General Information and Indications:
Metformin (met-FOR-min) is used to treat
a type of diabetes mellitus (sugar diabetes) called type 2 diabetes. With
this type of diabetes, insulin produced by the pancreas is not able to get
sugar into the cells of the body where it can work properly. Using metformin
alone, with a type of oral antidiabetic medicine called a sulfonylurea, or
with insulin will help to lower blood sugar when it is too high and help
restore the way you use food to make energy.
Many people can control type 2 diabetes with diet alone or diet and
exercise. Following a specially planned diet and exercising will always be
important when you have diabetes, even when you are taking medicines. To
work properly, the amount of metformin you take must be balanced against the
amount and type of food you eat and the amount of exercise you do. If you
change your diet, your exercise, or both, you will want to test your blood
sugar to find out if it is too low. Your health care professional will teach
you what to do if this happens.
At some point, this medicine may stop working as well and your blood glucose
will increase. You will need to know if this happens and what to do. Instead
of taking more of this medicine, your doctor may want you to change to
another antidiabetic medicine. If that does not lower your blood sugar, your
doctor may have you stop taking the medicine and begin receiving insulin
injections instead.
Metformin does not help patients who have insulin-dependent or type 1
diabetes because they cannot produce insulin from their pancreas gland.
Their blood glucose is best controlled by insulin injections.
Information For Users:
In deciding to use a medicine, the risks of taking the
medicine must be weighed against the good it will do. This is a decision you
and your doctor will make. For metformin, the following should be
considered:
Allergies—Inform your doctor if you have ever had any unusual or allergic
reaction to metformin. Also tell your health care professional if you are
allergic to any other substances, such as foods, preservatives, or dyes.
Pregnancy—Metformin has not been shown to cause birth defects or other
problems in humans. However, metformin is not used during pregnancy.
Instead, your doctor may want to control your blood sugar by diet or by a
combination of diet and insulin. It is especially important for your health
and your baby's health that your blood sugar be closely controlled. Close
control of your blood sugar can reduce the chance of your baby gaining too
much weight, having birth defects, or having high or low blood sugar. Be
sure to Inform your doctor if you plan to become pregnant or if you think
you are pregnant.
Breast-feeding—It is not known whether metformin passes into human breast
milk. Although most medicines pass into breast milk in small amounts, many
of them may be used safely while breast-feeding. Mothers who are taking this
medicine and who wish to breast-feed should discuss this with their doctor.
Children—Metformin tablets have been tested in children older than 10 years
old and, in effective doses, have not been shown to cause different side
effects or problems than it does in adults.
Studies with metformin extended-release tablets have been done only in adult
patients, and there is no specific information comparing use of this
medicine in children with use in other age groups.
Older adults—Use in older adults is similar to use in adults of younger age.
However, if you have blood vessel disorders or kidney problems, your health
care professional may adjust your dose or tell you to stop taking this
medicine, if necessary.
Other medicines—Although certain medicines should not be used together at
all, in other cases two different medicines may be used together even if an
interaction might occur. In these cases, your doctor may want to change the
dose, or other precautions may be necessary. Do not take any other medicine
unless prescribed or approved by your doctor . When you are taking metformin,
it is especially important that your health care professional know if you
are taking any of the following:
o Alcohol—Small amounts of alcohol taken with meals do not usually cause a
problem; however, either larger amounts of alcohol taken for a long time or
a large amount of alcohol taken in one sitting without food can increase the
effect of metformin. This can keep the blood sugar low for a longer period
of time than normal
Use this medicine as directed even if you feel well and
do not notice any signs of high blood sugar. Do not take more of this
medicine and do not take it more often than your doctor ordered. To do so
may increase the chance of serious side effects. Remember that this medicine
will not cure your diabetes, but it does help control it. Therefore, you
must Continue taking it as directed if you expect to lower your blood sugar
and keep it low. You may have to take an antidiabetic medicine for the rest
of your life. If high blood sugar is not treated, it can cause serious
problems, such as heart failure, blood vessel disease, eye disease, or
kidney disease.
Your doctor will give you instructions about diet, exercise, how to test
your blood sugar, and how to adjust your dose when you are sick.
o Blood sugar tests: Testing for blood sugar is the best way to tell whether
your diabetes is being controlled properly. Blood sugar testing helps you
and your health care team adjust your antidiabetic medicine dose, meal plan,
and exercise schedule.
o Diet: The daily number of calories in your meal plan should be adjusted by
your doctor or a registered dietitian to help you reach and maintain a
healthy body weight. In addition, regular meals and snacks are arranged to
meet the energy needs of your body at different times of the day. It is very
important that you carefully follow your meal plan.
o Exercise: Ask your doctor what kind of exercise to do, the best time to do
it, and how much you should do each day.
o Fluid (water) replacement: It is important to replace the water or fluid
that your body uses. Inform your doctor if you have less urine output than
usual or severe diarrhea that lasts for more than 1 day.
o On sick days:
o When you become sick with a cold, fever, or the flu, you need to take your
usual dose of metformin, even if you feel too ill to eat. This is especially
true if you have nausea, vomiting, or diarrhea. Infection usually increases
your need to produce more insulin. Sometimes you may need to be switched
from metformin to insulin for a short period of time while you are sick to
properly control blood sugar. Call your doctor for specific instructions,
especially if severe or prolonged vomiting occurs .
o Continue taking your metformin and try to stay on your regular meal plan.
If you have trouble eating solid food, drink fruit juices, nondiet soft
drinks, or clear soups, or eat small amounts of bland foods. A dietitian or
your health care professional can give you a list of foods and the amounts
to use for sick days.
o Test your blood sugar and check your urine for ketones. If ketones are
present, call your doctor at once. Even when you start feeling better, let
your doctor know how you are doing.
special precautions:
o Inform your doctor or pharmacist if you have
allergy to metoprolol or any other medications.
o Inform your doctor and pharmacist what prescription and nonprescription
medications, vitamins, nutritional supplements, and herbal products you are
taking. Be sure to mention any of the following: fluoxetine (Prozac, Sarafem);
paroxetine (Paxil); propafenone (Rythmol); quinidine (Quinidex); and
reserpine (Serpalan, Serpasil, Serpatab). Your doctor may need to change the
doses of your medications or monitor you carefully for side effects.
o inform your doctor if you are breast-feeding asthma or other lung disease;
a slow heart rate; heart or liver disease; diabetes; or an overactive
thyroid gland (hyperthyroidism).
o Inform your doctor if you are pregnant, plan to become pregnant, or are
breast-feeding. If you become pregnant while taking metoprolol, call your
doctor.
o if you are having surgery, including dental surgery, Inform your doctor or
dentist that you are taking metoprolol.
o you should know that metoprolol may make you drowsy. Do not drive a car or
operate machinery until you know how this medication affects you.
o remember that alcohol can add to the drowsiness caused by this medication.
o you should know that if you have allergic reactions to different
substances, your reactions may be worse while you are using metoprolol, and
your allergic reactions may not respond to the usual doses of injectable
epinephrine.
Possible Adverse
Effects:
Along with its needed effects, a medicine may
cause some unwanted effects. Although not all of these side effects may
occur, if they do occur they may need medical attention.
Check with your doctor immediately if the following side effect occurs:
Rare
o Lactic acidosis (quick and severe), including diarrhea, fast shallow
breathing, muscle pain or cramping, unusual sleepiness, unusual weakness or
tiredness
Check with your doctor as soon as possible if the following side effect
occurs:
Rare
o Low blood sugar (mild), including anxious feeling, behavior change similar
to being drunk, blurred vision (Impaired vision), cold sweats, confusion,
cool pale skin, difficulty in concentrating, drowsiness, excessive hunger,
fast heartbeat, headache, nausea, nervousness, nightmares, restless sleep,
shakiness, slurred speech
Other side effects may occur that usually do not need medical attention.
These side effects may go away during treatment as your body adjusts to the
medicine. However, check with your doctor if any of the following side
effects continue or are bothersome:
More common
o loss of appetite (anorexia); metallic taste in mouth; passing of gas;
stomachache; vomiting; weight loss
Brand Name(s):
o Glucophage
o Glucophage XR
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