Metformin is used in treating type II diabetes to decrease blood sugar (glucose). Metformin increases tissues sensitivity (liver, muscle, fat etc) to insulin uptake and effects. Hormone insulin, produced by the pancreas, decreases blood glucose levels. It reduces the amount of glucose, produced by liver and assists muscle and fat tissues to remove more glucose from the blood. Diabetes arises when too little insulin is produced and when its uptake (and effect) on the body's tissues is too small. Metformin lowers sugar level in the blood. Unlike sulfonylurea class drugs that decrease glucose, e.g. glyburide (Micronase; Diabeta) or glipizide (Glucotrol), Metformin does not increase the insulin concentration in the blood, when used alone, and, therefore, does not give rise to hypoglycemia - too low blood glucose levels. Investigations have shown that, Metformin reduces heart disease, blindness and kidney disease, which are diabetes complications.
Usually adults start with Metformin dose of 500 mg twice daily or 850 mg daily. Every week dose is increased gradually by 500 mg or every two weeks by 850 mg, depending on tolerance and taking into consideration response of blood glucose levels. It cannot be taken more than 2550 mg a day, divided in three doses. Initial dose is 500 mg daily with the supper for Glucophage XR tablets. You can increase this dose gradually by 500 mg a week, but not more than 2000 mg once or in two divided doses daily (maximum dose). Metformin is taken with meal, and Glumetza tablets to be taken once a day.
When you have missed a dose of drug, you must take it immediately. If too much time passed and it's time to take the next dose, you may skip missed dose and return to your regular schedule, but you never take 2 doses at once.
To be stored at the temperature of 20-25 degrees C (68-77 degrees F).
Glucophage Safety information
- While taking Metformin be careful with alcohol. Alcohol and Glucophage, being taken simultaneously, may provoke lactic acidosis and hypoglycemia.
- Don't step aside from your medication, diet and exercise routines to guarantee stable blood sugar levels. If you are going to undergo surgery or x-ray procedures with contrast agents injection, tell your health care provider that you are taking Metformin , because it may be necessary to stop Metformin treatment for a while.
- Do not take any over-the-counter drugs (cough, cold, allergy, pain, or weight-loss) with no advises of your doctor. Glucophage may increase lactic acidosis risk under some conditions. The following obstacles require obligatory doctor's advice as to go on taking Glucophage: you are ill, you have a heart attack; have a stroke, congestive heart failure, diarrhea, fever, vomiting or dehydration from any cause; decreased amount of food you eat or liquid you drink or other health conditions. In this cases some interval may be required to interrupt treatment with Metformin .
- Cimetidine (Tagamet) can increase the amount of Metformin in the blood by 40%, because it decreases Metformin elimination from the body, and thus it may provoke some side effects.
- As to pregnant women, most experts agree that insulin is the best diabetes treatment for them; there were no studies on Metformin therapy of pregnant women. Metformin can be transferred to the infant with the breast milk, that’s why nursing mothers should not use it.
Glucophage Side effects
The following are the most common side effects with Metformin: gas, bloating, nausea, vomiting, diarrhea and appetite loss. One out of every three patients has these symptoms. One out of every twenty patients usually need to stop the therapy because of strong side effects, some of patients need only dose decrease, as in that case side effects may decrease. The most significant side effect of Metformin is relatively rare (one out of every 30,000 patients). It is lactic acidosis, which is fatal in 50% of cases. Risk for lactic acidosis have patients with reduced kidneys or liver function, severe acute illnesses, congestive heart failure and dehydration. Its symptoms are weakness, unusual muscle pain, stomach discomfort, trouble breathing, abnormal heartbeats, light-headedness and feeling cold.
If you have an allergic reaction (breathing difficulty; lips, tongue or face swelling; closing of the throat; hives), stop taking Metformin immediately and seek emergency medical help. While taking Metformin few people have developed a serious side effect, that has been fatal in up to 50% of cases - lactic acidosis. It was mostly the people who had ill kidneys or liver problems. If you experience a feeling of general discomfort or sickness; weakness; sore or aching muscles; difficult breathing, drowsiness, dizziness or lightheadedness; unusual or unexplained stomach upset (after the initial stomach upset that may occur at the start of therapy with Metformin ); or slow or irregular heartbeat, stop taking Metformin and call the doctor. These may be lactic acidosis. Metformin does not usually cause hypoglycemia (low sugar level in the blood). Nevertheless, hypoglycemia may occur after meals skipping, excessive exercise or alcohol taking. Signs of low blood sugar are: hunger, headache, drowsiness, weakness, dizziness, a fast heartbeat, sweating, tremor, and nausea.
To treat episodes of low blood sugar patient has to carry candy or glucose tablets. If another, less serious side effects occur (they are more likely), then go on taking Metformin , but contact your doctor. These effects are: nausea, abdominal pain, vomiting, diarrhea at the beginning of therapy; abdominal bloating or increased gas production; decreased appetite; metallic taste in the mouth, taste changes.There may be some other side effects – in any case tell your doctor about every unusual or bothersome feelings.