Glucophage is a relatively recent diabetes medicine in the U.S., although it
has been available in other countries for over a decade.
It is
prescribed to people with NIDDM, or "adult onset" diabetes.
Although it
lowers blood sugar both right after meals and between meals, it works
differently from most other diabetes pills.
It improves the body's
response to insulin and reduces the liver's output of sugar.
It also
lowers blood fats somewhat, and it is hoped this will reduce the risk of heart
disease.
Glucophage may be used alone or in combination with other
diabetes pills.
The most common side effects of Glucophage are
digestive: loss of appetite, nausea or diarrhea. These may fade with time.
Rash, flatulence, and a metallic taste have also been
reported.
One rare but serious adverse effect may occur when a person has
kidney problems or becomes dehydrated.
Lactic acid may build up in the
bloodstream and lead to dangerous consequences. Contact your doctor promptly if
you feel ill, with muscle aches, trouble breathing, stomach pain and drowsiness.
Blood tests will determine if lactic acidosis has developed. This is a medical
emergency.
If Glucophage seems to be losing its effectiveness for
controlling blood sugar, discuss the situation with your
doctor.
Furosemide (Lasix) can increase blood levels of Glucophage, while
levels of furosemide may be lower than expected.
Nifedipine (Adalat,
Procardia) can also boost Glucophage levels modestly, while cimetidine (Tagamet)
can raise Glucophage levels substantially.
Other drugs, including
Lanoxin (digoxin), quinidine and Zantac (ranitidine), might theoretically
increase Glucophage blood levels but no interactions have been reported
yet.
Medications such as cortisone or estrogen that tend to raise blood
sugar may interfere with the effectiveness of Glucophage.
Check with
your physician and pharmacist regarding potential interactions of Glucophage
with any other drugs or herbs you take.
People with poor kidney function may need lower doses of Glucophage to avoid a dangerous build-up of the drug.
Older people may also need dosage adjustments so that they take the minimum possible dose that controls blood sugar.
Periodic monitoring of kidney function is essential.
Glucophage should be stopped temporarily before surgery or any x-ray procedure using iodinated contrast media ("dye"). Ask your doctor for specific instructions.
Glucophage is usually taken with meals, twice a day.
It works best in patients following
a sensible diet for diabetes.
Excessive alcohol intake can increase the potential for a
serious reaction and should be avoided by people taking Glucophage.