Metformin (Systemic)

Brand Names : Glucophage, Glucophage XR, Apo-Metformin, Gen-Metformin, Glycon, Novo-Metformin, Nu-Metformin

Proper Use of This Medicine

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 to take 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.

• 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.
• 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 .
• Exercise: Ask your doctor what kind of exercise to do, the best time to do it, and how much you should do each day.
• Fluid (water) replacement: It is important to replace the water or fluid that your body uses. Tell your doctor if you have less urine output than usual or severe diarrhea that lasts for more than 1 day.
• On sick days:
  • 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 .
  • 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.
  • 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.

Dosing - The dose of metformin will be different for different patients. Follow your doctor's orders or the directions on the label . The following information includes only the average doses of metformin. If your dose is different, do not change it unless your doctor tells you to do so.

The number of tablets that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the amount of sugar in your blood or urine .

• For oral dosage form (tablets):
  • For type 2 diabetes:
    • For patients taking metformin tablets
    • Adults:
      • Metformin alone: At first, 500 milligrams (mg) two times a day taken with the morning and evening meals. Or, 850 mg a day taken with the morning meal. Then, your doctor may increase your dose a little at a time every week or every other week if needed. Later, your doctor may want you to take 500 or 850 mg two to three times a day with meals.
      • Metformin with a sulfonylurea: Your doctor will determine the dose of each medicine.
      • Metformin with insulin: At first, 500 mg a day. Then, your doctor may increase your dose by 500 mg every week if needed.
    • Children up to 10 years of age - Use and dose must be determined by your doctor.
    • Children 10 years of age and over - At first, 500 milligrams (mg) with your morning meal and 500 mg with your evening meal. Then, your doctor may increase your dose a little at a time every week if needed.
    • For patients taking metformin extended-release tablets
    • Adults and teenagers:
      • Metformin alone: At first, 500 milligrams (mg) once daily with the evening meal. Then, your doctor may increase your dose a little at a time every week if needed. If you need more medicine, your doctor may tell you to take more than one dose a day.
      • Metformin with a sulfonylurea: Your doctor will determine the dose of each medicine.
      • Metformin with insulin: At first, 500 mg a day. Then, your doctor may increase your dose by 500 mg every week if needed.
    • Children up to 17 years of age - Use and dose must be determined by your doctor.
    
    

Missed dose - If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage - To store this medicine:

• Keep out of the reach of children.
• Store away from heat and direct light.
• Keep the medicine from freezing. Do not refrigerate.
• Do not keep outdated medicine or medicine no longer needed. Be sure that any discarded medicine is out of the reach of children.