Glucophage sr dosage

[smillingjimmyc]

Hi,
Currently on insulin and metformin(500s twice daily) and due to the well documented side effects have been given the slow release version however I notice the dosage with the sr is now 500g four times daily. Is this normal with the sr version? :shock:

 

[carty]

When I was changed from metformin to Glucophage I was on the same dosage but I am not on insulin so it may be different for you but it may be worth ringing your GP or whoever prescribed your meds just to check .Mistakes can be made ! CAROL

 

[smillingjimmyc]

Thanks for that carol,I just rang the chemist and he suggested the doctor must have had a reason for increasing the dosage as just changing to sr shouldn't matter.I have rang the local surgery but they are closed for "training" until tomorrow,I feel it must be a mistake because changing to sr was purely because of side effects.

 

[smillingjimmyc]

just realised i got your name wrong maybe i should see about changing specs prescription too!

 

[Pinnig]

Hi,

The composition on the side of the glucophage sr 500mg packet that I have says "Each prolonged release tablet contains metformin hydrochloride 500mg equivalent to 390mg metformin".

Perhaps that's why your doseage has been inceased since it looks like the SR contains less metformin than the original formula.

Still worth checking with your GP though.

 

[smillingjimmyc]

Thanks pinnig,I just looked and mines the same though covered by the pharmacy label.Just been to the docs and he is going to ring me back in about half an hour.

 

[Pinnig]

No worries. Hope your GP called back and put your mind at ease

 

[smillingjimmyc]

Hi,
Doc rang me and suggested the nurse had increased the dosage whilst changing to sr because my bs levels were a touch high however i remember her saying she was happy with the figures(7 something)and no mention was made at the time of an increase just a change to sr .
Taking into account sr type is 390mg as opposed to 500 it still means over a third increase.Frankly i think its been an error but I shall go with it and take the four sr each morning and reduce my insulin by a couple of units whilst checking my bs reguarly.

 

[cugila]

Hi,
Doc rang me and suggested the nurse had increased the dosage whilst changing to sr because my bs levels were a touch high however i remember her saying she was happy with the figures(7 something)and no mention was made at the time of an increase just a change to sr .
Taking into account sr type is 390mg as opposed to 500 it still means over a third increase.Frankly i think its been an error but I shall go with it and take the four sr each morning and reduce my insulin by a couple of units whilst checking my bs reguarly.

SJ and others posting on this thread.

First of all a little clarification here:
EVERY 500mg tablet of Metformin, whether SR/MR or standard contains the same base amount of Metformin 390mg. An 850mg tab contains 662.9mg of Metformin.

The rest is made up of sodium starch glycolate, colloidal anhydrous silica, maize starch, povidone and magnesium sterate in the core of the tablet. The outer film contains hypromellose, titanium dioxide (E171), propolene glycol, purified talc and macrogol 6000. Mainly fillers and stuff to hold it all together as a tablet.

The only difference between standard and Slow Release is as the name says.....it gets released into the system over a longer period so making sure you don't get the bad sde effects you were suffering from. Nothing more.

As you were originally on 1g daily your dose has been increased 100% to 2g daily. This is supposed to be split 1g twice daily, NOT 2g in one dose ! Please contact your Nurse/GP and clarify the dose as there appears to be some confusion on either your or the Nurse's part.

Hope that helps.
Ken

 

[witsum]

Hi
I have just started on Glucophage SR 500mg and it is being used as a preventative measure as I am not yet diabetic but I will be on 2mg daily too by the end of a month.
I have to take 1 tablet in the morning for a week, then 1 in morning and 1 at night for next week, followed by 2 in morning, 1 at night for next week and finally 2 tablets in morning and night so I would be worried for you if you are taking the 4 tablets at once. When you were just on 1mg did you take the 2 tablets in the morning.
I'm concerned that I am being put straight on to 2 mg dosage when not even diabetic but endo stated that maximum daily dosage is 4g for Type 2, so 2mg is fine-I just have to be guided by his recommendations but would have thought 1mg would have been enough.
I'm sure your MF dosage has being increased to counteract the slight rise in BS levels-you dont mention that you have had to increase your insulin so change of tablet dose is sufficient.

 

[cugila]

Hi
I have just started on Glucophage SR 500mg and it is being used as a preventative measure as I am not yet diabetic but I will be on 2mg daily too by the end of a month.
I have to take 1 tablet in the morning for a week, then 1 in morning and 1 at night for next week, followed by 2 in morning, 1 at night for next week and finally 2 tablets in morning and night so I would be worried for you if you are taking the 4 tablets at once. When you were just on 1mg did you take the 2 tablets in the morning.
I'm concerned that I am being put straight on to 2 mg dosage when not even diabetic but endo stated that maximum daily dosage is 4g for Type 2, so 2mg is fine-I just have to be guided by his recommendations but would have thought 1mg would have been enough.
I'm sure your MF dosage has being increased to counteract the slight rise in BS levels-you dont mention that you have had to increase your insulin so change of tablet dose is sufficient.

Witsum.
First of all, the MAXIMUM daily dosage of both types of Metformin, Standard or SR/MR is 2g daily, NOT 4g daily. I was once on 3g daily but that was frowned on by all concerned and was eventually changed in the BNF, the prescribing bible. It now reads a MAX of 2g daily.

Therefore if you ever get upped to 4g daily I would sure be asking loads of questions before ever I would consider taking that amount ! Endocrinologist or no ! :?

Ken

 

[witsum]

Ken
Thanks for your quick response-I am still so undecided about taking the Glucophage at all seeing as I am not even diabetic but supppose my family history,fatty liver and high cholestrol etc have made endo keen for me to take MF as a preventative measure. I definitely now think that 2mg is too much if that is the maximum dosage!!!!

 

[cugila]

Witsum.
This is something that you really need to discuss with your Endo....he may have a perfectly valid reason why he/she is putting you on the Max straight away. Only they will know.

Can I just clarify that each tablet is 500 milligrammes, so therefore 4 tablets is 2 grams. I think there may have been some confusion over the actual dosing amounts reading back through some of the posts, just to clear that up for everybody.

Ken

 

[smillingjimmyc]

Hi,
Doc rang me and suggested the nurse had increased the dosage whilst changing to sr because my bs levels were a touch high however i remember her saying she was happy with the figures(7 something)and no mention was made at the time of an increase just a change to sr .
Taking into account sr type is 390mg as opposed to 500 it still means over a third increase.Frankly i think its been an error but I shall go with it and take the four sr each morning and reduce my insulin by a couple of units whilst checking my bs reguarly.

SJ and others posting on this thread.

First of all a little clarification here:
EVERY 500mg tablet of Metformin, whether SR/MR or standard contains the same base amount of Metformin 390mg. An 850mg tab contains 662.9mg of Metformin.

The rest is made up of sodium starch glycolate, colloidal anhydrous silica, maize starch, povidone and magnesium sterate in the core of the tablet. The outer film contains hypromellose, titanium dioxide (E171), propolene glycol, purified talc and macrogol 6000. Mainly fillers and stuff to hold it all together as a tablet.

The only difference between standard and Slow Release is as the name says.....it gets released into the system over a longer period so making sure you don't get the bad sde effects you were suffering from. Nothing more.

As you were originally on 1g daily your dose has been increased 100% to 2g daily. This is supposed to be split 1g twice daily, NOT 2g in one dose ! Please contact your Nurse/GP and clarify the dose as there appears to be some confusion on either your or the Nurse's part.

Hope that helps.
Ken

Hi,
just seen your post and thanks for that! As I said i spoke to the doc and he seemed of the opinion that the nurse had increased the dosage though she did not indicate any such thing to me other than a change to sr, but after spoken to the pharmacist and his assistant along with doctors receptionists I just decided to go with the flow and take the higher dose and adjust insulin according to bs levels.
Strangely, I did ask the pharmacist about taking the sr all in one dose as indicated on the package
label and he said "yes".Quite a mouthful when taken with the other four meds I am on, though coincidently just before I read your post i had decided to take two in the morning and two later in the day! Indeed I had logged on here to see if it was ok to split the sr dose as is the norm with "regular" metformin.

 

[Dennis]

With the SR version, splitting the daily dose into two parts is perfectly logical. The SR version works for up to 12 hours, so taking it in 2 doses means that it is covering you for a full 24 hours. If you take it all in a single dose then for half of every day you are getting a concentrated dose, then nothing at all for the other half.