What Glucophage Is
Glucophage is an oral medication against type 2 diabetes. Its active substance called metformin balances the blood sugar levels and helps to avoid or slow down the dangerous effects of diabetes on the body. Glucophage is normally prescribed as a part of complex treatment that combines exercise, diet, and medications to maintain healthy blood sugar levels. Glucophage is usually recommended for patients diagnosed with type 2 diabetes mellitus. Sometimes the drug is prescribed in a combination with other remedies including insulin. However, note that Glucophage does not treat type 1 diabetes.
Recommendations for Use, Dosage, and Overdose
Glucophage dosage depends on the age of the patient, severity of condition, other health issues, and current therapies. On average, 500 mg daily dose, taken either once or divided into two times a day, is enough to ensure normal blood sugar. The maintenance dose equals to 2,000 mg a day used in divided doses. The maximum daily dose should not exceed 2,550 mg. Your doctor may also advise you to take vitamin B12 while you are taking Glucophage.
Take the drug exactly as prescribed by your doctor. Follow all the directions on your prescription, label, and instruction sheets. Depending on your response, your doctor may occasionally adjust your dose. Use the drug exactly as instructed.
Take Glucophage with food, unless your doctor says otherwise. If Glucophage was prescribed with an interval once a day, it is normally taken with the evening meal. Follow your doctor’s directions.
Since Glucophage is an extended-release medication, do not crush, chew, or break the pills. Swallow the pill whole.
Glucophage pill has a coating that is not fully absorbed or digested in the body. You may find fragments of this coating in your stool. This is normal and does not influence the effectiveness of the drug.
Sometimes misuse or wrong dosage of Glucophage may cause blood sugar to drop too low and create hypoglycemia. Its symptoms are hunger, dizziness, irritability, confusion, anxiety, or shaky feeling. To restore proper sugar levels, eat or drink something that contains quickly-released sugar (juice, crackers, hard candy, dried fruits, or soda). In case you experience severe hypoglycemia, your doctor can prescribe a glucagon injection kit. Make sure you, your family, and friends know how to give you this shot in case of an emergency.
Blood sugar levels can also be affected by illness, stress, surgery, excessive exercise or lack of it, alcohol, or skipping meals. Tell your doctor about any contributing factors before changing your therapy schedule or dose.
Glucophage is only a part of comprehensive treatment that also includes exercise, diet, regular blood sugar testing, weight control, etc. Follow your doctor’s directions very carefully.
If you accidentally forget to take the medicine on time, take it as soon as you remember. However, if it is almost time for your next dose, skip the missed one. Do not take two doses at a time to compensate the missed one.
Keep in mind that overdose can lead to lactic acidosis or severe hypoglycemia. If you suspect an overdose, get urgent medical help.
Precautions and Contraindications
Glucophage cannot be used by patients allergic to metformin or those who have severe kidney condition, metabolic acidosis or diabetic ketoacidosis.
If you need a surgery, an X-ray or a CT scan with a contrast agent, you may have to temporarily discontinue Glucophage. Make sure your healthcare providers know in advance that you are taking this medication.
To ensure that the treatment with Glucophage is safe for you, tell your doctor if you have had any of the following in your medical history:
- Kidney disease (you might need to run a few tests on your kidney function before proceeding to Glucophage therapy);
- High ketones in your blood or urine;
- Heart condition, congestive heart failure;
- Liver disease;
- If you are using insulin or other anti-diabetic medication.
Sometimes diabetic patients may develop lactic acidosis which is a dangerous build-up of lactic acid in your blood. In this regard, patients with other medical conditions, chronic alcoholism, severe infection, or older than 65 are particularly vulnerable. Ask your doctor if you are at risk.
Follow your doctor’s orders about Glucophage treatment particularly carefully if you are or have become pregnant. Controlling blood sugar is highly important during pregnancy as high blood sugar levels may cause complications for both the mother and the baby. If you become pregnant while using Glucophage, tell your doctor right away.
Metformin may stimulate ovulation in premenopausal women and increase the risk of unwanted pregnancy. Consult your doctor about your risk and applicable methods of birth control.
Glucophage passes into breast milk and may cause harm to the baby. Therefore, breastfeeding is not advised while on this drug.
Glucophage cannot be used for children under 10. Glucophage XR is meant for adult patients only (older than 18).
Interactions with Other Drugs and Substances
Certain drug interactions may change the effectiveness of the medications or increase the chances of serious side effects. Tell your doctor about all the products that you are using (both prescription and over-the-counter medications, vitamins, herbal products). Do not start, discontinue or change the dose of any drugs on your own without your doctor’s approval.
Beta-blockers (such as propranolol, metoprolol, glaucoma eye drops such as timolol) may help to avoid the fast pounding heartbeat that sometimes happens when your blood sugar drops too low (hypoglycemia). However, they will not help with other symptoms of hypoglycemia, such as hunger, dizziness, or sweating. Remember to eat something as soon as possible if you feel hypoglycemic.
Many drugs (especially those that contain sugar or artificial sweeteners) can affect your blood sugar. Before you make any changes to your medications or go on any new treatment, ask your doctor about how the medication can affect your problem. It is strongly advised for diabetic patients to check their blood sugar levels regularly. Tell your doctor at once if you feel the symptoms of either high or low blood sugar. They may have to adjust your treatment, diet, or exercise program.
Common Glucophage side effects include nausea, upset stomach, vomiting, diarrhea, fatigue, and a metallic taste in the mouth. They normally pass as your body adjusts to metformin. However, if any of these effects persist or get worse, tell your doctor right away. Keep in mind that stomach symptoms occurring after a few days of your treatment may indicate lactic acidosis. Another thing to remember is that you should not be discouraged from treatment if you experience any side effects. Your doctor has prescribed Glucophage because he/she thinks that the benefit from treatment for you is greater than the risk of side effects. A lot of people taking this medication do not experience severe side effects.
Metformin does not normally cause low blood sugar (hypoglycemia). But it may occur due to other factors (like exhaustion or skipping meals) or if the drug is taken with other diabetes medications. The symptoms of hypoglycemia include shaking, sudden sweating, fast heartbeat, hunger, dizziness, blurred vision, and tingling sensations in your hands and feet. It is recommended to always have glucose tablets, gel or a quick-release source of sugar such as honey, candy, table sugar, fruit juice or non-diet soda with you. The risk of hypoglycemia is increased with alcohol consumption, intense exercise, or low-calorie diet. To prevent low blood sugar, create and adhere to a regular eating schedule. If you still get hypoglycemic often and suspect that the medication can be the cause, talk to your doctor about lowering the dose or changing the drug.
In the opposite case, if the dose you are taking is too low and not enough to reduce blood sugar, the symptoms of hyperglycemia (high blood sugar) may occur. These include increased urination, thirst, confusion, flushing, drowsiness, rapid breathing, and fruity breath odor. If you experience these symptoms, talk to your doctor about making the necessary adjustments to your treatment or increasing the dose.
In rare cases metformin can build up in your body and lead to a serious (sometimes lethal) condition called lactic acidosis. It is more likely to occur in vulnerable patients from risk groups: older patients, with a severe kidney or liver condition, heart failure, dehydration, alcoholism. Lactic acidosis may also occur due to certain drug interactions, surgery, an X-ray or a CT scan with iodinated contrast. If you are to have these procedures, you may have to discontinue Glucophage treatment for a while. If you experience the symptoms of lactic acidosis, such as dizziness, severe sleepiness, unusual tiredness, chills, muscle pain, blue or cold skin, short and obstructed breathing, slow or irregular heartbeat, stomach pain with diarrhea/nausea/vomiting, stop taking the medication at once and get emergency medical help.
A serious allergic reaction to Glucophage is rare. However, if you notice any of the following symptoms, such as rash, severe dizziness, itching or swelling (especially in the face/throat/tongue), shortness of breath, get medical help right away.
Keep in Mind
Provide your doctor with full information about your medical history, any currently taken drugs, or any special circumstances such as allergies, breastfeeding, pregnancy, etc.
Do not share your medications with other people, even if their symptoms are similar to yours. Keep the pills away from children and store them in a dry and ventilated place.
Inform your doctor about any bodily response you experience. If you have any strong side effects, call your doctor immediately.