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Metformin

Metformin

Overview

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.

Side Effects and Interactions

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.

Special Precautions

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.

Taking the Medicine

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.

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About the Author
Joe Graedon is a pharmacologist who has dedicated his career to making drug information understandable to consumers. His best-selling book, The People’s Pharmacy, was published in 1976 and led to a syndicated newspaper column, syndicated public radio show and web site. In 2006, Long Island University awarded him an honorary doctorate as “one of the country's leading drug experts for the consumer.” .
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