20/10/2016 Glucophage,GlucophageXR(metformin)dosing,indications,interactions,adverseeffects,andmore

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metformin(Rx)BrandandOtherNames:Glucophage,
GlucophageXR,Fortamet,Glumetza,Riomet
Classes:Antidiabetics,Biguanides

PatientHandout
PatientEducation
metforminoral
IMPORTANT:HOWTOUSETHISINFORMATION:ThisisasummaryanddoesNOThaveallpossibleinformation
aboutthisproduct.Thisinformationdoesnotassurethatthisproductissafe,effective,orappropriateforyou.This
informationisnotindividualmedicaladviceanddoesnotsubstitutefortheadviceofyourhealthcareprofessional.
Alwaysaskyourhealthcareprofessionalforcompleteinformationaboutthisproductandyourspecifichealthneeds.

METFORMINSOLUTIONORAL

(metFORmin)

COMMONBRANDNAME(S):Riomet

WARNING:Metformincanrarelycauseaserious(sometimesfatal)conditioncalledlacticacidosis.Stoptaking
metforminandgetmedicalhelprightawayifyoudevelopanyofthefollowingsymptomsoflacticacidosis:unusual
tiredness,dizziness,severedrowsiness,chills,blue/coldskin,musclepain,fast/difficultbreathing,slow/irregular
heartbeat,stomachpainwithnausea,vomiting,ordiarrhea.

Lacticacidosisismorelikelytooccurinpatientswhohavecertainmedicalconditions,includingkidneyorliver
disease,recentsurgery,aseriousinfection,conditionsthatmaycausealowlevelofoxygeninthebloodorpoor
circulation(suchascongestiveheartfailure,recentheartattack,recentstroke),heavyalcoholuse,aseverelossof
bodyfluids(dehydration),orXrayorscanningproceduresthatrequireaninjectableiodinatedcontrastdrug.Tell
yourdoctorrightawayifanyoftheseconditionsoccurorifyounoticeabigchangeinyouroverallhealth.Youmay
needtostoptakingthismedicationtemporarily.Theelderlyarealsoathigherrisk,especiallythoseolderthan80
yearswhohavenothadkidneytests.(SeealsoSideEffectsandPrecautionssections.)

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20/10/2016 Glucophage,GlucophageXR(metformin)dosing,indications,interactions,adverseeffects,andmore
USES:
Metforminisusedwithaproperdietandexerciseprogramandpossiblywithothermedicationstocontrolhighblood
sugar.Itisusedinpatientswithtype2diabetes.Controllinghighbloodsugarhelpspreventkidneydamage,
blindness,nerveproblems,lossoflimbs,andsexualfunctionproblems.Propercontrolofdiabetesmayalsolessen
yourriskofaheartattackorstroke.Metforminworksbyhelpingtorestoreyourbody'sproperresponsetotheinsulin
younaturallyproduce.Italsodecreasestheamountofsugarthatyourlivermakesandthatyourstomach/intestines
absorb.

OTHERUSES:
Thissectioncontainsusesofthisdrugthatarenotlistedintheapprovedprofessionallabelingforthedrugbutthat
maybeprescribedbyyourhealthcareprofessional.Usethisdrugforaconditionthatislistedinthissectiononlyifit
hasbeensoprescribedbyyourhealthcareprofessional.

Metforminmaybeusedwithlifestylechangessuchasdietandexercisetopreventdiabetesinpeoplewhoareat
highriskforbecomingdiabetic.Itisalsousedinwomenwithacertaindiseaseoftheovaries(polycysticovarian
syndrome).Metforminmaymakemenstrualcyclesmoreregularandincreasefertility.

HOWTOUSE:
ReadthePatientInformationLeafletifavailablefromyourpharmacistbeforeyoustarttakingmetforminandeach
timeyougetarefill.Ifyouhaveanyquestions,consultyourdoctororpharmacist.

Takethismedicationbymouthasdirectedbyyourdoctor,usually13timesadaywithmeals.Drinkplentyoffluids
whiletakingthismedicationunlessotherwisedirectedbyyourdoctor.

Carefullymeasureyourdosewithaspecialmeasuringdevice/spoon.Donotuseahouseholdspoonbecauseyou
maynotgetthecorrectdose.

Thedosageisbasedonyourmedicalcondition,responsetotreatment,andothermedicationsyoumaybetaking.
Besuretotellyourdoctorandpharmacistaboutalltheproductsyouuse(includingprescriptiondrugs,
nonprescriptiondrugs,andherbalproducts).Toreduceyourriskofsideeffects(suchasupsetstomach),yourdoctor
maydirectyoutostartthismedicationatalowdoseandgraduallyincreaseyourdose.Followyourdoctor's
instructionscarefully.

Takethismedicationregularlyinordertogetthemostbenefitfromit.Remembertouseitatthesametimeseach
day.

Ifyouarealreadytakinganotherantidiabeticdrug(suchaschlorpropamide),followyourdoctor'sdirectionscarefully
forstopping/continuingtheolddrugandstartingmetformin.

Checkyourbloodsugarregularlyasdirectedbyyourdoctor.Keeptrackoftheresults,andsharethemwithyour
doctor.Tellyourdoctorifyourbloodsugarmeasurementsaretoohighortoolow.Yourdosage/treatmentmayneed
tobechanged.

SIDEEFFECTS:
Nausea,vomiting,stomachupset,diarrhea,weakness,orametallictasteinthemouthmayoccur.Ifanyofthese
effectspersistorworsen,tellyourdoctororpharmacistpromptly.Ifstomachsymptomsreturnlater(aftertakingthe
samedoseforseveraldaysorweeks),tellyourdoctorrightaway.Stomachsymptomsthatoccurafterthefirstdays
ofyourtreatmentmaybesignsoflacticacidosis.

Rememberthatyourdoctorhasprescribedthismedicationbecauseheorshehasjudgedthatthebenefittoyouis
greaterthantheriskofsideeffects.Manypeopleusingthismedicationdonothaveserioussideeffects.

Metformindoesnotusuallycauselowbloodsugar(hypoglycemia).Lowbloodsugarmayoccurifthisdrugis
prescribedwithotherantidiabeticmedications.Talkwithyourdoctororpharmacistaboutwhetherthedoseofyour
otherdiabeticmedication(s)needstobelowered.

Symptomsoflowbloodsugarincludesuddensweating,shaking,fastheartbeat,hunger,blurredvision,dizziness,or
tinglinghands/feet.Itisagoodhabittocarryglucosetabletsorgeltotreatlowbloodsugar.Ifyoudon'thavethese
reliableformsofglucose,rapidlyraiseyourbloodsugarbyeatingaquicksourceofsugarsuchastablesugar,
honey,orcandy,ordrinkfruitjuiceornondietsoda.Tellyourdoctoraboutthereactionrightaway.Lowbloodsugar
ismorelikelyifyoudrinklargeamountsofalcohol,dounusuallyheavyexercise,ordonotconsumeenoughcalories
fromfood.Tohelppreventlowbloodsugar,eatmealsonaregularschedule,anddonotskipmeals.Checkwith
yourdoctororpharmacisttofindoutwhatyoushoulddoifyoumissameal.

Symptomsofhighbloodsugar(hyperglycemia)includethirst,increasedurination,confusion,drowsiness,flushing,
rapidbreathing,andfruitybreathodor.Ifthesesymptomsoccur,tellyourdoctorrightaway.Yourdoctormayneed
toadjustyourdiabetesmedication(s).

Stoptakingthismedicationandtellyourdoctorrightawayifthisveryserioussideeffectoccurs:lacticacidosis(see
Warningsection).

Averyseriousallergicreactiontothisdrugisrare.However,getmedicalhelprightawayifyounoticeanyofthe
followingsymptomsofaseriousallergicreaction:rash,itching/swelling(especiallyoftheface/tongue/throat),severe
dizziness,troublebreathing.

Thisisnotacompletelistofpossiblesideeffects.Ifyounoticeothereffectsnotlistedabove,contactyourdoctoror
pharmacist.

IntheUS

Callyourdoctorformedicaladviceaboutsideeffects.YoumayreportsideeffectstoFDAat1800FDA1088orat
www.fda.gov/medwatch.

InCanadaCallyourdoctorformedicaladviceaboutsideeffects.YoumayreportsideeffectstoHealthCanadaat
18662342345.

PRECAUTIONS:
SeealsoWarningsection.

Beforetakingthismedication,tellyourdoctororpharmacistifyouareallergictometforminorifyouhaveanyother
allergies.Thisproductmaycontaininactiveingredients,whichcancauseallergicreactionsorotherproblems.Talk
toyourpharmacistformoredetails.

Beforeusingthismedication,tellyourdoctororpharmacistyourmedicalhistory,especiallyof:severebreathing
problems(suchasobstructivelungdisease,severeasthma),bloodproblems(suchasanemia,vitaminB12
deficiency),kidneydisease,liverdisease.

BeforehavingsurgeryoranyXray/scanningprocedureusinginjectableiodinatedcontrastmaterial,tellyourdoctor
thatyouaretakingthismedication.Youwillneedtotemporarilystopthismedicationbeforethetimeofyour

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20/10/2016 Glucophage,GlucophageXR(metformin)dosing,indications,interactions,adverseeffects,andmore
surgery/procedure.Consultyourdoctorforfurtherinstructions.

Beforehavingsurgery,tellyourdoctorordentistaboutalltheproductsyouuse(includingprescriptiondrugs,
nonprescriptiondrugs,andherbalproducts).

Youmayexperienceblurredvision,dizziness,ordrowsinessduetoextremelyloworhighbloodsugarlevels.Donot
drive,usemachinery,ordoanyactivitythatrequiresalertnessorclearvisionuntilyouaresureyoucanperform
suchactivitiessafely.

Limitalcoholwhileusingthismedicationbecauseitcanincreaseyourriskoflacticacidosisanddevelopinglow
bloodsugar.

Highfever,"waterpills"(diureticssuchashydrochlorothiazide),toomuchsweating,diarrhea,orvomitingmaycause
lossoftoomuchbodywater(dehydration)andincreaseyourriskoflacticacidosis.Stoptakingthismedicationand
tellyourdoctorrightawayifyouhaveprolongeddiarrheaorvomiting.Besuretodrinkenoughfluidstoprevent
dehydrationunlessyourdoctordirectsyouotherwise.

Itmaybehardertocontrolyourbloodsugarwhenyourbodyisstressed(suchasduetofever,infection,injury,or
surgery).Consultyourdoctorbecauseincreasedstressmayrequireachangeinyourtreatmentplan,medications,or
bloodsugartesting.

Olderadultsmaybeatgreaterriskforsideeffectssuchaslowbloodsugarorlacticacidosis.

Duringpregnancy,thismedicationshouldbeusedonlywhenclearlyneeded.Discusstherisksandbenefitswith
yourdoctor.Yourdoctormaydirectyoutouseinsulininsteadofthisproductduringyourpregnancy.Followyour
doctor'sinstructionscarefully.

Metformincancausechangesinthemenstrualcycle(promoteovulation)andincreasetheriskofbecoming
pregnant.Consultyourdoctororpharmacistabouttheuseofreliablebirthcontrolwhileusingthismedication.

Metforminpassesintobreastmilkinsmallamounts.Consultyourdoctorbeforebreastfeeding.

DRUGINTERACTIONS:
Druginteractionsmaychangehowyourmedicationsworkorincreaseyourriskforserioussideeffects.This
documentdoesnotcontainallpossibledruginteractions.Keepalistofalltheproductsyouuse(including
prescription/nonprescriptiondrugsandherbalproducts)andshareitwithyourdoctorandpharmacist.Donotstart,
stop,orchangethedosageofanymedicineswithoutyourdoctor'sapproval.

Betablockermedications(suchasmetoprolol,propranolol,glaucomaeyedropssuchastimolol)maypreventthe
fast/poundingheartbeatyouwouldusuallyfeelwhenyourbloodsugarlevelfallstoolow(hypoglycemia).Other
symptomsoflowbloodsugar,suchasdizziness,hunger,orsweating,areunaffectedbythesedrugs.

Manydrugscanaffectyourbloodsugarlevels,makingitmoredifficulttocontrolyourbloodsugar.Beforeyoustart,
stop,orchangeanymedication,talkwithyourdoctororpharmacistabouthowthemedicationmayaffectyourblood
sugar.Checkyourbloodsugarlevelsregularlyasdirectedbyyourdoctor.Tellyourdoctorabouttheresultsandof
anysymptomsofhighorlowbloodsugar.(SeealsoSideEffectssection.)Yourdoctormayneedtoadjustyouranti
diabeticmedication,exerciseprogram,ordiet.

OVERDOSE:
Ifoverdoseissuspected,contactapoisoncontrolcenteroremergencyroomrightaway.USresidentscancalltheir
localpoisoncontrolcenterat18002221222.Canadaresidentscancallaprovincialpoisoncontrolcenter.
Overdosecancauselacticacidosis.Symptomsofoverdosemayinclude:severedrowsiness,severe
nausea/vomiting/diarrhea,rapidbreathing,slow/irregularheartbeat.

NOTES:
Donotsharethismedicationwithothers.

Youshouldattendadiabeteseducationprogramtolearnmoreaboutdiabetesandalltheimportantaspectsofits
treatment,includingmeals/diet,exercise,personalhygiene,medications,andgettingregulareye/foot/medical
exams.

Keepallmedicalappointments.Laboratoryand/ormedicaltests(suchasliver/kidneyfunctiontests,bloodglucose,
hemoglobinA1c,completebloodcounts)shouldbeperformedperiodicallytocheckforsideeffectsandmonitoryour
responsetotreatment.Checkyourbloodsugarlevelsregularlyasdirected.

MISSEDDOSE:
Ifyoumissadose,takeitassoonasyouremember.Ifitisnearthetimeofthenextdose,skipthemisseddose
andresumeyourusualdosingschedule.Donotdoublethedosetocatchup.

STORAGE:
Storeatroomtemperatureawayfromlightandmoisture.Donotstoreinthebathroom.Keepallmedicationsaway
fromchildrenandpets.

Donotflushmedicationsdownthetoiletorpourthemintoadrainunlessinstructedtodoso.Properlydiscardthis
productwhenitisexpiredornolongerneeded.Consultyourpharmacistorlocalwastedisposalcompanyformore
detailsabouthowtosafelydiscardyourproduct.

MEDICALALERT:Yourconditioncancausecomplicationsinamedicalemergency.Forinformationaboutenrolling
inMedicAlert,call18886334298(US)or18006681507(Canada).

InformationlastrevisedOctober2015.Copyright(c)2015FirstDatabank,Inc.

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