended-release metformin treatment regimens (1,500 mg/day q.d., 1,500 mg/day twice daily, or 2,000 mg/day q.d.) or immediate-release metformin (1,500 mg/day twice daily) in a double-blind 24-week trial. RESULTS—Significant decreases (P < 0.001) in mean HbA1c (A1C) levels were observed by week 12 in all treatment groups. The mean changes from baseline to end point in the two groups given 1,500 mg extended-release metformin (−0.73 and −0.74%) were not significantly different from the change in the immediate-release metformin group (−0.70%), whereas the 2,000-mg extended-release metformin group showed a greater decrease in A1C levels (−1.06%; mean difference [2,000 mg extended-release metformin − immediate-release metformin]: −0.36 [98.4% CI −0.65 to −0.06]). Rapid decreases in fasting plasma glucose levels were observed by week 1, which continued until week 8, and were maintained for the duration of the study. The overall incidence of adverse events was similar for all treatment groups, but fewer patients in the extended-release metformin groups discontinued treatment due to nausea during the initial dosing period than in the immediate-release metformin group. CONCLUSIONS—Once- or twice-daily extended-release metformin was as safe and effective as twice-daily immediate-release metformin and provided continued glycemic control for up to 24 weeks of treatment. Metformin hydrochloride has been w Continue reading >>
- A Novel Intervention Including Individualized Nutritional Recommendations Reduces Hemoglobin A1c Level, Medication Use, and Weight in Type 2 Diabetes
- A Novel Intervention Including Individualized Nutritional Recommendations Reduces Hemoglobin A1c Level, Medication Use, and Weight in Type 2 Diabetes
- Identification of novel biomarkers to monitor β-cell function and enable early detection of type 2 diabetes risk
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 Wonder Drug
A while back I wrote about why metformin is the number one treatment for Type 2 diabetes. Now new research finds metformin prevents cancer and heart disease and may actually slow aging! Where can I get this stuff? A study from Scotland found that people on metformin had only roughly half the cancer rate of people with diabetes who weren’t on the drug. This is important, because diabetes is associated with higher risks of liver, pancreas, endometrial, colon and rectum, breast, and bladder cancer. Nobody could explain how metformin helped, but then Canadian researchers showed that metformin reduces cell mutations and DNA damage. Since mutations and DNA damage promote both cancer and aging, this is striking news. No one thought we could limit mutations before, but perhaps metformin can do it. A study on mice exposed to cigarette smoke showed that those given metformin had 70% less tumor growth. A small study of humans in Japan showed similar improvements in colorectal cancer outcomes. Metformin is now being studied in clinical trials for breast cancer. The researchers write, “Women with early-stage breast cancer taking metformin for diabetes have higher response rates to [presurgical cancer therapies] than diabetic patients not taking metformin.” They also had better results than people without diabetes. How Does It Work? According to Michael Pollak, MD, professor in McGill’s Medicine and Oncology Departments, metformin is a powerful antioxidant. It slows DNA damage by reducing levels of “reactive oxygen species” (ROS). ROS are produced as byproducts when cells burn glucose. Just as oxygen helps fires burn or metals rust, ROS will oxidize (“burn” or “rust”) the nuclei or other parts of cells. ROS are what the antioxidant vitamins are supposed to block. 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 >>
Fortamet
FORTAMET® (metformin hydrochloride) Extended-Release Tablets DESCRIPTION FORTAMET® (metformin hydrochloride) Extended-Release Tablets contain an oral antihyperglycemic drug used in the management of type 2 diabetes. Metformin hydrochloride (N, Ndimethylimidodicarbonimidic diamide hydrochloride) is a member of the biguanide class of oral antihyperglycemics and is not chemically or pharmacologically related to any other class of oral antihyperglycemic agents. The empirical formula of metformin hydrochloride is C4H11N5•HCl and its molecular weight is 165.63. Its structural formula is: Metformin hydrochloride is a white to off-white crystalline powder that 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. FORTAMET® Extended-Release Tablets are designed for once-a-day oral administration and deliver 500 mg or 1000 mg of metformin hydrochloride. In addition to the active ingredient metformin hydrochloride, each tablet contains the following inactive ingredients: candellila wax, cellulose acetate, hypromellose, magnesium stearate, polyethylene glycols (PEG 400, PEG 8000), polysorbate 80, povidone, sodium lauryl sulfate, synthetic black iron oxides, titanium dioxide, and triacetin. FORTAMET® meets USP Dissolution Test 5. System Components And Performance FORTAMET® was developed as an extended-release formulation of metformin hydrochloride and designed for once-a-day oral administration using the patented single-composition osmotic technology (SCOT™). The tablet is similar in appearance to other film-coated oral administered tablets but it consists of an osmotically active core formulation that is surrounded by a semipermeable membra Continue reading >>
Efficacy Of Once- Or Twice-daily Extended Release Metformin Compared With Thrice-daily Immediate Release Metformin In Type 2 Diabetes Mellitus.
Abstract BACKGROUND: The extended-release formulation of metformin (MXR) prolongs drug absorption in the upper gastrointestinal tract and permits once-daily dosing in patients with type 2 diabetes mellitus (T2DM). This newer formulation may enhance patient compliance with oral therapy compared to conventional immediate-release metformin (MIR) in T2DM. OBJECTIVES: To analyse whether a switch from thrice daily MIR to once or twice daily MXR wouldachieve comparable degrees of glycemic control in patients with type 2 diabetes mellitus (T2DM). METHODS: We conducted an open study of the efficacy and tolerability of MXR in 40 patients with T2DM who had achieved moderate or good glycemic control with MIR alone or in combination with other antihyperglycemic agents. After a lead in period of 3 months patients were switched over to a specific brand of MIR at baseline (Visit 0). Patients were subsequently followed for 4 more visits. These visits were done monthly, after taking MIR in a dose of 1-2 g/day (Visit 1); MXR as a single dose at dinner but 0.5 g less than baseline dose of MIR (Visit 2); MXR, 1-2 g/day as a single dose at bedtime, with strength same as that of baseline dose of MIR (Visit 3); and MXR, 1-2 g/day in two divided doses keeping dose same as baseline MIR (Visit 4). Glycemic control was assessed by a four-point glucose profile (fasting and three postprandial levels) at each visit. RESULTS: At visit 2, when patients had been on 500 mg lesser dose of MXR for 1 month, glucose profile worsened. However, glycemic control, at visit 3, returned to earlier levels when dose of MXR was increased back to original dose. Overall the MXR formulation was well tolerated with minor gastrointestinal adverse effects, reported by only 3 patients. CONCLUSION: Patients with T2DM who had Continue reading >>
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U.s. Fda Approves Once-daily Jentadueto Xr (linagliptin And Metformin Hydrochloride Extended-release) Tablets For Adults With Type 2 Diabetes
U.S. FDA Approves Once-daily Jentadueto XR (linagliptin and metformin hydrochloride extended-release) Tablets for Adults with Type 2 Diabetes New formulation of medicines that helps lower blood sugar in type 2 diabetes can be taken once a day Ridgefield, Conn., and Indianapolis, May 31, 2016 The U.S. Food and Drug Administration (FDA) has approved Jentadueto XR (linagliptin and metformin hydrochloride extended-release) tablets for the treatment of type 2 diabetes (T2D) in adults. JENTADUETO XR, which is marketed by Boehringer Ingelheim and Eli Lilly and Company (NYSE: LLY), is the seventh new treatment from the Boehringer Ingelheim-Lilly Diabetes alliance to be approved by the FDA in the last five years. JENTADUETO XR combines 2.5 mg or 5 mg of linagliptin with 1000 mg of metformin. Linagliptin, a dipeptidyl peptidase-4 (DPP-4) inhibitor, works by increasing hormones that stimulate the pancreas to produce more insulin and the liver to produce less glucose. Metformin, a commonly prescribed initial treatment for T2D, lowers glucose production by the liver and its absorption in the intestine. Adults with type 2 diabetes are often required to take more than one medication to manage their condition, including some that have to be taken multiple times a day, said Paul Fonteyne, president and CEO, Boehringer Ingelheim Pharmaceuticals, Inc. JENTADUETO XR, the first extended-release therapy to emerge from our alliance with Lilly, offers adults with type 2 diabetes the convenience of a combination pill taken once a day to help lower blood sugar levels. JENTADUETO XR is indicated as an adjunct to diet and exercise to improve glycemic control in adults with T2D when treatment with both linagliptin and metformin is appropriate. JENTADUETO XR should not be used in patients with type Continue reading >>
Metformin Weight Loss – Does It Work?
Metformin weight loss claims are something that are often talked about by health professionals to be one of the benefits of commencing metformin therapy, but are they true? At myheart.net we’ve helped millions of people through our articles and answers. Now our authors are keeping readers up to date with cutting edge heart disease information through twitter. Follow Dr Ahmed on Twitter @MustafaAhmedMD Metformin is possibly one of the most important treatments in Type II Diabetes, so the question of metformin weight loss is of the utmost importance, as if true it could provide a means to lose weight as well as control high sugar levels found in diabetes. What is Metformin? Metformin is an oral hypoglycemic medication – meaning it reduces levels of sugar, or more specifically glucose in the blood. It is so effective that the American Diabetes Association says that unless there is a strong reason not to, metformin should be commenced at the onset of Type II Diabetes. Metformin comes in tablet form and the dose is gradually increased until the maximum dose required is achieved. How Does Metformin Work & Why Would it Cause Weight Loss? Metformin works by three major mechanisms – each of which could explain the “metformin weight loss” claims. These are: Decrease sugar production by the liver – the liver can actually make sugars from other substances, but metformin inhibits an enzyme in the pathway resulting in less sugar being released into the blood. Increase in the amount of sugar utilization in the muscles and the liver – Given that the muscles are a major “sink” for excess sugar, by driving sugar into them metformin is able to reduce the amount of sugar in the blood. Preventing the breakdown of fats (lipolysis) – this in turn reduces the amount of fatt Continue reading >>
Fda Approves Combo Of Januvia Plus Metformin In Once A Day Dosage
The FDA approved JANUMET® XR (sitagliptin and metformin hydrochloride (HCl) extended-release) tablets, a treatment for type 2 diabetes that combines sitagliptin, which is the active component of JANUVIA® (sitagliptin), with extended-release metformin…. JANUMET XR provides a convenient once-daily treatment option for patients who need help to control their blood sugar. JANUMET XR is indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes when treatment with both sitagliptin and extended-release metformin is appropriate. JANUMET XR should not be used in patients with type 1 diabetes or for the treatment of diabetic ketoacidosis. JANUMET XR has not been studied in patients with a history of pancreatitis. It is unknown whether patients with a history of pancreatitis are at increased risk for the development of pancreatitis while using JANUMET XR. The FDA approved JANUMET XR based upon a clinical bioequivalence study that demonstrated that administration of JANUMET XR was equivalent to co-administration of corresponding doses of the two individual medications, sitagliptin and metformin HCl extended- release. Extended-release metformin was as effective as immediate-release metformin. The labeling for JANUMET XR contains a boxed warning for lactic acidosis, a rare, but serious complication that can occur due to metformin accumulation. JANUMET XR is contraindicated in patients with renal impairment (e.g., serum creatinine levels ≥1.5 mg/dL for men, ≥1.4 mg/dL for women or abnormal creatinine clearance), which may also result from conditions such as cardiovascular collapse (shock), acute myocardial infarction, and septicemia; hypersensitivity to metformin HCl; acute or chronic metabolic acidosis, including diabetic ketoacid Continue reading >>
