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Doctors' Answers to "Frequently Asked Questions" - Glucophage

These comments are made for the purpose of discussion and should NOT be used as recommendations for or against therapies or other treatments. An individual patient is always advised to consult their own physician.

[posted 07/1/2000]
Question: My doctor is considering prescribing Glucophage for control of my polycystic ovarian disease, but has never heard of anyone taking both Glucophage and birth control pills at the same time - is this a potential problem? I do not want to get pregnant right now, and I know that Glucophage increases the chance of pregnancy - can I still take the birth control?

Answer: Shouldn't be a problem.

[posted 06/10/2000]
Question: Are there any known problems with taking herbal supplements along with Glucophage (Metformin)? I have been taking Glucophage for the treatment of Polycystic Ovarian Disease for over a year, and still have many symptoms. I recently started taking herbal supplements (like St. Johns Wort, calcium/magnesium/zinc, an herbal PMS formula, etc.) and want to make sure it won't interfere with the Glucophage.

Answer: None that I know of.

[posted 06/7/2000]
Question: Last month I was diagnosed with Polycystic Ovarian Syndrome and put on 500 mg of Glucophage. My question regards how I take my medication. I cannot swallow pills due to discomfort in my throat, so I have been dissolving the pill in a cup of milk in the morning and evenings. Is it okay for me to keep taking my medication this way? Will it affect the way the medicine works in my body? Thank you.

Answer: Don't think it is a problem, but would check with the manufacturer if they have any specific information. Bristol Myers Squibb 800-426-7644

[posted 05/26/2000]
Question: icurrently take glucaphage 500mg 2times per day/ and lipator
20mg 1 time per day..my problem// within 20 to 30 minutes of
eating and taking my glucaphage 50 mg i get very sleepy and have
a realy tough time staying awake. this passes in 10 to 15 minutes. then again
in the late afternoon 5to 5.30 i again get very tired and my
eyes burn and i begin tofall asleep. this again passes in 20 to 30 minutes.
is this a result of my blood sugar level movement, orwhat?
I TRY TO EAT ON A REGULAR BASIS both breakfast and lunch,watching
to limit my carbo intake and drink diet drinks or water only.
i also get muscle pain in my upper left arm (tricep area) a
burning in the muscle for a 30 second time during the day.
could this be a result of the lipator usage for this length
of time.. my average blood sugar is 110 to120. my last blood
test showed my chorlestoral at 132.
thanks in advance to your response to this question

Answer: Probably just the effects of the glucophage and not a low glucose. But, you can do a finger stick glucose concurrently and know for sure. The muscle pain with the HMG CoA Reductase drugs (like lipitor) is usually generalized. A blood test for an enzyme called CPK will give the answer since it is elevated if there is a problem with the lipitor.

[posted 04/12/2000]
Question: The patient info about glucophage says you should stop taking glucophage before surgery or testing with certian types of dyes. Why? What would happen if you didn't stop taking it? What would you do in case of emergency surgery?

Answer: It can have an interaction with IV dye that can cause renal problems and low blood pressure. Surgery is not the problem, dye is. It needs to be stopped at least two days prior to any anticipated dye, some would use 3 days.

[posted 04/16/2000]
Question: Why do all the labels on this medication state that you shouldn't consume any ETOH while taking this drug, besides the obvious that Diabetics should not consume ETOH anyway. What is the serious interaction between the two? Also, should I be taking the Dyazide with the Glucophage? I'm having a lot of side effects from the Glucophage, mainly stomach upset. What is the antidiabetic medication with the least adverse effects? I live in the bush in Alaska, and the physicians here are marginal at best. Any help would be greatly appreciated. Thank you in advance for all your time and assistance in this matter. Sincerely, Mark Campbell

Answer: Alcohol is basically a type of sugar which gives diabetics more trouble with their glucose control. There aren't any serious interactions between glucophage and etanol in moderate levels. There can be liver problems with either alcohol or glucophage(although glucophage is minimal here)other than than no obvious interactions other than raising your blood sugar. As to other drugs, you need to take them and see. Glucophage is generally pretty well tolerated. Try another class of drugs like diabeta.

[posted 11/24/1999]
Question: My doctor prescribed glucophage 500mg to reduce the size of fibroid tumors of the uterous. I am told this is a faily new method, do you have more information on this topic? What are some of the side effect possible from taking this drug? I also have thyroid disease, can the combination of these two conditions combined contribute to weight gain?

Answer: This has been used recently by ob/gyn, I haven't had any experience with this usage. Probably of little risk to try and should be no interaction at all with your thyroid.

[posted 11/15/1999]
Question: I have been diagnosed as having Polycystic Ovaries. What is the difference between Polycystic Ovaries and Polycystic ovary Syndrome? I have been trying to fall pregant for the past five years to no avail. I have gone from 100kilos down to 90 kilos in the past three months because I have been taking Duromine(combined with exercise,no butter and grilling everything). Can I take this drug for more than three Months, safely? I have been told it will no longer work after three months. Is that true? Does it effect menstration? I thought that once I lost weight my periods would become more regular and I would ovulate and maybe fall pregant. If anything it has gotten worse as I missed a period in October. I have never missed a period, only been late. I have had three failed attempts at Ivf and feel that I can't waste any more time as I am getting older. Which comes to my other question on the drug Metformin. I don't have diabeties but have been told this drug could help my hormones with excess hair and weight loss and may lead to pregancy. Is this true? Can I get this drug from a General Practioner? Is there any trials of this drug in IVF clinics in Queensland or New South Wales? How much is this drug? I would appreciate any help you could give myself.

Answer: Some physicians use Metformin in this syndrome with some success, although not an indicated use. A gp can proscribe this as can any licensed physician. The US cost is about 60$ to 80$ depending on the pharmacy and the dosage. Polycystic ovaries are the ovaries, the syndrome referes to the weight, hair, and menstrual problems as well.

[posted 08/25/1999]
Question: I am wondering if it is harmful to take metformin if you are not eating, or are eating minimally. My question is in regards to illness or in situations where one cannot eat regularly - I know you cannot get hypoglycemia - but are there other health concerns?

Answer: Depends on your sugar level. The best way is to monitor it and take the metformin as necessary. Usually 1/2 dosage would be ok. But it is also ok to not take it and take it later in the day-depending on your glucose levels. This should be individually discussed with your doctor.

[posted 10/18/1999]
Question: My Dr. prescribed Glucophage for hypogycemia. All info I find only mentions it being used for diabetics. What is your opinion ?

Answer: Designed to block the release of glucose production by the liver. I guess it could block swings of high glucose going to low-worth a try and not supposed to cause hypoglycaemia itself. Sometimes cutting carbohydrates and adding more protein and fat will fix the problem, worth a try.

[posted 10/19/1999]
Question: In early September '99, I was diagnosed with type II diabetes and my doctor prescribed glucophage 500 mg twice a day. I took the first tablet about 9pm and awoke the next morning feeling like a new man. I had several overall body aches and pains mostly concentrated in my feet and legs and a bit in my lower back. I really wasn't aware of the pain until it went away. I'm a few months away from 40 and had just written it off to being an old fat guy and something that goes with the territory.
After a couple of days (I didn't yet have a glucometer), I started having a return of the pain around 3pm (my times for taking the medicine were 7am and 7pm). On my next doctor visit, I asked my doctor if I could go up to 3 times a day since I assumed the glucophage was wearing off when the pain returned. He approved that and I was fine for about two weeks.
I was beginning to feel a return of pain a couple of hours before my dose was due, but just writing it off again to fatigue. During the second week of October, I was back to hurting just about all the time. Yesterday (10/19/99) around 7pm (4 hours early on the 3 a day schedule), I was hurting so bad I didn't care what happened and I took another glucophage just to see if there really was a connection. Within two hours I was feeling a marked reduction in pain and this morning (I also took my 11pm dose) I was virtually pain free. My 7am dose was taken and I've made it through most of the day without much pain at all. I took my 3pm dose about an hour ago, and still the pain is returning.
I am (presently) convinced that glucophage is "fixing" something, but I don't know what. I'd like some narrowing of areas to suggest to my doctor to explore. I have a hard time describing the pain. It is at once sharp and very localized and also general. It hits in muscle areas (like my calves), the soles of my feet, and sometimes seems also to be an itch in the soles of my feet and palms of my hands. The itch doesn't respond to scratching and seems to be located deep under the skin.
The general pain is in my lower back, and my legs. It feels like I've been standing much too long, but I haven't been standing. Standing for long periods makes it worse, but not a great deal. It seems to intensify with time more than anything else.
My fasting blood sugar at diagnosis was 300. I'm down now to a 14 day average of 128 (provided by my glucometer). My morning blood sugars are about 125 or so, and my blood sugar before meals (lunch/dinner) generally is lower than that down to 105 or so.
I'd be happy to think it's an allergy, and originally thought that was what it was. I limited my diet pretty much to salad during the first week of diagnosis, but that still won't explain the first day of glucophage being pain free since I ate normally up to that point.
I have not yet discussed this with my doctor since I really don't think he'll have an answer. I'd rather not have a huge battery of tests thrown at me. What I'd like is for someone who has heard of this "side-effect" to tell me where to look. I'm not opposed to taking 1000mg 10 times a day if it makes it go away, but realize it's not practical.
Any information you can provide would be greatly appreciated.

Answer: Sorry, haven't a clue, but, I'll post it and maybe get some other information from other patients.

Glucophage [posted 8/4/98]
Question: Are there any studies to confirm or refute the idea that glucophage can increase fatty cell build up in the liver of overweight diabetics? I think I read something about this recently, but can't locate the article.

Answer: I'm not aware of any specific article, but you might contact the scientific department of the company, they are usually happy to locate it for you. Glucophage is made by Bristol-Myers- Squibb: 800-468-7746.

Glucophage [posted 7/21/98]
Question: If my mother has been taking insulin for over 5 years, will she be able to revert back to taking glucophage and eventually cut out the insulin? I heard that once you go on insulin, you can't go back to orals. Is this true?

Answer: There are two types of Diabetics. Type I do not produce Insulin - or in negligible quantities. There patients cannot stop taking insulin without experiencing ketosis. Type II produce insulin, but have some type of resistance to its use. These patients can be treated with insulin or with other agents. Also, losing weight may restore the insulin sensitivity so they don't need medications at all. Checking a c peptide level will establish which she is, this is the cleaved protein made by your body on its "own" insulin, not present on manufactured insulin. If high or normal she can probably be tried on oral agents (like glucophage or others) and do ok.

Glucophage for Diabetics
Question: I am a Type I Insulin dependent diabetic, and my doctor recently prescribed 500 mg twice daily of glucophage. All the info I read on this drug says it is for non-insulin dependent Type II diabetics. I mentioned this to my doctor, and she said that it was okay for me to take it because it will not cause low blood sugar reactions. The insert the pharmacist gave me also said that it should not be taken with certain drugs like beta-blockers and diuretics. I'm on 10 mg of lisinopril daily plus 25 mg of spironolactone. I think the former is a beta-blocker (I'm not sure) and that the other is a diuretic. I also take provostatin for cholesterol. The doctor and pharmacist both know that I'm on these medications, but didn't seem concerned to give me glucophage. As a matter of fact, the pharmacist handed me 6 vials of insulin at the same time he handed me the glucophage with the patient education report. I mentioned the above concerns to my doctor, but she said for me to give it a try as it had worked on others taking insulin. Is this so, and if so, what have been the results? Am I in danger of an adverse reaction of some type? Please provide more info, as I'm concerned after reading the patient education report. The doctor wanted to try this as Iím on a sliding scale insulin regiment which does not seem to be working all that well lately and my weight has increased. It's like my body is resisting the insulin. I've been diabetic for 28 years since age 15.

Answer: When this medication came out, it seemed that combination with insulin would really decrease insulin dosage. It didn't usually help and most physicians have stopped the combination, although there is no contraindication to combine them (or with your other medications). However, Rezulin a new oral medication, is used specifically to increase the sensitivity of insulin and is very effective (nationally and in my patients). So, I'm a little puzzled why he/she would start glucophage instead of Rezulin. However, there is no concern and if it works, it works.

Glucophage and Surgery
Question: I have a question concerning Glucophage and surgery. I am scheduled for a hysterectomy. How many days prior to surgery should Glucophage be discontinued? What should be given for the days prior to surgery to control blood glucose?

Answer: Prior to any IV dye, stop 3 days prior to surgery. Prior to regular surgery with no anticipated dye you could stop the morning of surgery. Other agents or insulin will have to suffice if you stop more than a day prior to surgery.

Question: If a person is going to have some tests run where an injection is required for tests concerning the heart, is it safe to be taking glucophage?

Answer: This drug should not be taken prior to dye injection. Other injections are usually not a problem. This drug should be stopped about 2-3 days prior to dye studies.

Question: My mother has been taking glucophage for the last six months and has experienced bouts with diarrhea. I have heard stories of heart attacks. Is this possible? Is there a normal/safe amount. Her dosage is 850 mg, twice per day.

Answer: Is the diarrhea constant? If it is episodic, I doubt the glucophage is involved. Patients do experience diabetic enteropathy, which is manifested by diarrhea. Clonidine usually fixes this. Heart Attacks are common in diabetics, but glucophage has not been implicated yet. Her dosage is about average.

Glucophage & Alcohol
Question:I am curently taking Glucophage 500 mg. can I have a glass of wine with my meal?

Answer:Glucophage(metformin hydrochloride) is a relatively new oral medication for the treatment of diabetes mellitus. It is a medicine that works primarily by inhibiting the glucose release from the liver-rather than at the cellular level like other oral agents(glyburide, tolinase, etc.). Metformin unlike the sulfonyureas, will not produce hypoglycaemia. It should be used with extreme caution-or not used- in patients with renal or liver dysfunction. Alcohol can potentiate the effect of glucophage so one should watch the finger stick glucose very closely after alcohol. For practical purposes, one drink shouldn't be a big deal if you monitor your glucose.

Glucophage & Porphyries
Question:Glucophage has been known to cause drug-induced porphyries. In what percentage of cases does it do this? Do you know of any cases where vitamin B12 deficiency has increased glucophage's tendency to induce porphyry? What percentage of cases?

Answer:News to me. I'd check with the company for detailed information on this adverse reaction. Bristol-Meyers-Squibb 800-468-7746.
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