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Glucophage (Metaformin) clinical pharmacology:rxlist:"Metformin HCl is an antihyperglycemic agent which improves glucose tolerance in NIDDM subjects, lowering both basal and postprandial plasma glucose. Its pharmacologic mechanisms of action are different from those of sulfonylureas. Metformin HCl decreases hepatic glucose production, decreases intestinal absorption of glucose and improves insulin sensitivity (increases peripheral glucose uptake and utilization). Unlike sulfonylureas, metformin HCl does not produce hypoglycemia in either diabetic or nondiabetic subjects (except in special circumstances, see PRECAUTIONS) and does not cause hyperinsulinemia. With metformin therapy, insulin secretion remains unchanged while fasting insulin levels and day-long plasma insulin response may actually decrease."
http://www.rxlist.com/cgi/generic/metformi_cp.htm
Glucophage (Metformin) FDA information:niddk:"In December 1994, the U.S. Food and Drug Administration (FDA) approved the use of metformin for the treatment of Type 2 diabetes. Metformin was approved for use either alone or with sulfonylureas, a commonly used group of diabetes medicines. Metformin's brand name is Glucophage.
Metformin is in the group of diabetes medicines called biguanides. Metformin lowers blood sugar by keeping the liver from making too much sugar. The medicine does not increase how much insulin the pancreas makes. Metformin also helps lower the fatty blood components—triglycerides and cholesterol—that are often high in people with Type 2 diabetes. Metformin also has been shown to decrease the appetite and help people lose a few pounds when they starting taking the medicine. Another benefit of metformin is that it does not cause low blood sugar (hypoglycemia) when it is used as the only diabetes medicine."
http://www.niddk.nih.gov/health/diabetes/summary/metform/metform.htm
What is lactic acidosis and can it happen to me?:diabetesmonitor:"Lactic acidosis is caused by a buildup of lactic acid in the blood. Lactic acidosis associated with GLUCOPHAGE is rare and has occurred mostly in people whose kidneys were not working normally. Lactic acidosis has been reported in about one in 33,000 patients taking GLUCOPHAGE over the course of a year. Although rare, if lactic acidosis does occur, it can be fatal in up to half the cases. It's also important for your liver to be working normally when you take GLUCOPHAGE. Your liver helps remove lactic acid from your bloodstream. Your doctor will monitor your diabetes and may perform blood tests on you from time to time to make sure your kidneys and your liver are functioning normally. There is no evidence that GLUCOPHAGE causes harm to the kidneys or liver
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http://www.diabetesmonitor.com/metf-qa.htm
Side effects of Glucophage (Metformin):Joslin Diabetes Center:"Minor side effects:
These side effects usually go away after your body gets used to taking the medicine for several weeks. These include mild diarrhea, nausea, or upset stomach. Taking Glucophage with meals can lessen side effects. Call your health care provider if you experience severe discomfort or if the side effects last longer than a few weeks. Hypoglycemia (low blood glucose) is less likely to occur when Glucophage is taken alone. Hypoglycemia may occur when Glucophage is taken in combination with insulin, sulfonylurea agents or Prandin (repaglinide). (Sulfonylurea agents and Prandin are other types of diabetes pills.) Major side effects: Serious side effects are very rare and occur mostly in people whose kidneys or liver are not working normally. The most serious side effect is lactic acidosis. It may be life threatening. Your health care provider will check your kidney and liver function to determine if you are at risk"
http://www.joslin.harvard.edu/education/library/glucophage.shtml
Glucophage Reduces Deaths In Type II Diabetics, Study Shows:pslgroup:"The results of a landmark study reported at the 34th Annual meeting of the European Association for the Study of Diabetes (EASD) confirmed that intensive diabetes control reduces morbidity (complications) and mortality in patients with Type II diabetes. The results of the United Kingdom Prospective Diabetes Study (UKPDS) were published in The Lancet. These findings show that Merck Lipha Pharmaceutical’s Glucophage(R)(metformin) significantly improve blood glucose control and reduce the incidence of all fatal and non-fatal complications when given as first line therapy to overweight Type II diabetic patients for up to 20 years."
http://www.pslgroup.com/dg/AEE62.htm
precautions when taking Glucophage (Metformin):healthtrust:"Wear disease medical alert identification for diabetes.
Avoid alcohol intake (includes wine, beer, and liquor). Can cause side effects.
Use caution if you have kidney, heart, lung, liver disease. Talk with healthcare provider.
Do not drive if blood sugar has been low. There is a greater risk of an accident.
Keep hard candies, liquid glucose, or milk on hand for low blood sugars.
If you are 80 years of age or older, you may have more side effects. You may need a low dose.
Tell healthcare provider if you are allergic to any medicine. Make sure to tell about the allergy and how it affected you. This includes telling about rash; hives; itching; shortness of breath; wheezing; cough; swelling of face, lips, tongue, throat; or any other symptoms involved.
Tell healthcare provider if you are pregnant or plan on getting pregnant.
Tell healthcare provider if you are breast-feeding"
http://www.healthtrust.com/intmed/Access2Cons2/ConsDrugs/Metformincd.shtml
What you should monitor while taking Glucophage (Metformin):usadrug:"Check blood sugar as ordered by healthcare provider. Call if glucose is less than 80 mg/dL or greater than 250 mg/dL. Bring results to follow-up visits.
Watch for low blood sugar. This can cause anger, shaking, rapid heartbeats, confusion, sweating.
Watch for high blood sugar. Causes many trips to the bathroom, thirst, and weight loss.
Check blood work for diabetes, liver, and kidney function. Talk with healthcare provider.
Follow diet plan and exercise program as recommended by healthcare provider.
Have a yearly eye exam and visit to the foot doctor.
Check weight."
http://www.usadrug.com/IMCAccess/ConsDrugs/Metformincd.shtml#Monitor
Dosing for Glucophage (Metformin):edoc:"Glucophage 500mg:
The dose should be increased gradually.One 500mg tablet three times daily is often sufficient to obtain diabetic control.If necessary, the dose can be increased to two 500mg tablets three times a day. Control may be attained within a few days, but occasionally requires up to two weeks.Once control is obtained, it may be possible to reduce the dosage. Glucophage forte (850mg):
Initially the dose should be one Forte (850mg) tablet daily, increasing gradually until control is obtained.A larger dose than two Forte (850mg) tablets twice a day may be used when required.
When combined with existing sulphonylurea therapy which is not giving adequate control one 500mg or one Forte (850mg) tablet should be added initially, the dosage of Glucophage being gradually increased until optimal control is obtained."
http://www.edoc.co.za/medilink/products/1059.html
Glucophage (Metformin) as a treatment for polycystic ovary syndrom:Abington Reproductive Medicine:"Polycystic Ovarian Syndrome (PCOS) is a common cause of infertility. The doctor has tested you for insulin resistance, which means that your pancreas is producing a large amount of insulin to maintain a normal glucose level. This is called hyperinsulinemia. Hyperinsulinemia leads to increased levels of androgens in the ovaries. Hyperandrogenemia may directly interfere with ovulation. PCOS patients are at increased risk of developing type 2 diabetes, hypertension, dyslipidemia, and coronary heart disease. Metformin is an oral antihyperglycemic agent and has been shown to improve the body's use of insulin therefore decreasing androgen levels and restoring normal ovulatory function"
http://www.abington-repromed.com/metformin.html
Special warnings about
Glucophage (Metformin):heartdrs:"Before you start therapy with Glucophage, 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 Glucophage, 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 Glucophage, you should check your blood or urine periodically for abnormal sugar (glucose) levels. Your doctor will do annual blood checks to see if Glucophage is causing a vitamin B12 deficiency or any other blood problem. It's possible that drugs such as Glucophage 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 Glucophage, may decrease with time. This may be due to either a diminished responsiveness to the medication or a worsening of the diabetes."
http://www.heartdrs.com/meds/Glucophage.htm
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