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Brand name: Glucophage
Other brand name: Dianben
Generic name: Metformin
Glucophage is an oral antidiabetic medication used to treat
type 2 (non-insulin-dependent) diabetes. Diabetes develops
when the body proves unable to burn sugar and the unused sugar
builds up in the bloodstream. Glucophage lowers the amount
of sugar in your blood by decreasing sugar production and
absorption and helping your body respond better to its own
insulin, which promotes the burning of sugar. It does not,
however, increase the body's production of insulin. Glucophage
is sometimes prescribed along with insulin or certain other
oral antidiabetic drugs such as Micronase or Glucotrol. It
is also used alone.
Glucophage tablets are taken two or three times daily.
Always remember that Glucophage is an aid to, not a substitute
for, good diet and exercise. Failure to follow a sound diet
and exercise plan can lead to serious complications such as
dangerously high or low blood sugar levels. Remember, too,
that Glucophage is not an oral form of insulin and cannot
be used in place of insulin.
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Most important fact about Glucophage
Glucophage could cause a very rare,but potentially fatal,side
effect known as lactic acidosis. It is caused by a buildup
of lactic acid in the blood. The problem is most likely to
occur in people whose liver or kidneys are not working well,
and in those who have multiple medical problems, take several
medications, or have congestive heart failure. The risk also
is higher if you are an older adult or drink alcohol. Lactic
acidosis is a medical emergency that must be treated in a
hospital.
Notify your doctor immediately if you experience any of the
following:
Symptoms of lactic acidosis may include:
Dizziness, extreme weakness or tiredness, light-headedness,
low body temperature, rapid breathing or trouble breathing,
sleepiness, slow or irregular heartbeat, unexpected or unusual
stomach discomfort, unusual muscle pain
How should you take Glucophage ?
Do not take more or less of Glucophage than directed by your
doctor. Glucophage should be taken with food to reduce the
possibility of nausea or diarrhea, especially during the first
few weeks of therapy.
If you miss a dose of Glucophage
Take it as soon as you remember. If it is almost time for
your next dose, skip the one you missed and go back to your
regular schedule. Never take 2 doses at the same time.
Storage instructions for Glucophage
Store it at room temperature.
What side effects when taking Glucophage may occur ?
Side effects of Glucophage cannot be anticipated. If any
develop or change in intensity, tell your doctor as soon as
possible. Only your doctor can determine if it is safe for
you to continue taking Glucophage.
If side effects from Glucophage occur, they usually happen
during the first few weeks of therapy. Most side effects are
minor and will go away after you've taken Glucophage for a
while.
More common side effects when taking Glucophage may include:
Abdominal discomfort, diarrhea, gas, headache, indigestion,
nausea, vomiting, weakness
Less common side effects when taking Glucophage may include:
Abdominal distention, abnormal stools, altered sense of taste,
chest discomfort, chills, constipation, dizziness, flu-like
symptoms, flushing, increased sweating, low blood sugar, light-headedness,
muscle pain, nail disorders, pounding heartbeat, rash, shortness
of breath, upper respiratory infection
Why should Glucophage not be prescribed ?
Glucophage is processed primarily by the kidneys, and can
build up to excessive levels in the body if the kidneys aren't
working properly. It should be avoided if you have kidney
disease or your kidney function has been impaired by a condition
such as shock, blood poisoning, or a heart attack.
You should not use Glucophage if you need to take medicine
for congestive heart failure.
Do not take Glucophage if you have ever had an allergic reaction
to metformin.
Do not take Glucophage if you have metabolic or diabetic
ketoacidosis (a life-threatening medical emergency caused
by insufficient insulin and marked by excessive thirst, nausea,
fatigue, pain below the breastbone, and fruity breath). Diabetic
ketoacidosis should be treated with insulin.
Special warnings about Glucophage
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 Glucophage. 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.
You should not take Glucophage for 2 days before and after
having an X-ray procedure (such as an angiogram) that uses
an injectable dye. Also, if you are going to have surgery,
except minor surgery, you should stop taking Glucophage. Once
you have resumed normal food and fluid intake, your doctor
will tell you when you can start Glucophage therapy again.
Avoid drinking too much alcohol while taking Glucophage.
Heavy drinking increases the danger of lactic acidosis and
can also trigger an attack of low blood sugar.
Because poor liver function could increase the risk of lactic
acidosis, your doctor may decide to check your liver function
before prescribing Glucophage and periodically thereafter.
If you develop liver problems, your doctor may stop treatment
with Glucophage.
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.
Glucophage does not usually cause hypoglycemia (low blood
sugar). However, it remains a possibility, especially in older,
weak, and undernourished people and those with kidney, liver,
adrenal, or pituitary gland problems. The risk of low blood
sugar increases when Glucophage is combined with other diabetes
medications. The risk is also boosted by missed meals, alcohol,
and excessive exercise. To avoid low blood sugar, you should
closely follow the diet and exercise plan suggested by your
doctor.
If your blood sugar becomes unstable due to the stress of
a fever, injury, infection, or surgery, your doctor may temporarily
take you off Glucophage and ask you to take insulin instead.
You should stop taking Glucophage if you become seriously
dehydrated, since this increases the likelihood of developing
lactic acidosis. Tell your doctor if you lose a significant
amount of fluid due to vomiting, diarrhea, fever, or some
other condition.
The effectiveness of any oral antidiabetic, including Glucophage,
may decrease with time. This may occur because of either a
diminished responsiveness to Glucophage or a worsening of
the diabetes.
Possible food and drug interactions when taking Glucophage
If Glucophage is taken with certain other drugs, the effects
of either could be increased, decreased, or altered.
It is especially important to check with your doctor before
combining Glucophage with the following:
Amiloride (Moduretic)
Calcium channel blockers (heart medications) such as Calan,
Isoptin, and Procardia
Cimetidine (Tagamet)
Decongestant, airway-opening drugs such as Sudafed and Ventolin
Digoxin (Lanoxin)
Estrogens such as Premarin
Furosemide (Lasix)
Glyburide (Micronase)
Isoniazid (Rifamate), a drug used for tuberculosis
Major tranquilizers such as Thorazine
Morphine
Niacin (Niaspan)
Nifedipine (Adalat, Procardia)
Oral contraceptives
Phenytoin (Dilantin)
Procainamide (Procanbid, Pronestyl)
Quinidine (Quinidex)
Quinine
Ranitidine (Zantac)
Steroids such as prednisone (Deltasone)
Thyroid hormones such as Synthroid
Triamterene (Dyazide, Dyrenium)
Trimethoprim (Bactrim, Septra)
Vancomycin (Vancocin)
Water pills (diuretics) such as HydroDIURIL, Dyazide, and
Moduretic
Do not drink too much alcohol, since excessive alcohol consumption
can cause low blood sugar and alcohol enhances some effects
of Glucophage.
Special information if you are pregnant or breastfeeding
If you are pregnant or plan to become pregnant, tell your
doctor immediately. Glucophage should not be taken during
pregnancy. Since studies suggest the importance of maintaining
normal blood sugar (glucose) levels during pregnancy, your
doctor may prescribe insulin injections instead. It is not
known whether Glucophage appears in human breast milk. Therefore,
women should discuss with their doctors whether to discontinue
the medication or to stop breastfeeding. If the medication
is discontinued and if diet alone does not control glucose
levels, then your doctor may consider insulin injections.
Recommended dosages for Glucophage
Your doctor will tailor your dosage to your individual needs.
ADULTS
The usual starting dose is one 500-milligram tablet twice
a day, taken with morning and evening meals. Your doctor may
increase your daily dose by 500 milligrams at weekly intervals,
based on your response up to a total of 2,000 milligrams.
An alternative starting dose is one 850-milligram tablet
a day, taken with the morning meal. Your doctor may increase
this by 850 milligrams at 14-day intervals, to a maximum of
2,550 milligrams a day.
The usual maintenance dose ranges from 1,500 to 2,550 milligrams
daily. If you take more than 2,000 milligrams a day, your
doctor may recommend that the medication be divided into three
doses, taken with each meal.
CHILDREN
For children 10 to 16 years old, the usual starting dose
is one 500-milligram tablet twice a day with meals. The dosage
may be increased by 500 milligrams at weekly intervals up
to a maximum of 2,000 milligrams daily. Glucophage has not
been tested in children younger than 10.
OLDER ADULTS
Older people and those who are malnourished or in a weakened
state are generally given lower doses of Glucophage because
their kidneys may be weaker, making side effects more likely.
Overdosage with Glucophage
An overdose of Glucophage can cause lactic acidosis. If you
suspect a Glucophage overdose, seek emergency treatment immediately.
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