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TOPIC: Any one who's gone off Metformin . . .

 
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May 4, 2009 7:37 AM
how long does it stay in your system?? I know it takes 2 - 3 weeks to kick in when you start taking it, how long does it take to completely leave your system when you stop? Due to my increase in exercise and lowering of carbs I have stopped taking it (2nd day) but feel that kind of weird lowish, head spinny thing. Last time I tested - 2 hours after lunch yesterday, I was 103. drinker If any one has any experience - I appreciate the input!!
  129430
May 4, 2009 7:50 AM
I got gesational diabetes with my 2nd child and was put on metformin. I would say I was only on it for a few months but when I stopped taking it I didn't notice any change. Maybe since you were on it for what I'm guessing is longer that would be why you are experiencing your symptoms. Have you asked you doctor if this is normal?
  190427
May 4, 2009 8:10 AM
QUOTE:

I got gesational diabetes with my 2nd child and was put on metformin. I would say I was only on it for a few months but when I stopped taking it I didn't notice any change. Maybe since you were on it for what I'm guessing is longer that would be why you are experiencing your symptoms. Have you asked you doctor if this is normal?


My doctor didn't even tell me that it takes 2 - 3 weeks to kick in! She's a nice doc, but I basically am on my own with this. Good thing I do a lot of research and did when I had gestational diabetes with my now 5 year old. I learned a lot and had a doc who gave a lot of information and was much more active in my care - but the health and well-being of my baby were on the line.
  129430
May 4, 2009 8:20 AM
Are you weaning yourself off or stopped cold Turkey????

I weaned myself off of it, I also self-adjusted my meds after my Dr teaching me how it should be done.......

You should never stop cold Turkey!!!
  117920
May 4, 2009 8:25 AM
QUOTE:

Are you weaning yourself off or stopped cold Turkey????

I weaned myself off of it, I also self-adjusted my meds after my Dr teaching me how it should be done.......

You should never stop cold Turkey!!!


I was only on 500 mg in the am and 500 in the pm - 1000 if I ate a bunch of carbs. With my diet currently - if I even take the 500 I get pretty low. I also think that yesterday was because I took 1000 mg Sat night in anticipation of going to the barbecue and having a lot of carbs, then I didn't go. Then didn't hardly eat and had to battle going low for awhile of course. Duh. I may have mistaken my light-headedness today though, I think something is out in my neck. Just tested my bs and am in good shape that was. But I have a spot in my neck that is bugging me and causing a slight headache. Thanks for the info - how did your doc say to go off it? 1500/day was the most I ever took.
  129430
May 4, 2009 8:29 AM
I take 2000 mg a day.

When I start getting the BS lows, I cut it down to1500 (so 1 whole pill in the AM and then a half in the PM)............do this for a few days testing BS frequently.........

When BS starts to go low again, then taper off to 1000 mg per day, half pill in the AM, half in the PM......

Then down to 500 mg, half pill in the AM............

Then none............

Takes about 2-3 weeks. I went the opposite way to work my way up to the 2000 mg also.
  117920
May 4, 2009 8:37 AM
My pills are only 500 mg. I've only been taking 1 in the am and 1 in the pm for the last week or so. I probably should have just cut one out for awhile then the other, but I didn't know that. Thanks for the info!! There will never be a next time - but I will keep it in mind anyway glasses

I walked out to the mailbox and my neck popped a little coming back and the lightheadedness went away - must have been a compressed nerve.
  129430
May 4, 2009 8:51 AM
Patient information:
Glucophage/Glucophage XR:
Read this information carefully before you start taking this medicine and each time you refill your prescription. There may be new information. This information does not take the place of your doctor's advice. Ask your doctor or pharmacist if you do not understand some of this information or if you want to know more about this medicine.1 4

What is metformin?
Metformin is used to treat type 2 diabetes. This is also known as non-insulin-dependent diabetes mellitus. People with type 2 diabetes are not able to make enough insulin or respond normally to the insulin their bodies make. When this happens, sugar (glucose) builds up in the blood. This can lead to serious medical problems, including kidney damage, amputations, and blindness. Diabetes is also closely linked to heart disease. The main goal of treating diabetes is to lower your blood sugar to a normal level.

High blood sugar can be lowered by diet and exercise, a number of medicines taken by mouth, and insulin shots. Before you take metformin, try to control your diabetes with exercise and weight loss. While you take your diabetes medicine, continue to exercise and follow the diet advised for your diabetes. No matter what your recommended diabetes management plan is, studies have shown that maintaining good blood sugar control can prevent or delay complications of diabetes, such as blindness.

Metformin IR and ER have the same active ingredient. However, metformin ER tablets work longer in your body. Both of these medicines help control your blood sugar in a number of ways. These include helping your body respond better to the insulin it makes naturally, decreasing the amount of sugar your liver makes, and decreasing the amount of sugar your intestines absorb. Metformin IR and ER do not cause your body to make more insulin. Because of this, when taken alone, they rarely cause hypoglycemia (low blood sugar) and usually do not cause weight gain. However, when they are taken with a sulfonylurea or with insulin, hypoglycemia is more likely to occur, as is weight gain.1 4

Warning: A small number of people who have taken metformin have developed a serious condition called lactic acidosis. Lactic acidosis is caused by a buildup of lactic acid in the blood. This happens more often in people with kidney problems. Most people with kidney problems should not take metformin. (See “What are the adverse reactions of metformin?”)1 4


Who should not take metformin?
Some conditions increase your chance of getting lactic acidosis or cause other problems if you take either of these medicines. Most of the following conditions listed can increase your chance of getting lactic acidosis.

Do not take metformin if you:
have kidney problems
have liver problems
have heart failure that is treated with medicines, such as digoxin or furosemide
drink a lot of alcohol. This means you binge drink for short periods or drink all the time.
are seriously dehydrated (have lost a lot of water from your body)
are going to have an x-ray procedure with injection of dyes (contrast agents)
are going to have surgery
develop a serious condition, such as heart attack, severe infection, or a stroke
are 80 years of age and/or older and you have not had your kidney function tested


Tell your doctor if you are pregnant or are planning to become pregnant. Metformin may not be right for you. Talk with your doctor about your choices. You should also discuss your choices with your doctor if you are breast-feeding a child.1 4


Can metformin tablets be used in children?
Metformin IR tablets have been shown to effectively lower glucose levels in children (10 to 16 years of age) with type 2 diabetes. Metformin has not been studied in children younger than 10 years of age.

Metformin IR tablets have not been studied in combination with other oral glucose-control medicines or insulin in children. If you have any questions about the use of metformin in children, talk with your doctor or other health care provider.

Metformin ER tablets have not been studied in children.1


How should I take metformin?
Your doctor will tell you how much medicine to take and when to take it. You will probably start out with a low dose of the medicine. Your doctor may slowly increase your dose until your blood sugar is better controlled. You should take metformin with meals.

Your doctor may have you take other medicines along with metformin to control your blood sugar. These medicines may include insulin shots. Taking metformin with insulin may help you better control your blood sugar while reducing the insulin dose.

Continue your exercise and diet program and test your blood sugar regularly while taking metformin. Your doctor will monitor your diabetes and may perform blood tests on you from time to time to make sure your kidneys and liver are functioning normally. There is no evidence that metformin causes harm to the liver or kidneys.

Tell your doctor if you:
have an illness that causes severe vomiting, diarrhea, or fever, or if you drink a much lower amount of liquid than normal. These conditions can lead to severe dehydration (loss of water in your body). You may need to stop taking metformin for a short time.
plan to have surgery or an x-ray procedure with injection of dye (contrast agent). You may need to stop taking metformin for a short time.
start to take other medicines or change how you take a medicine. Metformin can affect how well other drugs work, and some drugs can affect how well metformin works. Some medicines may cause high blood sugar.


Metformin ER must be swallowed whole and never crushed or chewed. Occasionally, the inactive ingredients of metformin ER may be eliminated as a soft mass in your stool that may look like the original tablet; this is not harmful and will not affect the way metformin ER works to control your diabetes.1 4


What should I avoid while taking metformin? Do not drink a lot of alcoholic drinks while taking metformin. This means you should not binge drink for short periods, and you should not drink a lot of alcohol on a regular basis. Alcohol can increase your chance of getting lactic acidosis.1 4

What are the adverse reactions of metformin?
Lactic acidosis:
In rare cases, metformin can cause a serious side effect called lactic acidosis. This is caused by a buildup of lactic acid in your blood. This buildup can cause serious damage and/or death. Lactic acidosis caused by metformin is rare and has occurred mostly in people whose kidneys were not working normally. Lactic acidosis has been reported in about 1 in 33,000 patients taking metformin over the course of a year. Although rare, if lactic acidosis does occur, it can be fatal in up to half the people who develop it.

It is also important for your liver to be working normally when you take metformin. Your liver helps remove lactic acid from your blood.

Make sure you tell your doctor before you use metformin if you have kidney or liver problems. You should also stop using metformin and call your doctor right away if you have signs of lactic acidosis. Lactic acidosis is a medical emergency that must be treated in a hospital.

Signs of lactic acidosis are as follows:
a feeling of weakness, tiredness, or discomfort;
unusual muscle pain;
trouble breathing;
unusual or unexpected stomach discomfort;
a feeling of coldness;
a feeling of dizziness or light-headedness;
sudden development of a slow or irregular heartbeat.


If your medical condition suddenly changes, stop taking metformin and call your doctor right away. This may be a sign of lactic acidosis or another serious side effect.1 4


Other adverse reactions:
Common adverse reactions of metformin include diarrhea, nausea, and upset stomach. These adverse reactions generally go away after you take the medicine for a while. Taking your medicine with meals can help reduce these adverse reactions. Tell your doctor if the adverse reactions bother you a lot, last for more than a few weeks, come back after they have gone away, or start later in therapy. You may need a lower dose or need to stop taking the medicine for a short period of time or for good.

About 3 out of every 100 people who take metformin have an unpleasant metallic taste when they start taking the medicine. It lasts for a short time.

Metformin rarely causes hypoglycemia (low blood sugar). However, hypoglycemia can happen if you drink alcohol, take other medicines to lower blood sugar, or do not eat enough.1 4


General advice about prescription medicines: If you have questions or problems, talk with your doctor or other health care provider. You can ask your doctor or pharmacist for the information about metformin that is written for health care providers. Medicines are sometimes prescribed for purposes other than those described in patient information. Do not use metformin for a condition for which it was not prescribed. Do not share your medicine with other people.1 4


Fortamet patient information:
Why do I need to take Fortamet? Your doctor has prescribed Fortamet to treat your type 2 diabetes, a condition in which blood sugar (blood glucose) is elevated. There are 2 types of diabetes. Fortamet is indicated for the most common type, known as type 2 diabetes.3

Why is it important to control type 2 diabetes? Type 2 diabetes has multiple possible complications, including blindness, kidney failure, and circulatory and heart problems. Lowering your blood sugar to a normal level may prevent or delay these complications.3

How is type 2 diabetes usually controlled? High blood sugar can be lowered by diet and exercise, by a number of oral medications, and by insulin injections. Your doctor may recommend that your try lifestyle modifications, such as improved diet and exercise before initiating drug treatment for type 2 diabetes. Each patient will be treated individually by his or her doctor and should follow all treatment recommendations.3

Does Fortamet work differently from other glucose-control medications? Yes, Fortamet, as well as other formulations of metformin, lowers the amount of sugar in your blood by controlling how much sugar is released by your liver. Fortamet does not cause your body to produce more insulin. Fortamet rarely causes hypoglycemia (low blood sugar), and it does not usually cause weight gain when taken alone. However, if you do not eat enough, if you take other medications to lower blood sugar, or if your drink alcohol, you can develop hypoglycemia. Specifically, when Fortamet is taken together with a sulfonylurea or with insulin, hypoglycemia and weight gain are more likely to occur.3

What happens if my blood sugar is still too high? If your blood sugar is high, consult your doctor. When blood sugar cannot be lowered enough by either Fortamet or a sulfonylurea, the 2 medications can be effective when taken together. Other alternatives involve switching to other oral antidiabetic drugs (eg, alpha glucoside inhibitors, glitazones). Fortamet may be stopped and replaced with other drugs and/or insulin. If you are unable to maintain your blood sugar with diet, exercise, and glucose-control medications taken orally, your doctor may prescribe injectable insulin to control your diabetes.3

Why should I take Fortamet in addition to insulin if I am already on insulin alone? Adding Fortamet to insulin can help you better control your blood sugar while reducing the insulin dose and possibly reducing your weight.3

Can Fortamet cause adverse reactions? Fortamet, like all blood sugar–lowering medications, can cause adverse reactions in some patients. Most of these adverse reactions are minor and will go away after you have taken Fortamet for a while. However, there are also serious but rare adverse reactions related to Fortamet (see the following information).3

What kind of adverse reactions can Fortamet cause?
If adverse reactions occur, they usually occur during the first few weeks of therapy. They are normally minor ones such as diarrhea, nausea, abdominal pain, and upset stomach. Fortamet is generally taken with meals, which may reduce these adverse reactions.3

Although these adverse reactions are likely to go away, call your doctor if you have severe discomfort or if these effects last for more than a few weeks. Some patients may need to have their doses lowered or stop taking Fortamet, either temporarily or permanently. You should tell your doctor if the problems come back or start later on during the therapy.3


Warning: A rare number of people who have taken metformin have developed a serious condition called lactic acidosis. Properly functioning kidneys are needed to help prevent lactic acidosis. You should not take Fortamet if you have impaired kidney function, as measured by a blood test.3

Are there any serious adverse reactions that Fortamet can cause? Fortamet rarely causes serious adverse reactions. The most serious side effect that Fortamet can cause is called lactic acidosis.3

What is lactic acidosis and can it happen to me?
Lactic acidosis is caused by a buildup of lactic acid in the blood. Lactic acidosis associated with metformin is rare and has occurred mostly in people whose kidneys were not working normally. Lactic acidosis has been reported in about 1 in 33,000 patients taking metformin over the course of a year. Although rare, if lactic acidosis does occur, it can be fatal in up to half the cases.3

It is also important for your liver to be working normally when you take Fortamet. Your liver helps to 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 Fortamet causes harm to the kidneys or liver.3


Are there other risk factors for lactic acidosis? Your risk of developing lactic acidosis from taking Fortamet is very low as long as your kidneys and liver are healthy. However, some factors can increase your risk because they can affect kidney and liver function. You should discuss your risk with your doctor. You should not take Fortamet if:
you have some forms of kidney or liver problems.
you have CHF that is treated with medications (eg, digoxin, furosemide).
you drink alcohol excessively (all the time or short-term “binge” drinking).
you are seriously dehydrated (have lost a large amount of body fluids).
you are going to have, within a few days, certain x-ray tests with injectable contrast agents.
you are going to have surgery.
you develop a serious condition such as heart attack, severe infection, or a stroke.
you are 80 years of age and/or older and have not had your kidney function tested.
3

What are the symptoms of lactic acidosis? Some of the symptoms include feeling very weak, tired, or uncomfortable; unusual muscle pain; trouble breathing; unusual or unexpected stomach discomfort; feeling cold, dizzy, or light-headed; or suddenly developing a slow or irregular heartbeat. If you notice these symptoms, or if your medical condition has suddenly changed, stop taking Fortamet and call your doctor right away. Lactic acidosis is a medical emergency that must be treated in a hospital.3

What does my doctor need to know to decrease my risk of lactic acidosis? Tell your doctor if you have an illness that results in severe vomiting, diarrhea, and/or fever, or if your intake of fluids is generally reduced. These situations can lead to severe dehydration, and it may be necessary to stop taking Fortamet temporarily. You should let your doctor know if you are going to have any surgery or specialized x-ray procedures that require injection of contrast agents. Fortamet therapy will need to be stopped temporarily is such instances.3

Can I take Fortamet with other medications? Remind your doctor and/or pharmacist that you are taking Fortamet when any new drug is prescribed or a change is made in how you take a drug already prescribed. Fortamet may interfere with the way some drugs work, and some drugs may interfere with the action of Fortamet.3

What if I become pregnant while taking Fortamet? Tell your doctor if you plan to become pregnant or have become pregnant. As with other oral glucose-control medications, you should not take Fortamet during pregnancy. Usually your doctor will prescribe insulin while you are pregnant.3

How do I take Fortamet? Fortamet tablets should be swallowed whole. Fortamet should not be cut, crushed, or chewed. Fortamet should be taken once daily with food. You will be started on a low dose of Fortamet and your dosage will be increased gradually until your blood sugar is controlled.3

When can I get more information about Fortamet? This section is a summary of the most important information about Fortamet. If you have any questions or problems, you should talk with your doctor or other health care provider about type 2 diabetes, as well as Fortamet and its adverse reactions.3


Glumetzapatient information:
Read this information carefully before you start taking this medicine and each time you refill your prescription. There may be new information. This information does not take the place of your doctor's advice. Ask your doctor or pharmacist if you do not understand some of this information or if you want to know more about this medicine.

What is the most important information I should know about Glumetza?
Warning: Glumetza can cause a rare, but serious condition called lactic acidosis (a buildup of an acid in the blood) that can cause death. Lactic acidosis is a medical emergency and must be treated in the hospital. Stop taking Glumetza and call your doctor right away if you get the following symptoms of lactic acidosis:
you feel very weak or tired.
you have unusual (not normal) muscle pain.
you have trouble breathing.
you have stomach pain with nausea, vomiting, and diarrhea.
you feel cold, especially in your arms and legs.
you feel dizzy or light-headed.
you have a slow or irregular heartbeat.
your medical condition suddenly changes.


You have a higher chance of getting lactic acidosis with Glumetza if you:
have kidney or liver problems.
have CHF that requires treatment with medicines.
drink a lot of alcohol (very often or short-term “binge” drinking).
get dehydrated (lose a large amount of body fluids). This can happen if you are sick with a fever, vomiting, or diarrhea. Dehydration can also happen when you sweat a lot with activity or exercise and don't drink enough fluids.
have certain x-ray test with injectable dye used.
have surgery.
have a heart attack, severe infection, or a stroke.
are 80 years of age and/or older and have not had your kidney function tested.



What is Glumetza? Glumetza is used along with diet and exercise to improve blood sugar control in adults with type 2 diabetes. Glumetza may also be used with another antidiabetes medicine called a sulfonylurea or with insulin to improve blood sugar levels in adults. Glumetza helps control your blood sugar in a number of ways. These include helping your body respond better to the insulin it makes naturally, decreasing the amount of sugar your liver makes, and decreasing the amount of sugar your intestines absorb. Glumetza has not been studied in children younger than 18 years of age.

Who should not take Glumetza? Do not take Glumetza if you:
have kidney problems.
have heart failure that is treated with medicines.
have a condition called metabolic acidosis, including diabetic ketoacidosis. Diabetic ketoacidosis should be treated with insulin.
are allergic to Glumetza or to any of its ingredients. See the end of this patient information section for a list of ingredients in Glumetza.


What should I tell my doctor before taking Glumetza?
Tell your doctor about all of your medical conditions, including if you:
have kidney problems.
have liver problems.
have heart problems.
drink a lot of alcohol.
are pregnant or planning to become pregnant. It is not known if Glumetza can harm your fetus. Talk with your doctor about the best way to control your blood sugar levels while pregnant.
are breast-feeding. It is not known if Glumetza passes into your milk and if it can harm your baby. Talk with your doctor about the best way to feed your baby while talking Glumetza.


Tell your doctor about all the medicines you take, including prescription and nonprescription medicines, vitamins, and herbal supplements. Glumetza and some of your other medicines can interact. You may need to have the dose of Glumetza or certain other medicines adjusted. Certain other medicines can affect your blood sugar control.

Know the medicines you take. Keep a list of them to show your doctor and pharmacist. Talk with your doctor before you start any new medicine.


How should I take Glumetza?
Take Glumetza exactly as prescribed. Your doctor will usually start you on a low dose and increase your dose slowly to control your blood sugar levels. Do not change your dose unless told to do so by your doctor.
Take Glumetza once daily in the evening with food.
Swallow Glumetza tablets whole. Never crush or chew Glumetza tablets. Tell your doctor if you cannot swallow tablets whole. Your doctor will prescribe a different medicine for you.
You may see the Glumetza tablet shell in your stool. You may also see a soft mass of the Glumetza inactive ingredients in your stool. Both of these are normal to see in your stool.
Stay on your exercise and diet program and test your blood sugar regularly while taking Glumetza.
Your doctor should monitor your diabetes and do blood tests on you from time to time to check your kidneys and your liver.
If you miss a dose of Glumetza, resume dosing according to schedule.
If you take too much Glumetza or overdose, call your doctor or poison control center right away.
You may need to stop Glumetza for a short period of time if you:
are sick with severe vomiting, diarrhea, or fever, or if you drink a much lower amount of liquid than normal.
plan to have surgery.
are having an x-ray procedure with an injection or dye.
Call your doctor right away for instructions.

What should I avoid while taking Glumetza? Do not drink a lot of alcoholic drinks while taking Glumetza. This means you should not binge drink for short periods, and you should not drink a lot of alcohol on a regular basis. Alcohol can increase the chance of getting lactic acidosis.

What are the adverse reactions of Glumetza?
Glumetza can cause a rare but serious adverse reaction called lactic acidosis (a buildup of an acid in your blood) that can cause death. See “What is the most important information I should know about Glumetza?”

The most common adverse reactions of Glumetza include diarrhea, nausea, and upset stomach. These adverse reactions usually go away after you take the medicine for a while. Taking your medicine with the evening meal can help reduce these adverse reactions.

Glumetza rarely causes low blood sugar (hypoglycemia) by itself. However, low blood sugar can happen if you drink alcohol, if you take other medicines to lower blood sugar, or if you do not eat enough.

Tell your doctor if you have adverse reactions that bother you, last for more than a few weeks, come back after they have gone away, or start later in therapy. You may need a lower dose or need to stop taking Glumetza.

These are not all adverse reactions with Glumetza. For more information, ask your doctor or pharmacist.


How should I store Glumetza?
Store Glumetza at room temperature, 15° to 30°C (59° to 86°F).
Keep Glumetza and all medicines out of the reach of children.


General information about Glumetza:
Medicines are sometimes prescribed for conditions that are not mentioned in patient information. Do not use Glumetza for a condition for which it was not prescribed. Do not give Glumetza to other people, even if they have the same symptoms you have. It may harm them.

This section summarizes the most important information about Glumetza. If you would like more information, talk with your doctor. You can ask your doctor or pharmacist for information about Glumetza that is written for health care providers.


What are the ingredients in Glumetza?
Active ingredients: 500 or 1,000 mg of metformin.

Inactive ingredient: Each 500 mg tablet contains coloring, hypromellose, magnesium stearate, microcrystalline cellulose, and polyethylene oxide. Each 1,000 mg tablet contains crospovidone, dibutyl sebacate, ethylecellulose, glyceryl behenate, polyvinyl alcohol, polyvinylpyrrolidone, and silicone dioxide. Glumetza 500 and 1,000 mg tablets both utilize advanced polymer-based, oral drug delivery systems, which allow delivery of metformin to the upper GI tract.
  27614
May 4, 2009 9:08 AM
Wow, that's a lot of information rpo! It never said anywhere under the Metformin section anything about going off it. Thanks for the info though!
  129430

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