Metformin & food

[qimqim]

What are the dangers of taking the pills without food? For instance, if you forgot and take them a couple of hours later?

Also: what is the main difference between the SR (slow release) and the normal pills that you take one after each meal? What I am trying to understand is the spped at which they work. That is, does the normal pill bring down sugar levels immediately after a meal; and are the SR slower at doing that, but better at overall control?

 

[bernie.freeman]

Hi there
I don't understand the technicalities of Metformin, but I do know that the "tummy" side effects are much less if you take Metformin in the middle of a meal.

Bernie

 

[qimqim]

How quickly does metformin SR work, compared to normal one you take with each meal?

Thanks

qim

 

[Trinkwasser]

Metformin is generally a long acting drug, it takes a while for its effects to build up and there shouldn't be much difference from when you take it. Having said which, some people *do* find a fairly immediate effect on the meal they take it with. It has several effects, reducing insulin resistance (long term), reducing liver overractivity (probably medium term) and actually blocking the absorption of carbs (probably the reason why some people have the immediate effect and many get the wind and squits)

 

[Dennis]

Slow release metformin (the SR version) doesn't work any faster or slower than the standard version. SR simply remains active for longer, 12 hours compared with 6 hours for standard metformin, so SR has a greater effect in controlling hepatic glucose production than standard metformin.

 

[Angela09]

Hi, are most doctors ok with prescribing SR Metformin as I suppose it is more expensive? I keep getting an upset stomach and it is getting a bit much. It is unpredictable, so far it hasn't been embarrassing but it easily could be. I have been on Metformin (and other diabetic meds) for about 9 years. My diet is getting very restricted because of this problem. I always take the Metformin after a meal. I am on 6 a day.

 

[cugila]

As one of the previous recent posters stated, take the Metformin whilst eating your meal.
It can help reduce or stop any side effects. I also used to take 6 a day for a very long time. Had no side effects when taken this way.

Ken

 

[qimqim]

How do you take the six daily pills? All at once wth one meal?

qim

 

[cugila]

Hi qim.

No Way !! :shock:

They were taken at three different meal times in accordance with the prescription instructions. Try taking them all at once and you will at the very least be in the Loo for a very long time.
It would also be considered an overdose.

I don't take anything like that amount any more due to tight control.

Ken

 

[croftmanor]

Thank you so much !!!! my wife will be eternally gratefull, i was taking my metformin on an empty stomach about half an hour before a meal, i take 1 850mg twice a day
if taking it with my meal reduces the "wind" factor then that would be wonderfull !!!
it has plagued me for ages and i had tried taking before, after or inbetween but never thought about taking it when i was actually eating my meal, will try that thanks!!!
Andy,

 

[qimqim]

What is the maximum recommended Metformin SR that you can take together safely?

I am on three, and, of course, would not increase without doctor's advice. But I wonder if it is possible to increase dosage safely.

qim

 

[lj1921]

Hi
I was diagnosed last september 2008 and was put on metformin I suffered upset stomach and the squits (and 1 or 2 embarrasing moments) so in 2009 my doctor put me on SR metformin and it has worked brill no more upset stomach and no more squits HBA1C is now down to 6, I take my metformin just after meals 1000mg in morning and 1000mg at night, good luck.

 

[Dennis]

What is the maximum recommended Metformin SR that you can take together safely?

The maximum dose of SR that you can take is the full 2000mg, but there would be little point in doing that. The tablets are designed to remain active for 12 hours, so if you take them in 2 doses, 12 hours apart, then they are helping your BS levels 24 hours a day. If you take them all at once then you will have a big dose for the next 12 hours, but nothing for the 12 hours after that.

On the leaflet that comes with my SR tablets, it says that if you are going to take them as a single dose then take them in the evening.

 

[hanadr]

The standard release Metformin reaches maximum effect in 2.5hours, in the SR the max imum is at 7 hours. Also the beneficial effect of Metformin on cholesterol is only found with the standard release tablets.

 

[qimqim]

Dear Dennis


I should have looked at the instructions that come with the medicine, before I ask the questions. I was surprised to read that Metformin SR works for 12 hours, as my doctor told me originally to take three tablet with dinner, and nothing else. So, I have now read for the first time the instructions that come with Glucophage SR and it says.

Normally, you should take the tablets once a day, with your evening meal.

Does that mean that they are only supposed to work during the night?

qim

 

[Dennis]

Hi qim,

I believe that the thought behind taking them all in the evening was so that they would have the maximum impact in deterring your liver from producing un-needed glucose. And that is true, but it doesn't help to overcome insulin resistance. A common problem with diabetes is that the liver produces 3 times more glucose than it should do, and most of this during the night. This is why you will find so many questions asked on the forum by people with blood sugar levels higher in the morning than when they went to bed. It is a very common problem and one that causes great confusion - after all how can you BS level suddenly go up when all you have been doing is sleeping?

For people for whom night time glucose production by the liver is a particular problem, then they would benefit from taking a higher dose (or the whole dose) in the evening. For people who have more of a problem with insulin resistance, and don't suffer from the "dawn phenomenon", taking them evenly through the day is better. Some doctors will just make an assumption that you probably suffer from night-time glucose production and so will suggest that you take them all at once. And some doctors unfortunately don't have a clue how metformin works and how it can or should be used - they just know it is what they are supposed to prescribe for type 2 diabetes!

 

[qimqim]

So...

If, as you say, Glocuphage SR works over 12 hours, I have a problem: I eat at 7 pm and get up, often, after 7 am. That means that whatever I do my BG is sure to go up during the night...

Should I eat later?

qim

 

[Dennis]

qim,

Your BS levels will only go up significantly during the night if you happen to be one of the diabetics for whom this is a problem. When you test your BS first thing in the morning is it always higher than it was when you went to bed?

 

[qimqim]

Usually, yes, by anything up to1 mmol/l.

Looking at the occasions when I took readings before going to bed, only twice did I get up with the SAME sugar level, and never below.

qim

 

[Dennis]

OK, so you have some overnight glucose production, but not enough to be a major problem as the difference is only 1mmol. For your circumstances my suggestion would be to take 2 of the 3 SR tablets with the evening meal and the third tablet with breakfast.