Studies have also found that metformin targets many pathways in the growth of cancer, and research is evaluating the possible increased survival of those with several cancers such as lung cancer , breast cancer , and bladder cancer who have been treated with metformin.
Metformin is also being studied for its effect on the thyroid as it appears to reduce the risk of goiter , thyroid nodules , and thyroid cancer. To assess if you're a good candidate for Glucophage or another form of metformin, your healthcare provider will test your blood glucose and A1C levels to get a range of your current blood sugar control. As metformin is typically part of the first line of defense when treating type 2 diabetes, you may start out on a low dosage with regular monitoring to see if glucose control improves.
Certain medical circumstances can make taking metformin risky or even prohibit its use, including:. Talk to your healthcare provider about all medications, supplements, and vitamins that you currently take. While some drugs pose minor interaction risks, others may outright contraindicate use or prompt careful consideration as to whether the pros of treatment outweigh the cons in your case. Glucophage does not directly reduce blood sugar in the same manner as insulin.
Therefore, it is typically not appropriate for people with type 1 diabetes who require insulin. Glucophage comes in , , and 1, milligrams mg tablets; glucophage XR comes in or mg tablets. This medicine should be increased or titrated gradually to ease any stomach discomfort and to identify the lowest possible effective dose when it is first started. How long this takes depends on what your healthcare provider prescribes and how you respond to the medication.
For example, a person who is new to metformin and has been prescribed 2, mg may take the medication as follows:. Those prescribed extended-release metformin typically begin with a starting once daily dose of mg and increase it by up to mg each week. A person who is prescribed 1, mg of extended-release metformin, for example, may take the medication as follows:.
Throughout the duration of titration, your healthcare provider may ask you to monitor your blood sugar. If you experience hypoglycemia low blood sugar or any other side effects, contact your healthcare provider so that the medication can be adjusted accordingly.
If you miss a dose, try to take the missed pill as soon as possible, unless you're approaching the time of your next regular dose. Doubling up on the medication dose or overdosing may result in hypoglycemia low blood sugar.
Your dosage may need to be modified by your healthcare provider if you have any pre-existing liver or kidney issues. In these cases, your symptoms and blood markers should be closely monitored. Elderly patients should be kept on the lowest possible dose due to the potential for decreased kidney, liver, or heart function that may increase risk of lactic acidosis.
Any dosage adjustment for those of advanced age should include a careful assessment of kidney function. To remember to take metformin, you should try to take it around the same time s every day. It is recommended that people take Glucophage with food as this both increases its absorption in the stomach and reduces side effects e.
The extended-release version is usually taken once per day with the evening meal. Store this medication at a controlled room temperature ideally 68 to 77 degrees F.
You can travel with it at temperatures ranging from 59 to 86 degrees F. Generally, try to avoid skipping meals and drinking alcohol while taking this medication. As with taking any medication, the potential side effects must be weighed against the potential benefits. In the case of metformin, most of the side effects are fairly innocuous.
The first two typically top people's list of complaints about the drug. Gas and diarrhea can often be reduced by increasing the dose gradually. If you do experience these side effects, contact your healthcare provider to make sure that you are taking the medication correctly. If you are experiencing persistent side effects and are not already on the extended-release version of this drug, consider asking your healthcare provider about making the switch.
The time-released delivery it offers may help prevent gastrointestinal side effects. Unlike many treatments for diabetes, Glucophage does not typically cause hypoglycemia.
Also, unlike many type 2 diabetes medications, Glucophage does not cause weight gain and may even assist with weight loss. Concern about lactic acidosis has been raised several times here. This side effect is rare, but serious. Lactic acidosis occurs when lactic acid builds up in the blood and is caused by the body having to metabolize sugars without the presence of oxygen instead of aerobically. Although the latest studies suggest this may not be directly associated with metformin, the risk of lactic acidosis is increased in those with chronic kidney disease, liver, or heart disease.
If you experience any of the following, which includes symptoms of lactic acidosis as well as other serious reactions to metformin, seek medical help right away. If lactic acidosis goes untreated, it may result in severe complications or even death cardiac arrest. While you are on metformin, your healthcare provider will want to monitor blood sugar levels and have you come in periodically for A1C testing to evaluate if the dose or medication regimen needs to be adjusted.
You may also need blood tests to monitor electrolytes and liver and kidney function. Metformin may also result in a B12 deficiency , a complication known as pernicious anemia that can lead to permanent neurological damage. B12 deficiency is also linked with an increased risk of strokes. Early symptoms of B12 deficiency may include anemia, ringing in the ears, and depression.
It's important to have your B12 levels monitored since supplementation may be needed. If metformin is inadequate to manage blood sugar, hyperglycemia high blood sugar may result. It's important to monitor blood sugar levels at home and to seek immediate medical care if you experience any signs of dangerously high blood sugar, which can lead to loss of consciousness. This may include confusion, seizures, dry mouth, vomiting, or sweet-smelling breath. Reduced response: Over a period of time, you may become progressively less responsive to a particular treatment for diabetes because your diabetes worsens.
If metformin fails to lower blood sugar to target levels, talk to your doctor. Your doctor may want to stop metformin or recommend another medication. Surgery: This medication should be stopped temporarily for surgery except for minor surgery where food and fluid intake is not restricted. You will be restarted on this medication once you are eating and drinking and your kidney function has been tested and is normal. Talk to your doctor for specific instructions.
Vitamin B12 levels: This medication may decrease vitamin B12 levels. Your doctor will monitor your B12 levels with blood tests while you are taking this medication. Pregnancy: This medication should not be used during pregnancy. If you become pregnant while taking this medication, contact your doctor immediately. Breast-feeding: Metformin is believed to pass into breast milk. This medication should not be used if you are breast-feeding.
Children: The safety and effectiveness of this medication have not been established for children. Seniors: Kidney function often decreases with age. As a result, seniors may be more likely to experience side effects of this medication.
If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:. An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed. Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter non-prescription , and herbal medications you are taking.
Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them. All material copyright MediResource Inc. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.
Source: www. About this Medication. How does this medication work? What will it do for me? Acne Doctor Discussion Guide. Acne: Fact vs Myth Quiz. Metformin can cause vitamin B12 deficiency if you take it for a long time. Treatment for diabetes is usually for life. But if your kidneys are not working properly, your doctor will tell you to stop taking metformin. If you have diabetes , you're entitled to free prescriptions for all of your medicines, not just your diabetes ones.
The application form for the medical exemption certificate is called FP92A. You can get this from your doctor's surgery. Metformin will not affect the combined pill or emergency contraception. But some women might need a small adjustment in their metformin dose after starting contraceptive pills. There's no clear evidence to suggest that taking metformin will reduce fertility in either men or women.
But speak to a pharmacist or a doctor if you're trying to get pregnant. They may want to review your treatment. Your doctor may tell you to stop taking metformin a few days before having an operation or medical tests. A general anaesthetic that puts you to sleep can also hide low blood sugar. Yes, you can drink alcohol while taking metformin, but it's best for men and women to drink no more than 2 units per day.
A standard glass of wine ml is 2 units. A pint of lager or beer is usually 2 to 3 units of alcohol. Be careful eating food and drink containing karela. This is because it can lower your blood sugar levels and mean your diabetes is not controlled as well as it should be. Karela also called bitter gourd is used to flavour foods, such as curries like bitter gourd masala.
If your blood sugar levels are stable, taking metformin should not affect your ability to drive, cycle or use machinery and tools. Metformin itself will not make your blood sugar levels too low, but your doctor might prescribe it alongside other medicines for diabetes that can affect your blood sugar. Metformin is usually prescribed when diet and exercise alone has not been enough to control your blood sugar levels. Page last reviewed: 8 February Next review due: 8 February Metformin On this page About metformin Key facts Who can and cannot take metformin How and when to take it Side effects How to cope with side effects Pregnancy and breastfeeding Cautions with other medicines Common questions.
About metformin Metformin is a medicine used to treat type 2 diabetes , and to help prevent type 2 diabetes if you're at high risk of developing it. PCOS is a condition that affects how the ovaries work. Metformin lowers your blood sugar levels by improving the way your body handles insulin. Metformin is available on prescription as tablets and as a liquid that you drink.
Metformin works by reducing the amount of sugar your liver releases into your blood. It also makes your body respond better to insulin. Insulin is the hormone that controls the level of sugar in your blood. It's best to take metformin with a meal to reduce the side effects. The most common side effects are feeling and being sick, diarrhoea, stomach ache and going off your food.
Metformin does not cause weight gain, unlike some other diabetes medicines. Liquid metformin is called by the brand name Riomet. Metformin is prescribed for adults, and children aged 10 years and older. Tell your doctor before starting the medicine if you : have had an allergic reaction to metformin or other medicines in the past have uncontrolled diabetes have liver or kidney problems have a severe infection are being treated for heart failure or have recently had a heart attack have severe problems with your circulation or breathing difficulties drink a lot of alcohol You may need to stop taking metformin before having surgery and certain medical tests.
Tell your doctor if you need to have: a test such as an X-ray or scan involving the injection of a dye that contains iodine into your blood surgery where you'll be put to sleep. Dosage The maximum daily dose is 2,mg a day for example, 4 x mg tablets. Different types of metformin Metformin comes as 2 different types of tablet: standard-release tablets and slow-release tablets. Will my dose go up or down? For example: one mg tablet with or after breakfast for at least 1 week, then one mg tablet with or after breakfast and your evening meal for at least 1 week, then one mg tablet with or after breakfast, lunch and your evening meal If you find you cannot tolerate the side effects of standard-release metformin, your doctor may suggest switching to slow-release tablets.
What if I forget to take it? If you often forget doses, it may help to set an alarm to remind you. What if I take too much? They include: stomach pain diarrhoea fast or shallow breathing feeling cold unusual sleepiness tiredness or weakness. Like all medicines, metformin can cause side effects, although not everyone gets them. Common side effects Common side effects happen in more than 1 in people. Talk to your doctor or pharmacist if these side effects bother you or do not go away after 1 week: feeling sick nausea being sick vomiting or diarrhoea stomach ache loss of appetite a metallic taste in the mouth Serious side effects Serious side effects are rare and happen in less than 1 in 10, people.
Call your doctor straight away if you get warning signs of: a general feeling of discomfort with severe tiredness, fast or shallow breathing, being cold and a slow heartbeat yellow skin or the whites of your eyes turn yellow - these can be signs of liver problems extreme tiredness, lack of energy, pins and needles, a sore and red tongue, mouth ulcers, muscle weakness and disturbed vision - these could be signs of vitamin B12 deficiency anaemia a skin rash, redness or itching - this could be a sign of a skin disorder Low blood sugar Metformin does not usually cause low blood sugar known as hypoglycaemia, or "hypos" when taken on its own.
Early warning signs of low blood sugar include: feeling hungry trembling or shaking sweating confusion difficulty concentrating It's also possible for your blood sugar to go too low while you're asleep. If this happens, it can make you feel sweaty, tired and confused when you wake up. Low blood sugar may happen if you: take too much of some types of diabetes medicines eat meals irregularly or skip meals are fasting do not eat a healthy diet and are not getting enough nutrients change what you eat increase your physical activity without eating more to compensate drink alcohol, especially after skipping a meal take some other medicines or herbal medicines at the same time have a hormone disorder, such as hypothyroidism have kidney or liver problems To prevent hypoglycaemia, it's important to have regular meals, including breakfast.
Serious allergic reaction It's possible to have a serious allergic reaction anaphylaxis to metformin. Information: You can report any suspected side effect using the Yellow Card safety scheme. Visit Yellow Card for further information. What to do about: feeling sick — take metformin with food to reduce the chances of feeling sick.
It may also help to slowly increase your dose over several weeks.
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