GLUCOPHAGE
Metformin Hydrochloride
oral antidiabetic
Patient Information for GLUCOPHAGE
Why is this drug prescribed?
Most important fact about this drug
How
should you take this medication?
What if you
miss a dose?
How do I store Glucophage
What side effects may occur?
Other
common side effects may include:
Glucophage and
hypoglycemia (low blood sugar)
Glucophage and
lactic acidosis
Why should this drug not be
prescribed?
Special warnings about this medication
Possible food and drug interactions when taking this medication
Special information if you are pregnant or breastfeeding
Recommended dosage
ADULTS
CHILDREN
OLDER ADULTS
Overdosage
Why is this drug prescribed?
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.
Standard Glucophage tablets are taken two or three times daily. An
extended-release form (Glucophage XR) is available for once-daily
dosing.
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Most important fact about this drug
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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How should you take this medication?
Do not take more or less of this medication 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.
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What if you miss a dose?
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.
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How do I store Glucophage
Store it at room temperature.
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What side effects may occur?
Side effects 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.
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Other common side effects may include:
- Abdominal discomfort
- diarrhea
- gas
- headache
- indigestion
- nausea
- vomiting
- weakness
Less common side effects 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
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Glucophage and hypoglycemia (low blood sugar)
Glucophage, unlike other oral antidiabetics, does not usually cause
hypoglycemia (low blood sugar). However, hypoglycemia remains a possibility,
especially in older, weak, and undernourished people and those with
kidney, liver, adrenal, or pituitary gland problems. The risk of hypoglycemia
increases when Glucophage is combined with other diabetes medications.
The risk is also boosted by missed meals, alcohol, and excessive exercise.
To avoid hypoglycemia, you should closely follow the dietary and exercise
plan suggested by your physician. If you feel hypoglycemia coming
on, get some fast-acting sugar, such as a 4 to 6 ounce glass of fruit
juice.
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Glucophage and lactic acidosis
Glucophage can cause a serious side effect called lactic acidosis,
a buildup of lactic acid in the blood. This 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. Although the condition is rare, it
can be fatal. Lactic acidosis is a medical emergency that must be
treated in a hospital.
Symptoms of lactic acidosis may include:
- Feeling very weak
- tired or uncomfortable
- feeling cold
- dizzy or light-headed
- increasing sleepiness
- muscle pain
- slow or irregular heartbeat
- trouble breathing
- unexpected or unusual stomach discomfort
If you notice these symptoms, stop taking Glucophage and call your
doctor right away.
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Why should this drug not be prescribed?
Avoid Glucophage if it has ever given you an allergic reaction.
If you have congestive heart failure, do not take Glucophage. This
condition increases your risk of developing lactic acidosis.
Do not take Glucophage if you are suffering from acute or chronic
metabolic acidosis, including 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).
You should not take Glucophage for 2 days before and after having
an X-ray procedure with an injectable contrast agent (radioactive
iodine). 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 go back to
therapy with Glucophage.
If you have kidney or liver disease or develop serious conditions
such as a heart attack, severe infection, or a stroke, do not take
Glucophage.
You should not take Glucophage if you are seriously dehydrated, having
lost a large amount of fluid from severe vomiting, diarrhea, or high
fever.
If you lose control of your blood sugar due to the stress of a fever,
injury, infection, or surgery, your doctor may temporarily take you
off of Glucophage and ask you to take insulin instead.
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Special warnings about this medication
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 this medication. 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.
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.
It's possible that drugs such as Glucophage
may lead to more heart problems than diet treatment alone, or diet
plus insulin. If you have a heart condition, you may want to discuss
this with your doctor. The effectiveness of any oral antidiabetic,
including Glucophage, may decrease with time. This may be due to either
a diminished responsiveness to the medication or a worsening of the
diabetes.
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Possible food and drug interactions when
taking this medication
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)
- Isoniazid (Rifamate), a drug used for tuberculosis
- Major tranquilizers such as Thorazine
- Morphine
- Niacin (Niaspan)
- Oral contraceptives
- Phenytoin (Dilantin)
- Procainamide (Procanbid, Pronestyl)
- Quinidine (Quinidex)
- Quinine
- Ranitidine (Zantac)
- Steroids such as prednisone (Deltasone)
- Thyroid hormones (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 this
drug.
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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.
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Recommended dosage
If you forget to take Actonel, do not double your next dose. Do not
take 2 tablets on the same day. Simply take Actonel as you normally
would for your next dose.
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ADULTS
Glucophage
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.
Glucophage XR
The usual starting dose is one 500-milligram tablet once daily with
the evening meal. Your doctor may increase your dose by 500 milligrams
at weekly intervals, up to a maximum dosage of 2,000 milligrams a
day. If a single 2,000-milligram dose fails to control your blood
sugar, you may be asked to take 1,000-milligram doses twice a day.
If you need more than 2,000 milligrams a day, the doctor will switch
you to regular Glucophage.
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CHILDREN
Glucophage
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.
Glucophage XR
This form of the drug has not been tested in children younger than
17.
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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.
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Overdosage
An overdose of Glucophage can cause lactic acidosis. (See "What Side
Effects May Occur?") If you suspect a Glucophage overdose, seek emergency
treatment immediately.
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