Change In Meds

[xfieldok]

Have been on metabet Metformin since DX with no problems.

Phoned for a repeat prescription and was told it had been changed to sukkarto. Looked at all the warnings and quite frankly I am not impressed.

Anybody else on it?

 

[Rachox]

I believe, I could be wrong that both Metabet and Sukkarto are brand names for Metformin slow release. What warnings have you seen?

 

[xfieldok]

I believe, I could be wrong that both Metabet and Sukkarto are brand names for Metformin slow release. What warnings have you seen?

For sukkarto
Contraindications:Acute metabolic acidosis or diabetic pre-coma. Hepatic or severe renal (GFR <30ml/min) impairment. Acute conditions predisposing to renal impairment. Respiratory failure, acute unstable heart failure, recent MI. Acute alcohol intoxication, alcoholism. Pregnancy, lactation. Elderly (≥75 years) when used for diabetes prevention.[https://www] Warnings:Moderate renal impairment (GFR 30—59ml/min). Monitor renal function before and at least annually during treatment (more frequently if elderly or risk of renal impairment progression). Assess risk factors for lactic acidosis; advise patient of symptoms and discontinue immediately if suspected. Stable chronic heart failure. Surgery; withdraw until 48 hrs post-op and confirm normal renal function before resuming.[https://www] Interactions:Alcohol, iodinated contrast agents, corticosteroids, sympathomimetics, diuretics, ACE inhibitors, angiotensin II antagonists, NSAIDs, other hypoglycaemics. Inhibitors or inducers of OCT1 (eg, verapamil, rifampicin), inhibitors of OCT2 (eg, cimetidine, dolutegravir, ranolazine, trimethoprim).[https://www] Adverse Effects:GI upset, dysgeusia. Reports of altered LFTs, hepatitis, skin reactions, reduced vit B12 absorption.

 

[DCUKMod]

For sukkarto
Contraindications:Acute metabolic acidosis or diabetic pre-coma. Hepatic or severe renal (GFR <30ml/min) impairment. Acute conditions predisposing to renal impairment. Respiratory failure, acute unstable heart failure, recent MI. Acute alcohol intoxication, alcoholism. Pregnancy, lactation. Elderly (≥75 years) when used for diabetes prevention.[https://www] Warnings:Moderate renal impairment (GFR 30—59ml/min). Monitor renal function before and at least annually during treatment (more frequently if elderly or risk of renal impairment progression). Assess risk factors for lactic acidosis; advise patient of symptoms and discontinue immediately if suspected. Stable chronic heart failure. Surgery; withdraw until 48 hrs post-op and confirm normal renal function before resuming.[https://www] Interactions:Alcohol, iodinated contrast agents, corticosteroids, sympathomimetics, diuretics, ACE inhibitors, angiotensin II antagonists, NSAIDs, other hypoglycaemics. Inhibitors or inducers of OCT1 (eg, verapamil, rifampicin), inhibitors of OCT2 (eg, cimetidine, dolutegravir, ranolazine, trimethoprim).[https://www] Adverse Effects:GI upset, dysgeusia. Reports of altered LFTs, hepatitis, skin reactions, reduced vit B12 absorption.

Have you compared that with Metabet?

 

[Rachox]

For sukkarto
Contraindications:Acute metabolic acidosis or diabetic pre-coma. Hepatic or severe renal (GFR <30ml/min) impairment. Acute conditions predisposing to renal impairment. Respiratory failure, acute unstable heart failure, recent MI. Acute alcohol intoxication, alcoholism. Pregnancy, lactation. Elderly (≥75 years) when used for diabetes prevention.[https://www] Warnings:Moderate renal impairment (GFR 30—59ml/min). Monitor renal function before and at least annually during treatment (more frequently if elderly or risk of renal impairment progression). Assess risk factors for lactic acidosis; advise patient of symptoms and discontinue immediately if suspected. Stable chronic heart failure. Surgery; withdraw until 48 hrs post-op and confirm normal renal function before resuming.[https://www] Interactions:Alcohol, iodinated contrast agents, corticosteroids, sympathomimetics, diuretics, ACE inhibitors, angiotensin II antagonists, NSAIDs, other hypoglycaemics. Inhibitors or inducers of OCT1 (eg, verapamil, rifampicin), inhibitors of OCT2 (eg, cimetidine, dolutegravir, ranolazine, trimethoprim).[https://www] Adverse Effects:GI upset, dysgeusia. Reports of altered LFTs, hepatitis, skin reactions, reduced vit B12 absorption.

I suspect as @DCUKMod hints too, that you’ll find the warnings for Metabet are similar, I’m not currently at home so can’t read the leaflet from my Metformin. But as Metabet and Sukkarto are just brand names for Metformin the side effects, contraindications and cautions will probably be the same. Dig out the info leaflet from your Metabet and compare them.

 

[Oldvatr]

Altough the two meds are supposed to be identical, they are NOT. There is one subtle difference that exists, and that is in the coating used to give the slow release. Most SR or XR forms of Metformin use cellulose as the enteric coating. But Sukkarto uses shellac whuxh is a varnish used by artists to protect paintings. Shellac does not dissolve if your astomach acid is weak, so the meds stop working. I use a PPI inhibitor to protect my stomach from my anti coagulant med (blood thinner) and this stopped Sukkarto working, and also incidentlly stopped my iron supplement and Vit A from being absorbed too, So I had to go back to standard Metformin and retime my PPI so it is clear of my other meds.

 

[Rachox]

Altough the two meds are supposed to be identical, they are NOT. There is one subtle difference that exists, and that is in the coating used to give the slow release. Most SR or XR forms of Metformin use cellulose as the enteric coating. But Sukkarto uses shellac whuxh is a varnish used by artists to protect paintings. Shellac does not dissolve if your astomach acid is weak, so the meds stop working. I use a PPI inhibitor to protect my stomach from my anti coagulant med (blood thinner) and this stopped Sukkarto working, and also incidentlly stopped my iron supplement and Vit A from being absorbed too, So I had to go back to standard Metformin and retime my PPI so it is clear of my other meds.

Oh now that’s interesting, I only take the standard release so didn’t realise the coatings differ. I also take a PPI and have never been told to take it clear of other meds!

 

[xfieldok]

Sorry, phone playing up making it difficult to post. I don't have my leaflet. I checked other websites for the contraindications and found the first site I looked at had limited info compared to others. It is not as bad as I thought.

 

[Oldvatr]

-

Oh now that’s interesting, I only take the standard release so didn’t realise the coatings differ. I also take a PPI and have never been told to take it clear of other meds!

There are FDA warnings out on Omeprazole in particular and it interacts with many other meds and supplements. Here in the UK we ignore FDA warnings, so NICE has no restrictions. There is an unofficial warning on Clopidogrel, but NHS has issued a counter riposte saying it does not accept these findings, Personally my experience (n=1) shows otherwise. Just google "FDA PPI"

This looks relevant to the reducing efficacy of other meds, but is not proven - yet
https://www.cbsnews.com/news/heartb...nhibitors-ppi-risks-prilosec-nexium-prevacid/

 

[DCUKMod]

Oh now that’s interesting, I only take the standard release so didn’t realise the coatings differ. I also take a PPI and have never been told to take it clear of other meds!

Rachox, please don't consider my next question as advice on medications, but more as a "have you ever wondered" sort of musing, but, has your PPI usage been reviewed since you made your lifestyle changes?

My OH has a long-standing hiatus hernia. Should his weight creep above 75kg he starts to experience reflux, but keep it lower and he's totally asymptomatic. When that happens he tends to trim back on his eating and utilise Gaviscon. When he dips below the magic (for him) 75kg, he reverts to a happier bunny again.

You have lost such a magnificent amount of weight, so I wondered if your GERD had been improved at all.

 

[Deleted member 308541]

My pharmacy swaps my Metformin brands around every now and then, I either get a run of Diamorfin XR or Blooms Metformin XR in the two and half years I have been taking them.

Neither which interfere with my Digoxin tablets thankfully.

 

[Rachox]

Rachox, please don't consider my next question as advice on medications, but more as a "have you ever wondered" sort of musing, but, has your PPI usage been reviewed since you made your lifestyle changes?

My OH has a long-standing hiatus hernia. Should his weight creep above 75kg he starts to experience reflux, but keep it lower and he's totally asymptomatic. When that happens he tends to trim back on his eating and utilise Gaviscon. When he dips below the magic (for him) 75kg, he reverts to a happier bunny again.

You have lost such a magnificent amount of weight, so I wondered if your GERD had been improved at all.

I have wondered indeed. My PPI is next in the firing line for striking off my repeat meds! Having dropped a BP med and reduced my Metformin I’m considering discussing my Esomeprazole next GP visit as I haven’t had heartburn for ages now.

 

[Daibell]

Hi. Metabet is merely one brand of Metformin SR (Slow Release). My prescription doesn't define the brand so occasionally I get another brand but mostly Glucophage SR. All thse variants have along list of warnings but Metformin SR is a very safe drug so don't worry unless you are a rare exception unless the coating on this new brand causes issues.