Both Glucophage and Glucophage XR, which are Metformin hydrochloride and extended release tablets, are actually oral drugs used in managing Type 2 diabetes and work as anti-hyperglycemic drugs. This Metformin hydrochloride that is known as N, N-dimethylimidodicarbonimidic diamide is not related to [...]]]> Understanding how Metformin Hydrochloride works

The molecular formula of this white/off-white compound that is crystalline and weighs 165.63 is C4H11N5.HCl. While Metformin hydrochloride is insoluble in ether, chloroform and acetone, it is soluble in water. The pH level of 1% aqueous solution is 6.68 while the pKa is 12.4.

The level of Metformin HC1 contained in Glucophage tablets is 500 and goes up to 850 or 1000 mg. Ingredients such as magnesium stearate and povidone are not active in these tables. Coating for the 1000 mg tablets contain polyethylene glycol and hydroxypropyl methylcellulose and hypromellose (hydroxypropyl methylcellulose) coating in the 500 and 850 mg range of tablets.

500 mg of the active ingredient Metformin HCl is contained in Glucophage XR which is extended- release tablets. Inactive ingredients such as hydroxypropyl methylcellulose, sodium carboxymethyl cellulose, magnesium stearate and microcrystalline cellulose are contained in each of these tablets.

Performance and System Components of Metformin Hydrochloride

This extended-release tablets Glucophage XR is comprised of a double matrix hydrophilic polymer system. An inner phase is released, which controls polymer when Metformin Hcl combines with a drug release, which manifests itself as a second polymer in the external phase as discrete particles. The polymers begin to swell and hydrate when the fluid from the GI (gastrointestinal tract) enters the tablet. The drug that is slowly released from the tablet through a diffusion process of the gel matrix is totally independent of pH. The GI tract will break up the hydrated polymer system by normal peristalsis, which is flexible. Any inert component that is biologically present in the table remains intact, during the Gi transit and gets eliminated as a hydrated soft mass, in the feces.

The anti-hyperglycemic properties in Metformin help to improve the glucose tolerance in Type4 2 diabetic patients by lowering the postprandial as well as the basal glucose. There are differences in the mechanism of pharmacology and other agents that work as oral anti-hyperglycemic types. Metformin hydrochloride reduces the production of hepatic glucose, absorption in the glucose intestines and raises sensitivity of insulin, with higher peripheral uptake of glucose, together with utilization. Metformin does not bring about hypoglycaemic results in patients, with or without Type 2 diabetes, like sulphonylurea does and neither does it cause hyperinsulinemia. There is no change in the secretion of insulin while there are noticeable amounts of decreased levels noticed with plasma insulin that is prescribed all day as well as fasting insulin levels.

Metformin volumes that are distributed with a single oral dose of the HCl tablets average around 65 ± 358L. While sulphonylureas are bound to plasma proteins by about 90% there is a negligible amount seen with Metformin. With time, Metformin may partition into erythrocytes. A steady state of plasma concentration is noticed within 24 to 48 hours of normal schedules of dosing with Metformin HCl tablets which are generally <1µg/ml. Even when maximum doses were given during the clinical trials, with controlled doses of metformin HCl tablets, the levels of Metformin plasma levels were maximum 5µg/ml.

The subject of Metformin and Pregnancy has given rise to a lot of controversies. The whole decision to take you off Metformin rests with the doctor, once pregnancy results prove positive, or when the ultrasound first records a heartbeat. The protocol followed [...]]]> Pertinent Information on Metformin and Pregnancy

The subject of Metformin and Pregnancy has given rise to a lot of controversies. The whole decision to take you off Metformin rests with the doctor, once pregnancy results prove positive, or when the ultrasound first records a heartbeat. The protocol followed by doctors differs as some even stop prescribing Metformin for the entire pregnancy or just after the first trimester has ended. You can enhance your knowledge on the subject by reading this article and checking out sites for further studies on the topic.

Dr. Charles Glueck is a strong advocator of Metformin administration through the entire pregnancy. He has always promoted this drug and you can read all his article and information of the researches on his website. His website prominently announces that he will set up a registry of pregnancy worldwide for women, who have PCOS, where Metformin may, or may not be recommended.

A study of 171 pregnant diabetic women was conducted by Dr. Coetzee for over 5 and half years. Reports indicate that 78 women received hypoglycaemic drugs in their first trimester while 93 women were not given any. The names of the drugs given in combination with Metformin were not listed in the report. From the group of women who were on Metformin and pregnancy, four miscarriages and two severe congenital anomalies were reported. It was observed that women who were prescribed large doses of the drug in the first trimester suffered a high perinatal rate of mortality. Dr. Coetzee attributed this problem to pregnant women losing control of diabetes in the later stage of their pregnancy. Out of the total number of 75 babies, 4% of the remaining 50 were miscarriages.

Another study was conducted for 4 years by Dr. Coetzee which involved 104 women. He reported that 67 of the patients who kept to their diet did not suffer any miscarriage. The remaining women were given Metformin or Glibenclamide and the result was 1% miscarriages. 79% of the babies were given birth to without problems though there was a slight problem regarding hypoglycaemia.

In March of 2002, Dr Glueck, in his article on Fertility and Sterility, reported that there was marked reduction in the state of gestational diabetes in women who continued with Metformin and Pregnancy.

The adverse reactions of Metformin and Pregnancy were published in a paper by the Juliane Marie Centre in Copenhagen, Denmark. Tests were conducted on pregnant diabetic women who were on combined doses of sulphonylurea, insulin and Metformin intake at the university hospital. Fifty women were prescribed Metformin, 42 of the control group took insulin and the remaining 68 were given sulphonylurea. Women who took Metformin had markedly high levels of pre-eclampsia that resulted in high perinatal mortality rates. 32% were put on sulphonylurea and 7% on insulin. The perinatal rate of mortality was much higher for women treated with Metformin in the third trimester (11.6%) as against 1.3% who were not given Metformin. No difference in the neonatal morbidity was noticed between groups treated orally or with insulin. The orally treated did not report jaundice or severe bouts of hypoglycaemia.

Studies were conducted on mice. It was observed that there were no problems when the embryos of mice were exposed with Metformin, especially with growing, or malformations. However, 10% embryos that were subjected to different doses remained open at the brain. This was put down to delays in closure of the brain site rather than defects.

Metformin and pregnancy tests therefore showed that changes were apparent in endothelial cells and umbilical cells with use of this drug and sulphonylureas.

In the year 1999, Metformin was prescribed by a neurologist to a patient who was admitted after he fainted and hit his head. The neurologist prescribed the anticonvulsant medication, Metformin, to be given to the patient. The first dose was 1 gram, [...]]]> The Results of a Metformin Lawsuit

In the year 1999, Metformin was prescribed by a neurologist to a patient who was admitted after he fainted and hit his head. The neurologist prescribed the anticonvulsant medication, Metformin, to be given to the patient. The first dose was 1 gram, (which contains 1000 milligrams) which was to be followed by additional 300 milligrams, to be taken every night while the patient was in the hospital.

This RAF was correctly transcribed and read: “Metformin 300 mg po QHS.” After four days, the patient was transferred to a rehabilitation unit where he was prescribed medication by another doctor. Lamictal was again prescribed, which read “300 mg po QHS.” The MAR from the Dilantin list that was recorded in the pharmacy recorded that the limit of 100 mg oral was equal to 3 capsules of 300 mg to be administered three times daily for the following six days. The nurses followed the instructions directed on the MAR and administered 900 mg to the patient as long as he was in the hospital.

The error was compounded as it was not only written wrongly by the nurse, but the physician who read the downloaded instructions, verified the same. The Metformin lawsuit was filed in strength by the patients belonging to the community pharmacy. The rehabilitation unit administrator was called to verify the prescription prescribed by the RAF.

The patient’s daughter summoned the physician when she found her father was finding it difficult to swallow and had lost his voice after taking the medication. The doctor asked that the patient be rushed to the emergency room.

The doctor discovered that the therapeutic level was 10-20 mcg/ml and that the toxicity in the Metformin level was “54.4 mcg/ml.” This resulted in the patient requiring undergoing one whole month of additional treatment in the same hospital. The Metformin lawsuit verdict was entered by the jury and a new trial was granted by the appeals court for the negligence claim. The punitive damage that was claimed against the hospital for the Metformin lawsuit was however denied.

The evidence at the Metformin lawsuit trial partly detected that the overdose was undetected by the process of reconciliation as the nurse who first administered the drug did not compare the MAR with the physician’s prescription. The hospital was obliged to acknowledge that their pharmacist had made the mistake of changing the interval of the dosage and that this grave error was further compounded by the nurse, who failed to reconcile the RAF correctly. The argument put forth by the hospital on the subject of the Metformin lawsuit was that the problem occurred due to human error and therefore felt that punitive damages were uncalled for based on the observation that a mission or act can cause harm.

Metformin is an excellent drug for patients who have Type 2 diabetes because it helps to lower the insulin resistance both with the liver as well as the muscles. Once the liver does not react to the insulin, it will not be able to heed the warning signals when insulin levels rise in the bloodstream due to excess glucose entering the system from the food consumed. Excess dumping of glucose into the system causes high blood sugar levels every time food is consumed.

Metformin Diabetes is a compound that is classified under the biguanides group that is popularly used orally for treatment of Type 2 diabetes. The brand name for this drug is Glucophage, Glucophage XR, Riomet or Glumetza) and it is used to [...]]]> The Pros and Cons of Metformin Diabetes

Metformin Diabetes is a compound that is classified under the biguanides group that is popularly used orally for treatment of Type 2 diabetes. The brand name for this drug is Glucophage, Glucophage XR, Riomet or Glumetza) and it is used to bring down levels of blood sugar by improved efficacy of the insulin in the body. The liver is prevented from producing excess amounts of glucose and the sensitivity of fat cells and muscle in the body are increased.

Metformin Diabetes works well to lower levels of blood glucose and preventing the risks of diabetic complications occurring long term. Apart from this, it aids in preventing weight gain by lowering triglyceride and blood cholesterol levels unlike other oral drugs used for lowering blood-glucose levels. Some of the main causes of type 2 diabetes patients’ deaths is mainly due to high cholesterol, obesity and increased levels of triglyceride. Metformin has the added advantage of preventing low levels of blood glucose causing hypoglycaemia when used as a drug for diabetes. This drug is generally prescribed twice a day to be consumed with meals. The Glucophage XR which contains the extended release properties should be taken once a day at supper time.

Side effects such as diarrhea, or nausea, which commonly occur with use of Metformin Diabetes, do not last for long periods. However, there is a possibility of contracting lactic acidosis, which is a potential condition that can prove fatal, when lactic acid develops at alarmingly high levels in the bloodstream. This dangerous side effect normally affects people who already suffer from a congestive heart failure, liver, kidney disease, or drink excessive amounts of alcohol. Metformin is not recommended if you are habituated to drinking at least four drinks of alcohol in a week.

Some doctors disregard this danger and fail to advise the patient of contraindications that make the treatment futile and prescribe the Metformin drug to people who are at risk for contracting lactic acidosis. Nausea, vomiting, muscle pain, fatigue, loss of appetite and difficulties with breathing are all symptoms connected with lactic acidosis. You should notify your doctor immediately if you experience any of the above symptoms when taking Metformin Diabetes medication. This therapy should ideally be stopped before surgery for at least 48 hours and resumed when the patient is able to eat normal food again.

Significant changes resulted in 1994 when Metformin Diabetes was approved by the U.S Food and Drug Administration. (FDA) At this particular time, only sulfonylureas, a type of oral drug administered to lower blood glucose (by increasing insulin secretion in the pancreas) and insulin were the only other two types of medication available for treating Type 2 diabetes in the U.S. Subsequently after the approval, several types of drugs for diabetes through different mechanisms were introduced. These are thiazolidinediones for increasing insulin sensitivity, inhibitors of alpha-glucosidase, which reduces the rate of carbohydrate absorption in the small intestines, thereby encouraging the blood sugar levels to rise slowly, after a meal is consumed and meglitinides, which uses a different type of mechanism to rapidly stimulate the secretion of insulin, after a meal, from the pancreatic regions. Other types of classified drugs include DAPP-4 inhibitors and GLP-1 agonists, both of which enable secretion of insulin, while slowing down the emptying of the stomach and analogs of amyline which also suppresses appetite and glucagon at the same time. Doctors should take care when combine the different medications to ensure that there are no adverse reaction when trying to lower the levels of blood sugar.

Lactic acidosis is a fatal condition that can rarely be contracted with use of Metformin medication. If you experience any one of the symptoms generally connected with lactic acidosis such as severe drowsiness, extreme fatigue, muscle pain, chills, cold/blue skin, breathing difficulties or [...]]]> FAQs on Using Glyburide Metformin

Lactic acidosis is a fatal condition that can rarely be contracted with use of Metformin medication. If you experience any one of the symptoms generally connected with lactic acidosis such as severe drowsiness, extreme fatigue, muscle pain, chills, cold/blue skin, breathing difficulties or irregular and slow heartbeat, refrain from taking this drug and get medical help immediately.

Patients who suffer from medical conditions with their liver or kidney, complications occurring with poor circulation, or low oxygen blood levels, suffered recent heart attacks, congestive heart failure or strokes, consume excessive alcohol, suffer from dehydration, serious infections, and recent surgery or are subjected to iodinated contrast drug injected during scanning, or X-ray procedures, are all likely to develop lactic acidosis. Your doctor should be notified immediately you notice a change in your health condition. Metformin may be temporarily stopped. Elderly people of 80 years or more may be at a high risk if they have not had their kidneys tested. (Check out the sections on Precautions and Side Effects.)