Metformin

 
What is Metformin and why is it prescribed?
Metformin is an oral antidiabetic medication used to treat type 2 diabetes. Diabetes develops when the body proves unable to burn sugar and the unused sugar builds up in the bloodstream. Metformin lowers the amount of sugar in your blood by decreasing sugar production and absorption and helping your body respond better to its own insulin, which promotes the burning of sugar. It does not, however, increase the body's production of insulin. Metformin is sometimes prescribed along with insulin or certain other oral antidiabetic drugs such as Micronase or Glucotrol. It is also used alone. Standard Metformin tablets are taken two or three times daily. An extended-release form is available for once-daily dosing. Always remember that Metformin is an aid to, not a substitute for, good diet and exercise. Failure to follow a sound diet and exercise plan can lead to serious complications such as dangerously high or low blood sugar levels. Remember, too, that Metformin is not an oral form of insulin and cannot be used in place of insulin.

How should you take Metformin?
Follow your doctors directions for taking Metformin. Do not take more or less Metformin than directed by your doctor. Metformin should be taken with food to reduce the possibility of nausea or diarrhea, especially during the first few weeks of therapy. If taking Metformin XR, be sure to swallow the tablet whole. Do not crush it or chew it. The inactive ingredients in the tablet may occasionally appear in the stool. This is not a cause for concern. If you miss a dose take it as soon as you remember. If it is almost time for your next dose, skip the one you missed and go back to your regular schedule. Never take two doses at the same time. Store Metformin it at room temperature.

Are there any Metformin side effects?
Metformin side effects cannot be anticipated. If any develop or change in intensity, inform your doctor as soon as possible. If side effects from Metformin occur, they usually happen during the first few weeks of therapy. Most side effects are minor and will go away after you've taken Metformin for a while. More common Metformin side effects may include abdominal discomfort, diarrhea, gas, headache, indigestion, nausea, vomiting, and weakness. Less common Metformin side effects may include abdominal distention, abnormal stools, altered sense of taste, chest discomfort, chills, constipation, dizziness, flu-like symptoms, flushing, increased sweating, low blood sugar, light-headedness, muscle pain, nail disorders, pounding heartbeat, rash, shortness of breath, and upper respiratory infection. Metformin, unlike other oral antidiabetics, does not usually cause hypoglycemia. However, hypoglycemia remains a possibility, especially in older, weak, and undernourished people and those with kidney, liver, adrenal, or pituitary gland problems. The risk of hypoglycemia increases when Metformin is combined with other diabetes medications. The risk is also boosted by missed meals, alcohol, and excessive exercise. To avoid hypoglycemia, you should closely follow the dietary and exercise plan suggested by your physician. If you feel hypoglycemia coming on, get some fast-acting sugar, such as a 4 to 6 ounce glass of fruit juice. Metformin can cause a serious side effect called lactic acidosis, a buildup of lactic acid in the blood. This problem is most likely to occur in people whose liver or kidneys are not working well, and in those who have multiple medical problems, take several medications, or have congestive heart failure. The risk also is higher if you are an older adult or drink alcohol. Although the condition is rare, it can be fatal. Lactic acidosis is a medical emergency that must be treated in a hospital. Symptoms of lactic acidosis may include feeling very weak, tired, or uncomfortable, feeling cold, dizzy, or light-headed, increasing sleepiness, muscle pain, slow or irregular heartbeat, trouble breathing, and unexpected or unusual stomach discomfort. If you notice these symptoms, stop taking Metformin and call your doctor right away.

What are the possible food and drug interactions when taking Metformin?
If Metformin is taken with certain other drugs, the effects of either could be increased, decreased, or altered. Be sure to inform your doctor of all the prescription and over the counter medications you are taking. It is especially important to check with your doctor before combining Metformin with Amiloride (Moduretic), Calcium channel blockers (such as Calan, Isoptin, and Procardia), Cimetidine (Tagamet), Decongestant (such as Sudafed and Ventolin), Digoxin (Lanoxin), Estrogens (such as Premarin), Furosemide (Lasix), Isoniazid (Rifamate), Major tranquilizers (such as Thorazine), Morphine, Niacin (Niaspan), Oral contraceptives, Phenytoin (Dilantin), Procainamide (Procanbid, Pronestyl), Quinidine (Quinidex), Quinine, Ranitidine (Zantac), Steroids (such as prednisone/Deltasone), Thyroid hormones (Synthroid), Triamterene (Dyazide, Dyrenium), Trimethoprim (Bactrim, Septra), Vancomycin (Vancocin), or Water pills (such as HydroDIURIL, Dyazide, and Moduretic). Do not drink too much alcohol, since excessive alcohol consumption can cause low blood sugar and alcohol enhances some effects of Metformin.

Are there any special warnings about Metformin?
Before you start therapy with Metformin, and at least once a year thereafter, your doctor will do a complete assessment of your kidney function. If you develop kidney problems while on Metformin, your doctor will discontinue this medication. If you are an older person, you will need to have your kidney function monitored more frequently, and your doctor may want to start you at a lower dosage. If you are taking Metformin, you should check your blood or urine periodically for abnormal sugar levels. Your doctor will do annual blood checks to see if Metformin is causing a vitamin B12 deficiency or any other blood problem. It's possible that drugs such as Metformin may lead to more heart problems than diet treatment alone, or diet plus insulin. If you have a heart condition, you may want to discuss this with your doctor. The effectiveness of any oral antidiabetic, including Metformin, may decrease with time. This may be due to either a diminished responsiveness to the medication or a worsening of the diabetes.
 

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