Metformin, Heart Failure, And Lactic Acidosis: Is Metformin Absolutely Contraindicated?
Many patients with type 2 diabetes are denied treatment with metformin because of “contraindications” such as cardiac failure, which may not be absolute contraindications Summary points Treatment with metformin is not associated with an increased risk of lactic acidosis among patients with type 2 diabetes mellitus who have no cardiac, renal, or liver failure Despite increasing disregard of contraindications to metformin by physicians, the incidence of lactic acidosis has not increased, so metformin may be safe even in patients with “contraindications” The vast majority of case reports relating metformin to lactic acidosis report at least one other disease/illness that could result in lactic acidosis Use of metformin in patients with heart failure might be associated with lower mortality and morbidity, with no increase in hospital admissions and no documented increased risk of lactic acidosis Further studies are needed to assess the risk of lactic acidosis in patients with type 2 diabetes and traditional contraindications to metformin Metformin first became available in the United Kingdom in 1957 but was first prescribed in the United States only in 1995.w1 The mechanism of action has been extensively reviewed.w2 w3 The UK prospective diabetes study showed that metformin was associated with a lower mortality from cardiovascular disease than sulphonylureas or insulin in obese patients with type 2 diabetes mellitus.1 It was also associated with reduced all cause mortality, which was not seen in patients with equally well controlled blood glucose treated with sulphonylureas or insulin.1 Despite the evidence base for the benefits of metformin, concerns remain about its side effects and especially the perceived risk of lactic acidosis in the presence of renal, hepatic Continue reading >>
A Side Effect You Should Know About
The glucose-lowering medication metformin (Glucophage) could cause lactic acidosis if your kidneys and liver are not working efficiently. Lactic acidosis is when high levels build up in the blood of a substance called lactic acid — a chemical that is normally produced by your body in small amounts and removed by your liver and kidneys. The risk of lactic acidosis goes up if you: have heart failure or a lung ailment have kidney or liver problems drink alcohol heavily In these cases, you might not be able to take metformin. If you don't have one of these problems, you are at a very low risk for developing lactic acidosis from metformin. You should, however, contact your doctor immediately if you suddenly develop any of these symptoms of lactic acidosis: diarrhea fast and shallow breathing muscle pain or cramping weakness tiredness or unusual sleepiness You should also let your doctor know if you get the flu or any illness that results in severe vomiting, diarrhea, and/or fever, or if your intake of fluids becomes significantly reduced. Severe dehydration can affect your kidney or liver function and increase your risk of lactic acidosis from metformin. Continue reading >>
Glyburide And Metformin (oral Route)
Precautions Drug information provided by: Micromedex It is very important that your doctor check your progress at regular visits to make sure this medicine is working properly. Blood tests may be needed to check for unwanted effects. Under certain conditions, too much metformin can cause lactic acidosis. The symptoms of lactic acidosis are severe and quick to appear. They usually occur when other health problems not related to the medicine are present and very severe, such as a heart attack or kidney failure. The symptoms of lactic acidosis include abdominal or stomach discomfort; decreased appetite; diarrhea; fast, shallow breathing; a general feeling of discomfort; muscle pain or cramping; and unusual sleepiness, tiredness, or weakness. If you have any symptoms of lactic acidosis, get emergency medical help right away. It is very important to carefully follow any instructions from your health care team about: Alcohol—Drinking alcohol may cause severe low blood sugar. Discuss this with your health care team. Other medicines—Do not take other medicines unless they have been discussed with your doctor. This especially includes nonprescription medicines such as aspirin, and medicines for appetite control, asthma, colds, cough, hay fever, or sinus problems. Counseling—Other family members need to learn how to prevent side effects or help with side effects if they occur. Also, patients with diabetes may need special counseling about diabetes medicine dosing changes that might occur because of lifestyle changes, such as changes in exercise and diet. Furthermore, counseling on contraception and pregnancy may be needed because of the problems that can occur in patients with diabetes during pregnancy. Travel—Keep your recent prescription and your medical history with yo Continue reading >>
Metformin And Alcohol
The combination of Metformin and alcohol is generally recommended to be avoided. This drug can lead to some rather uncomfortable side effects even without imbibing alcohol, especially within the first few weeks of the initial medical treatment program. Metformin side effects with alcohol consumption in vast quantities will only increase in their levels of discomfort when simultaneously drinking beer, wine or hard liquor. The occasional alcoholic beverage is considered to be generally safe, although the preference is to abstain from all use of alcohol until the treatment program has run its course. This combination of Metformin and alcohol can also lead to some potentially severe consequences, one of which is a resulting possible side effect of lactic acidosis. This can be fatal if not treated in time. This condition can occur when the blood does not have enough oxygen, which is required to transport the glucose throughout the body. The glucose then transforms into lactic acid. Although this is a naturally produced chemical agent within the body, increased levels can result in potentially fatal toxic effects. This resulting lactic acidosis and Metformin side effects with alcohol consumption will first appear in the form of breathing difficulties, fluctuations in heartbeat, nausea and vomiting. The patient should inform the prescribing physician immediately if any of these warning signs occur. Metformin works in relationship to the liver and its ability to regulate insulin production levels. Additionally, alcohol has a severe detrimental effect on the liver, especially when ingested in vast quantities over long periods of time. A common result of alcoholism is irreversible liver damage. Therefore, the combination of Metformin and alcohol can only exacerbate this possibili Continue reading >>
Metformin And Fatal Lactic Acidosis
Publications Published: July 1998 Information on this subject has been updated. Read the most recent information. Dr P Pillans,former Medical Assessor, Centre for Adverse Reactions Monitoring (CARM), Dunedin Metformin is a useful anti-hyperglycaemic agent but significant mortality is associated with drug-induced lactic acidosis. Significant renal and hepatic disease, alcoholism and conditions associated with hypoxia (eg. cardiac and pulmonary disease, surgery) are contraindications to the use of metformin. Other risk factors for metformin-induced lactic acidosis are sepsis, dehydration, high dosages and increasing age. Metformin remains a major reported cause of drug-associated mortality in New Zealand. Of the 12 cases of lactic acidosis associated with metformin reported to CARM since 1977, 2 occurred in the last year and 8 cases had a fatal outcome. Metformin useful but small risk of potentially fatal lactic acidosis Metformin is a useful therapeutic agent for obese non-insulin dependent diabetics and those whose glycaemia cannot be controlled by sulphonylurea monotherapy. Lactic acidosis is an uncommon but potentially fatal adverse effect. The reported frequency of lactic acidosis is 0.06 per 1000 patient-years, mostly in patients with predisposing factors.1 Examples of metformin-induced lactic acidosis cases reported to CARM include: A 69-year-old man, with renal and cardiac disease, was prescribed metformin due to failing glycaemic control on glibenclamide monotherapy. He was well for six weeks, then developed lactic acidosis and died within 3 days. Post-surgical lactic acidosis caused the death of a 70-year-old man whose metformin was not withdrawn at the time of surgery. A 56-year-old woman, with no predisposing disease, died from lactic acidosis following major Continue reading >>
Why No Alcohol With Metformin?
Registration is fast, simple and absolutely free so please,join our community todayto contribute and support the site. This topic is now archived and is closed to further replies. On my Metformin bottle it says to avoid alcohol while taking this drug. Anyone know the real reason why? My pharmacist couldn't really answer that and my Endo. couldn't give me a real good answer either. She just said that she thought it was because Metformin works with the liver and that alcohol also messes with the liver and that's the only reason she could think of. But she didn't seem to think it was a big concern unless you were overdoing it with the alcohol. Anyway, does someone know the real reason they put that on the label? Looking for a more technical description of why I can't take both at the same time. I googled "metformin and alcohol interaction," and the link said that alcohol increases the lactic acid production. Since lactic acidosis icould be a possible side effect of metformin in some individuals, drinking a lot of alcohol with it might mean a "double whammy," if you were prone to the lactic acidosis. I have a drink or two and am on metformin, and have had no problems. I think most meds have the alcohol warning on the label. Same reason Grapefruit Juice is on that list. Rare complications. If you already have kidney problems, then Ketosis is a possibility with Met and alcohol. But ... if you have kidney problems, alcohol is likely already on the no-no list! If your pharmacist didn't know, they need to have their license taken away! But ... don't listen to some stranger like me. I only know what I read about it, and that may be un-true! Ask your doctor who prescribed it. My understanding was as you say... they both work on the Liver. Here is my question. I have enjoyed 1-2 g Continue reading >>
Is It Safe To Mix Metformin And Alcohol?
If you’re taking metformin to treat your diabetes, you may be wondering how this drug affects your ability to drink safely. Drinking alcohol can affect your diabetes symptoms directly, but there are additional risks if you drink alcohol with metformin. This article gives you information on how alcohol interacts with metformin and also how drinking alcohol can affect your diabetes. With any medicine you take, you should be aware of interactions that can happen if you use other substances. Metformin and alcohol can interact to increase your risk of harmful effects. You are at much greater risk of these effects if you frequently drink a lot of alcohol or you binge drink (drink a lot in short periods). These effects include an extremely low blood sugar level, called hypoglycemia, and a condition called lactic acidosis. Hypoglycemia Drinking alcohol while you’re taking metformin may cause extremely low blood sugar levels. Some symptoms of low blood sugar levels can be similar to symptoms of having too much alcohol. These include: drowsiness dizziness confusion Tell the people who are with you while you drink that you have diabetes. They can help you watch for these symptoms. If you or the people around you notice these symptoms, stop drinking and eat something right away to help increase your blood sugar level. If your symptoms of hypoglycemia are severe, such as losing consciousness, and you do not have a glucagon hypoglycemia rescue kit, someone with you should call 9-1-1. A glucagon hypoglycemia rescue kit includes human glucagon (a natural substance that helps balance your blood sugar level), a syringe to inject it, and instructions. You can use this kit for severe hypoglycemia when eating food will not help. If you are not familiar with this kit, talk to your doctor Continue reading >>
Mixing Alcohol With Metformin
In this article, we answer a reader question regarding whether or not you can drink alcohol while taking metformin. Are there any interactions between Metformin and alcohol that might cause memory loss while drinking? Lately, I barely have to drink anything (2 or 3 beers) and my memory of the time is significantly impaired. I recently stopped taking Topiramate for migraines, but began taking Metformin to manage my PCOS symptoms. I've looked up information but the only harmful interactions I could find were lactic acidosis and low blood sugar. Answer It is recommended to either limit or avoid drinking alcohol while taking the diabetes medication metformin. As you mentioned in your question, metformin raises the risk of a condition known as lactic acidosis. Lactic acidosis is the accumulation of lactate in the blood, which lowers the pH (i.e.increases the acidity) of the bloodstream. Left untreated, it is a potentially fatal condition. Blood lactate concentrations are known increase when combining alcohol with metformin. At onset, the symptoms of lactic acidosis are often subtle, accompanied mostly by nonspecific symptoms such as fatigue and muscle pain. These can quickly be followed by more serious symptoms such as respiratory distress. Lactic acidosis is a medical emergency which must be treated immediately. In addition, metformin is well known to cause nausea and GI distress. Mixing alcohol with metformin can potentiate these adverse reactions leading to extreme nausea, vomiting and diarrhea. In regards to memory loss when mixing alcohol with metformin, there is no data regarding that specific interaction. Having said that, metformin has conflicting information in regard to how it may affect memory by itself. Early studies with metformin actually showed potential promi Continue reading >>
Metformin And Alcohol
'Avoid drinking alcohol while taking Glucophage. Alcohol lowers blood sugar and may increase the risk of lactic acidosis while you are taking this medicine. ' (Drugs.com) Oh Nooooooooooooooooooooooooooooooooooooooooooooooooo ooooooooooooooooooo! How can I ever hope to live my life without beer!!!!!!?????? Better talk to my doctor and bribe him to tell me it's fine to drink whilst taking Metformin On Christmas day, I had some wine with my dinner, and desert, and being on steroids for my breathing. My meter gave me a greeting HI. I think was the combination of things to cause that. But if we don't self abuse our selves once in a while, whats the fun of living then? Patrick DONT panic it is very rare and as long as you are aware of the symptoms and test frequently - drinking in moderation shouldnt be a problem! Lactic acidosis is found more in older people and those with renal impairment! I tend to try to stick to drinking once a week, though the holidays caused my some grief and I drank more regularly (how can I say no to a party??!!!! I'm getting back to normal with my routine now so don't expect any problems - I was just surprised that my docs never mentioned the vague possibility of problems with booze and Met! My docs only mentioned it when I asked but they said it was SO rare as to not worry about but to still be carefull !! They were more concerned about alcohol lowering sugars than the lactic acidosis !! From everything I've read, the biggest worry is liver damage. Most people can get away with anything in moderation... Remember too that while you're drinking, you're keeping your liver busy. So if you go low it can't help you out. Just keep an eye on numbers and have a little nibble if you're drinking anything that doesn't have the sugar hit (like spirits with cok Continue reading >>
Can You Drink Alcohol While On Metformin?
Home Q & A Questions Can you drink alcohol while... Can you drink alcohol while on metformin? If you're diabetic then you have to be careful of the drinks you have, because of sugar. The interaction checker says Ask your doctor before using ethanol together with metFORMIN. Taking this combination may cause a condition called lactic acidosis. Get emergency medical help if you have any of these symptoms of lactic acidosis: weakness, increasing sleepiness, slow heart rate, cold feeling, muscle pain, shortness of breath, stomach pain. Use alcohol cautiously. If your doctor prescribes these medications together, you may need a dose adjustment or special tests to safey take this combination. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor. Having one drink for women (12 oz beer, 5 oz glass of wine and 0.5-1 oz hard liquor means one drink) or two drinks (same measurements except for hard alcohol can be only 1 1/2 oz liquor between two drinks) for men is usually permissible but you must consider the drink as a sugar/carb in your diet. Alcohol becomes pure glucose in your body, just like eating a high carb/sugar dessert. If you have alcohol, have it with a meal or snack (be sure to adjust for the alcohol's added carbs so you will need to reduce carbs somewhere else in the diet). One effect of alcohol is that it shuts off your liver from releasing stored glucose from your liver into your blood stream which increases the likelihood of experiencing low blood sugar. Many of the symptoms of low blood sugar resemble intoxication (like dizziness, slurred speech, blurred vision, muscle weakness and a shaky feeling). If you are on insulin or pills, the medication Continue reading >>
Metformin And Lactic Acidosis
Diabetes Home > Metformin and Lactic Acidosis There are some potential adverse side effects of metformin; lactic acidosis can be one of them. Lactic acidosis is a life-threatening condition that is fatal in about 50 percent of cases and is caused by too much lactate in the blood and low blood pH. Some symptoms of lactic acidosis include shortness of breath, persistent nausea, and a slow or irregular heartbeat. Several factors can increase your risk of developing lactic acidosis while taking metformin, such as having kidney problems or congestive heart failure. An Overview of Metformin and Lactic Acidosis Metformin ( Glucophage ) is a prescription medication licensed for the treatment of type 2 diabetes . Very rarely, metformin can cause a life-threatening side effect called lactic acidosis. For this reason, the U.S. Food and Drug Administration (FDA) has given metformin a special warning, called a black box warning, about lactic acidosis. Lactic acidosis is a life-threatening condition caused by too much lactate in the blood and low blood pH. Low blood pH means that your blood contains too much acid, which can be harmful to the cells of your body. Lactic acidosis is a very dangerous condition and is fatal in about 50 percent of cases. Risk factors for lactic acidosis when taking metformin include: Continue reading >>
Metformin - Can You Absolutely Not Drink Any Alcohol???
Metformin - can you absolutely not drink any alcohol??? Drinking with it can cause a very serious condition called lactic acidosis. Still looking for answers? Try searching for what you seek or ask your own question . Metformin - How much alcohol is a safe amount with 500mg twice daily? The easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records. Available for Android and iOS devices. Subscribe to receive email notifications whenever new articles are published. Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. Data sources include Micromedex (updated Apr 12th, 2018), Cerner Multum (updated Apr 5th, 2018), Wolters Kluwer (updated Apr 6th, 2018) and others. To view content sources and attributions, please refer to our editorial policy . Continue reading >>
Alcohol And Metformin | Alcohol With Metformin Side Effects
What are the possible interactions of alcohol and metformin? What should you know about alcohol with metformin side effects? These are common questions people about metformin, which is a diabetic drug. Below what should be known about alcohol and metformin will be covered, including the possible alcohol with metformin side effects. Metformin is a drug that’s used to treat type 2 diabetes, and it can be used alone or with other medicines, and in adults and children. For people who are at risk of developing diabetes it can also be used as a way to prevent that, and it can be used as a treatment option for polycystic ovaries and weight gain due to the use of certain medicines. Metformin helps control high blood sugar levels, and this can in turn help prevent serious complications like kidney damage, nerve problems, and blindness. When your diabetes is well-controlled, it can also help lower the risk of a stroke or heart attack. The way metformin works is by restoring the way your body responds to the insulin you produce, and it decreases the amount of sugar made by your liver, and thereby absorbed by your stomach and intestines. Side effects of metformin can include nausea, vomiting, general upset stomach, diarrhea, weakness or a metallic taste in your mouth. In some cases, if metformin is taken with other diabetic medications, it can cause low blood sugar, but this isn’t usually a symptom of this medicine on its own. Understanding drug interactions is important with any medicine you’re prescribed, which is why you should tell your doctor about all other medicines you’re taking, your medical history, and even supplements and vitamins you take. Some of the medicines that can interact with metformin include beta-blockers and any medicine that affects your blood sugar Continue reading >>
What Should I Know Before Taking Metformin?
Can I drink alcohol while taking metformin? Although alcohol doesn't actually affect the medicine itself, you should avoid drinking alcohol while you are taking metformin, becauses it can increase the risk of getting low blood sugar (hypoglycaemia) and lactic acidosis (see below for details). Can I drive while taking metformin? Metformin does not affect your ability to drive. However, if you are taking other medicines for diabetes with metformin this can sometimes cause low blood sugar levels (see below). Symptoms may include feeling faint or tired, confusion and difficulty concentrating, which may affect your ability to drive safely. If you are taking metformin with other medicines for type 2 diabetes you should discuss this with your doctor. Do I need to avoid any food or drinks while taking metformin? There are no foods or drinks you specifically need to avoid while taking metformin. However, it is important to continue to follow the diet and exercise advice given to you by your nurse or doctor. Metformin only helps to control your blood sugar levels and should not be used as a substitute for eating healthily and taking regular exercise. What side effects should I look out for while taking metformin? When used on its own, metformin does not usually cause low blood sugar levels (hypoglycaemia). However, you may sometimes get low blood sugar if you take metformin in combination with other antidiabetic medicines. If this applies to you, you should make sure you know what to do if you experience the symptoms of hypoglycaemia (these may include cold sweats, cool pale skin, tremor, anxious feeling, unusual tiredness or weakness, confusion, difficulty in concentration, excessive hunger, temporary vision changes, headache or nausea). Discuss this with your GP, pharmacist or Continue reading >>
Metformin And Alcohol
Tweet It is generally recommended that people not use metformin and alcohol at the same time. Taking metformin and alcohol together can increase your risk of developing a life-threatening condition called lactic acidosis. However, drinking small amounts of alcohol should not be a problem for most people taking the medication. Before taking metformin, be sure to talk to your healthcare provider about drinking alcohol while taking the drug. An Overview of Metformin and Alcohol Metformin (Glucophage®) is a prescription medication licensed as a type 2 diabetes treatment. Often, people are warned to avoid alcohol entirely while taking metformin. This may (or may not) be good advice, depending on your particular situation. Metformin, Alcohol, and Lactic Acidosis Taking metformin increases your chance of developing a life-threatening condition called lactic acidosis (see Metformin and Lactic Acidosis). Drinking large amounts of alcohol also increases your risk for lactic acidosis, and combining metformin and large amounts of alcohol can be dangerous (due to the risk of lactic acidosis). As a result, drinking large amounts of alcohol (either on a daily basis or as "binge drinking") is not recommended while taking metformin. Small amounts of alcohol should not be a problem for most people taking metformin. However, because other medical conditions may also increase your risk of lactic acidosis (including kidney or liver problems), there may be some situations where avoiding alcohol entirely might be a good idea. Metformin and Alcohol: Suggestions It is usually not necessary to completely avoid alcohol while taking metformin. However, drinking large amounts of alcohol while taking metformin is not recommended. Be sure to ask your healthcare provider if it would be okay to drink Continue reading >>