GLUCOPHAGE

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Description

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DESCRIPTION

Glucophage is a biguanide antihyperglycemic agent used for treating non-insulin-dependent diabetes mellitus (NIDDM). It improves glycemic control by decreasing hepatic glucose production, as well as decreasing glucose absorption and increasing insulin-mediated glucose uptake.

Another well-known benefit of this drug is modest weight loss. Metformin is the drug of choice for obese NIDDM (non-insulin dependent diabetes mellitus) patients [12].

Glucophage was approved in Canada initially in 1972 [8], the 1970s in Europe, and in 1995 in the USA [13].

USES

Metformin is used with a proper diet and exercise program and possibly with other medications to control high blood sugar. It is used in patients with type 2 diabetes. Controlling high blood sugar helps prevent kidney damage, blindness, nerve problems, loss of limbs, and sexual function problems. Proper control of diabetes may also lessen your risk of a heart attack or stroke. Metformin works by helping to restore your body’s proper response to the insulin you naturally produce. It also decreases the amount of sugar that your liver makes and that your stomach/intestines absorb.

How to use Metformin HCL

Read the Patient Information Leaflet if available from your pharmacist before you start taking Glucophage and each time you get a refill. If you have any questions, consult your doctor or pharmacist.

Take this medication by mouth as directed by your doctor, usually 1-3 times a day with meals. Drink plenty of fluids while taking this medication unless otherwise directed by your doctor.

The dosage is based on your medical condition, response to treatment, and other medications you may be taking. Be sure to tell your doctor and pharmacist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products). To reduce your risk of side effects (such as upset stomach), your doctor may direct you to start this medication at a low dose and gradually increase your dose. Follow your doctor’s instructions carefully.

Take this medication regularly in order to get the most benefit from it. Remember to use it at the same times each day.

If you are already taking another diabetes drug (such as chlorpropamide), follow your doctor’s directions carefully for stopping/continuing the old drug and starting metformin.

Check your blood sugar regularly as directed by your doctor. Keep track of the results, and share them with your doctor. Tell your doctor if your blood sugar measurements are too high or too low. Your dosage/treatment may need to be changed.

INTERACTIONS

Aspir 81 (aspirin)

Aspirin Low Strength (aspirin)

Clomid (clomiphene)

Control (phenylpropanolamine)

Crestor (rosuvastatin)

Cymbalta (duloxetine)

Fish Oil (omega-3 polyunsaturated fatty acids)

glipizide (Glucotrol, GlipiZIDE XL, Glucotrol XL)

ibuprofen (Advil, Motrin, IBU, Proprinal, Advil Liqui-Gels, Motrin IB, IBU-200, Nuprin, Children’s Motrin, Motrin Migraine Pain, Advil Migraine, Caldolor, Ibuprofen PMR, Advil Children’s, Addaprin, NeoProfen, Advil Infant’s Concentrated Drops, A-G Profen, Motrin Childrens, Childrens Ibuprofen Berry, Ibu-6, Ibu-8, Motrin Infant Drops, Ibu-Tab, Rufen, Genpril, Haltran, Menadol, Midol IB, Saleto-200, Q-Profen, Saleto-400, Saleto-600, Saleto-800, Advil Junior Strength, Midol Maximum Strength Cramp Formula, Actiprofen, PediaCare Infants’ IB Ibuprofen Pain Reliever/Fever Reducer, Ibu-4, PediaCare Children’s IB Ibuprofen Pain Reliever/Fever Reducer, Motrin Junior Strength, Help I Have An Aching Body, Children’s ElixSure IB, Cap-Profen, Motrin Pediatric, Advil Film-Coated)

insulin

Januvia (sitagliptin)

Lantus (insulin glargine)

Lasix (furosemide)

Lipitor (atorvastatin)

lisinopril (Zestril, Prinivil, Qbrelis)

Lyrica (pregabalin)

Metoprolol Succinate ER (metoprolol)

Metoprolol Tartrate (metoprolol)

Nexium (esomeprazole)

phentermine (Adipex-P, Lomaira, Fastin, Suprenza, Ionamin, Teramine, Obenix, Atti-Plex P, Pro-Fast HS, Phentercot, Oby-Cap, Phentride, Obephen, Panshape M, Pro-Fast SR, T-Diet, Zantryl, Oby-Trim, Pro-Fast SA, Teramine ER)

Plavix (clopidogrel)

Synthroid (levothyroxine)

Trulicity (dulaglutide)

Vitamin B12 (cyanocobalamin)

Vitamin C (ascorbic acid)

Vitamin D3 (cholecalciferol)

Vitamins (multivitamin)

Xanax (alprazolam)

Zyrtec (cetirizine)

DOSAGE

If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. Canada residents can call a provincial poison control center. Overdose can cause lactic acidosis. Symptoms of overdose may include: severe drowsiness, severe nausea/vomiting/diarrhea, rapid breathing, slow/irregular heartbeat.

Notes

Do not share this medication with others.

Attend a diabetes education program to learn more about how to manage your diabetes with medications, diet, exercise, and regular medical exams.

Learn the symptoms of high and low blood sugar and how to treat low blood sugar. Check your blood sugar regularly as directed and share the results with your doctor.

Lab and/or medical tests (such as kidney function, liver function, blood sugar, hemoglobin A1c, complete blood counts) should be done before you start taking this medication and while you are taking it. Keep all medical and lab appointments. Consult your doctor for more details

Missed Dose

If you miss a dose, take it as soon as you remember with food. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.

Storage

Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product.Information last revised July 2018. Copyright(c) 2018 First Databank, Inc.

WARNING AND PRECAUTIONS

Keep out of reach of children. In case of overdose, get medical help or contact a Poison Control Center immediately.

Contraindications

Contraindication includes hypersensitivity, chronic heart failure, metabolic acidosis with or without coma, diabetic ketoacidosis (DKA), severe renal disease, abnormal creatinine clearance resulting from shock, septicemia, or myocardial infarction and lactation.

Effects of Drug Abuse

There are no effects of drug abuse from the use of metformin.

Short-Term Effects

There are no short-term effects from the use of Glucophage.

Long-Term Effects

There are no long-term effects from the use of metformin.

Cautions

Use with caution in patients with congestive heart failure, fever, trauma, surgery, the elderly, renal impairment, or hepatic impairment.

Instruct patients to avoid heavy alcohol use.

Suspend therapy prior to any type of surgery.

Rare, but serious, lactic acidosis can occur due to accumulation.

Possible increased risk of cardiovascular (CV) mortality.

May cause ovulation in anovulatory and premenopausal polycystic ovary syndrome (PCOS) patients.

It may be necessary to discontinue therapy with Glucophage and administer insulin if patient is exposed to stress (fever, trauma, or infection).

Ethanol may potentiate metformin’s effect on lactate metabolism.

May impair vitamin B12 or calcium intake/absorption; monitor B12 serum concentrations periodically with long-term therapy.

Not indicated for use in patients with type 1 diabetes mellitus that are insulin dependent due to lack of efficacy.

Withhold in patients with dehydration and/or prerenal azotemia.

Iodinated contrast imaging procedures.

Discontinue metformin at the time of or before an iodinated contrast imaging procedure in patients with an eGFR between 30-60 mL/minute/1.73 m²; in patients with a history of liver disease, alcoholism, or heart failure; or in patients who will be administered intra-arterial iodinate contrast.

Reevaluate eGFR 48 hr after the imaging procedure; restart Glucophage if renal function is stable.

Pregnancy and Lactation

Use in pregnancy may be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

Not recommended when lactating as metformin enters breast milk.

Glucophage, Oral Tablet

Highlights

About

Side effects

Treating low blood sugar

Interactions

Dosage

Warnings

Take as directed

Important considerations

Alternatives

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…

Show More

Highlights for metformin

Metformin oral tablets are available as generic drugs and as brand-name drugs. Brand names: Glucophage, Glucophage XR, Fortamet, and Glumetza.

Metformin comes in two forms: tablet and solution. Both forms are taken by mouth.

Glucophage oral tablet is used to treat high blood sugar levels caused by type 2 diabetes.

What is metformin?

Metformin is a prescription drug. It comes as an oral tablet and an oral solution.

Metformin oral tablet comes in two forms: immediate-release and extended-release. The immediate-release tablet is available as the brand-name drug Glucophage. The extended-release tablet is available as the brand-name drugs Glucophage XR, Fortamet, and Glumetza.

Both tablet forms are also available as generic drugs. Generics usually cost less than brand-name versions. In some cases, they may not be available in all strengths or forms as brand-name drugs.

Why it’s used

Metformin oral tablets are used to treat high blood sugar levels caused by type 2 diabetes. They’re used in combination with diet and exercise.

This drug may be used as part of a combination therapy. That means you may need to take it with other drugs.

How it works

Metformin belongs to a class of drugs called biguanides. A class of drugs is a group of medications that work in a similar way. These drugs are often used to treat similar conditions.

Metformin works by:

reducing the amount of glucose (sugar) made by your liver

decreasing the amount of glucose your body absorbs

increasing the effect of insulin on your body

Insulin is a hormone that helps your body remove extra sugar from your blood. This lowers your blood sugar levels.

SIDE EFFECTS

Metformin oral tablet doesn’t cause drowsiness. However, it may cause other side effects.

More common side effects

The more common side effects that can occur with metformin include:

stomach problems:

diarrhea

nausea

stomach pain

heartburn

gas

If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.

Serious side effects

Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

Lactic acidosis. Symptoms can include:

tiredness

weakness

unusual muscle pain

trouble breathing

unusual sleepiness

stomach pains, nausea, or vomiting

dizziness or lightheadedness

slow or irregular heart rate

Hypoglycemia (low blood sugar).* Symptoms can include:

headache

weakness

confusion

shaking or feeling jittery

drowsiness

dizziness

irritability

sweating

hunger

fast heart rate

Disclaimer:

Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.

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