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Is there a "normal" dosage of Metformin?

Discussion in 'Diabetes Medication and Drugs' started by kareng236, Feb 16, 2011.

  1. kareng236

    kareng236 · Member

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    Hello all,

    This may seem like a very innocent question .......but is there such a thing as a normal dosage of Metformin? I suppose I am needing to know what the maximum is before insulin is the next option. I was diagnosed as Type 2 at the start of this year and was prescribed 2000mg Metformin daily......building up over a few weeks from 1000mg to 1500mg and now 2000mg. My Doctor does not think that diet alone would do the trick. I realise that we are all different - but I'd like to know if others would consider this a high dosage. Many thanks.
     
  2. ))Denise((

    ))Denise(( Type 2 · Well-Known Member

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    Hi Karen

    2000mg is the current maximum dose of metformin (although I'm on 2550mg and have been for 3 years - I'm asking my endocrinologist about this when I see her in March). There are other drugs which can be added to metformin or instead of it including gliclacide, januvia and victoza more info http://www.diabetes.co.uk/diabetes-medication/index.html

    So it isn't usually a straight trip from metformin to insulin.
     
  3. kareng236

    kareng236 · Member

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    Hello Denise,

    Thank you so very much for your reply. I have been worried sick about this. I know that further down the line it may be inevitable - but I'd like to ward off that day by really trying to control things with diet, excercise and medication.

    Many many thanks.
    Karen
     
  4. croftmanor

    croftmanor · Well-Known Member

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    Hi Karen
    I have read the dosage advice in the leaflet for metormin, it would appear that 1 x 850mg 3 times per day is the max, but i will know for definate when i get back home and check again
    As metformin only brings down blood sugar by a couple of points, As above there are other medications that are used along with it to help bring levels down more before you would need to look at insulin.
    i would have a chat with your diabetes nurse or Doctor for more advice
    Crofty
     
  5. cugila

    cugila · Master

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    Up until a year or so back the maximum dose of Metformin was 3g per day in divided doses. That changed in the BNF59 (Prescribing Bible) and was reduced.

    The current usual maximum dose is as follows : Source BNF60.

    I was once on 3g daily but that is now NOT the usual max dose. There may be reasons why a Consultant/GP may go outside the recommended dose.
     
  6. Marvin

    Marvin Type 2 · Well-Known Member

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    After 4 yrs Type 2 Diet controlled, I was put on Metformin, and the dosage gradually increased until I reached what I was told was the maximum: 2x 500mg tablets twice a day with food (i.e. 2000mg in divided doses). As even this failed to reduce my bg sufficiently Gliclazide was added, I tablet with breakfast, and this has done the trick for me. So there is life between Metformin and Insulin, you'll be glad to hear. Hope a similar solution is found for you.
    (Only downside is that Gliclazide can (and for me does) induce hypos; I have to ensure a snack with my mid-morning coffee, and if this is not possible I go hypo towards lunchtime. Fortunately my hypo awareness is good enough to enable me to avoid serious problems.)
     
  7. kareng236

    kareng236 · Member

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    Thank you to each of you for being good enough to reply. I am really grateful to hear all that you have said. Thank you so very much.

    Karen
     
  8. searley

    searley Type 1 · Well-Known Member

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    last july i was diagnosed T2my hba1c was only 7.9 and the doctor put me straight on 2000mg i had to ramp it up from 1 tablet to 4 over a few weeks

    i had issues with metformin , so had gliclazide, then gliclazide sr.. then finally insulin

    i was however told 3000mg was the maximum 6 tablets a day!
     
  9. cugila

    cugila · Master

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    At the time you were diagnosed the usual maximum dose was 2g daily in divided doses. It changed about 6-8 months before that from the previous 3g daily maximum.

    The proper usual maximum now February 2011 is 2g daily in divided doses as recorded in the BNF60 and posted earlier. Maybe whoever told you was using an old out of date BNF........it happens !
     
  10. kareng236

    kareng236 · Member

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    Thank you folks for the latest replies. I am sorry Searley to hear that tablets did not work for you. At diagnosis, my fasting blood sugar was 7.8 and my two hour glucose tolerance test result was 17.8...so I am guessing that Metformin may not be enough for me either..............but I am trying hard to lose weight and hope that this will help things.
     
  11. pipsy2014

    pipsy2014 Type 2 · Well-Known Member

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  12. pipsy2014

    pipsy2014 Type 2 · Well-Known Member

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    Hi I have been on four slow release metformin for many years,i also take four gliclazide tablets,which worked for years until recectly,I am on more meds,but the metformin and gliclazide should work for you,as they did for me.
     
  13. jack412

    jack412 Type 2 · Expert

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    2000 slow release and 2500 normal met is the usual max
     
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  14. ))Denise((

    ))Denise(( Type 2 · Well-Known Member

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    This is an old thread @jack412

    I now take 2000mg metformin a day http://www.evidence.nhs.uk/formular...drugs/6122-biguanides/metformin-hydrochloride

    You can take up to 2550mg a day, I can't find the evidence, but the maximum was lowered due to the extra 550mg not having much effect. Most newly diagnosed will not be put on 2550mg, but as I was diagnosed in 2007 and put on this amount in 2008, that was normal practice then. I have seen in my time here people on 3000mg..

    http://www.rdehospital.nhs.uk/docs/patients/diabetes/RDE diabetes - type 2 glycaemia - metformin.pdf
     
  15. jack412

    jack412 Type 2 · Expert

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    I'm just into dead things...LOL

    [​IMG]
     
  16. Mandie1

    Mandie1 Type 2 · Newbie

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    Hi I am currently on 4 slow realease metformin adsy and 4 glicazide a day and not reaching the so called normal level. At what point does insulin become a reality.
     
  17. jack412

    jack412 Type 2 · Expert

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    Hi, what are your before breakfast and after meals BG?
    what is your Dr suggesting?
    If you already have a low carb diet and your weight is in range, there are a couple of other meds, that might stretch it out a bit if you want to.
     
  18. Mandie1

    Mandie1 Type 2 · Newbie

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    At the docs tomorrow to discuss. Levels are usually 12 -14 in morning and can go to 18 -20. Hardly ever get below 10 BG.
     
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  19. jack412

    jack412 Type 2 · Expert

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    that's probably more that the stop gaps can cover. IMO It's important to get your BG in range as a first off.
    then work on diet to get the meds as low as you can, some can even get off meds. so when you are ready, put up a BG/diet post and a few months to see what you can do.
     
  20. lessci

    lessci Type 2 · Well-Known Member

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    I started on 1000mg a day Metformin, but I'm currently on 2550mg (3x850) and Sitagliptin. I was on Glicazide too, but it was causing large amounts of weight gain, so I'm now waiting for my next Ac1 to see if they put me of forxiga
     
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