meds too big for me to swallow

[lucylocket61]

I popped in to the pharmacy today and they don’t have smaller ones, nor can they order any to see the size. Anything else is out of stock and more expensive so can’t be ordered.

I can’t help wondering how much diabetic complications would cost the NHS due to medication issues. I have managed without meds for seven years by changing my diet so must have saved a lot of money already for the NHS

The diabetic nurse will ring me on Wednesday to discuss my meds. Ordinary Metformin is much smaller, but when I tried it when I was first diagnosed it gave me terrible stomach issues.

I feel deflated and like I am being a nuisance, even though the pharmacist was as helpful as she could be given the restraints she is under.

I am in Wales, so maybe they have different rules to the rest of the UK.

 

[JohnEGreen]

You are not being a nuisance you are just trying to get your meds right which is your right.
What possible use is it to prescribe medication that the patient can't take.

 

[KK123]

I popped in to the pharmacy today and they don’t have smaller ones, nor can they order any to see the size. Anything else is out of stock and more expensive so can’t be ordered.

I can’t help wondering how much diabetic complications would cost the NHS due to medication issues. I have managed without meds for seven years by changing my diet so must have saved a lot of money already for the NHS

The diabetic nurse will ring me on Wednesday to discuss my meds. Ordinary Metformin is much smaller, but when I tried it when I was first diagnosed it gave me terrible stomach issues.

I feel deflated and like I am being a nuisance, even though the pharmacist was as helpful as she could be given the restraints she is under.

I am in Wales, so maybe they have different rules to the rest of the UK.

Hi there, don't be put off. Many people have an issue swallowing certain pills etc and there is ALWAYS a solution, think of those with conditions that actually prevent them from swallowing. The pharmacist can't authorise more expensive medicines BUT your Dr most certainly can albeit they are loathe to and won't want it coming out of their budget. If you make the case that you simply cannot swallow them and may have to go without......they will fork out for something else. If they say no, be prepared to take it to appeal, it's easier than you think. x

 

[pumas]

Liquid Metformin is available. My brother has trouble swallowing the tablets, takes them with something to eat rather than drink, but he does have a problem with his oesophagus.

 

[DCUKMod]

I popped in to the pharmacy today and they don’t have smaller ones, nor can they order any to see the size. Anything else is out of stock and more expensive so can’t be ordered.

I can’t help wondering how much diabetic complications would cost the NHS due to medication issues. I have managed without meds for seven years by changing my diet so must have saved a lot of money already for the NHS

The diabetic nurse will ring me on Wednesday to discuss my meds. Ordinary Metformin is much smaller, but when I tried it when I was first diagnosed it gave me terrible stomach issues.

I feel deflated and like I am being a nuisance, even though the pharmacist was as helpful as she could be given the restraints she is under.

I am in Wales, so maybe they have different rules to the rest of the UK.

Lucy - Oh bother.

I agree the pharmacist can't swap you to another medication, but your doctor or surgery can. The oral solution is a bit more expensive than the ordinary or SR Metformin, but that's not your challenge of course. When you discuss it with your nurse, they may not ever have prescribed the solution, so please do have that link I sent you to hand, as it demonstrates it exists and how to describe and find it.

I know you probably don't feel like it, but dig your heels in on this one

 

[lucylocket61]

Lucy - Oh bother.

I agree the pharmacist can't swap you to another medication, but your doctor or surgery can. The oral solution is a bit more expensive than the ordinary or SR Metformin, but that's not your challenge of course. When you discuss it with your nurse, they may not ever have prescribed the solution, so please do have that link I sent you to hand, as it demonstrates it exists and how to describe and find it.

I know you probably don't feel like it, but dig your heels in on this one

I was told that the liquid is too expensive for them to get for me.

 

[DCUKMod]

I was told that the liquid is too expensive for them to get for me.

It is expensive, and I guess the pharmacy wouldn't get it speculatively, but I bet they could get it if you had the script requiring it. (Unless your Doctor is saying it's too expensive?)

 

[Mr_Pot]

It is expensive, and I guess the pharmacy wouldn't get it speculatively, but I bet they could get it if you had the script requiring it. (Unless your Doctor is saying it's too expensive?)

But the liquid isn't slow release, if @lucylocket61 didn't need SR she could have the smaller normal tablets.

 

[VashtiB]

Hi Lucylocket61,

I feel your pain. I'm on the slow release as well. I describe them as my horse tablets- they are huge!. I've got better (over months) at taking them.

Are there any other pharmacies near you that may have other brands already in- if so maybe check them out.

Good luck- you already have enough on your plate without this to make it that much harder.

 

[DCUKMod]

But the liquid isn't slow release, if @lucylocket61 didn't need SR she could have the smaller normal tablets.

The forumlation for the oral suspension is bound to differ from the tablets, just by being liquid and likely not to have any fillers. Generally speaking (not specifically Metformin), many issues with drugs are due to fillers or lactose and so on. If the huge SR variant won't go down, it should be worth a short trial at least.

Bearing in mind Lucy's experience of standard release Metformin was several years ago, at the beginning of her journey, her reactions may differ this time around.

Apologies for talking about you, rather than to you @lucylocket61 .

 

[lucylocket61]

But the liquid isn't slow release, if @lucylocket61 didn't need SR she could have the smaller normal tablets.

good point. And i could break the smaller normal tablets in half to get used to them gradually, and see what happens. Its worth a try. Thanks.

 

[Mr_Pot]

Apologies for talking about you, rather than to you @lucylocket61

"There is only one thing in the world worse than being talked about, and that is not being talked about"

 

[lucylocket61]

Right, I spoke to the DN and she has given me a choice of trying the normal Metformin again, or trying empaglifozene 10mg.

Anyone else tried empaglifozene? The side effects and possible hypo if low carbing looks scary.

 

[Brunneria]

Hi @lucylocket61

forgive me if I misunderstood, but I thought you had been prescribed the Metformin because of pcos?
If that is the case, the insulin resstance lowering property (and maybe a bit of appetite supression) of Met are likely to be the goal.

did your nurse explain what relevance she thought empaglifozene has for pcos? Because I am unaware of any.

 

[DCUKMod]

Right, I spoke to the DN and she has given me a choice of trying the normal Metformin again, or trying empaglifozene 10mg.

Anyone else tried empaglifozene? The side effects and possible hypo if low carbing looks scary.

Hmmmmm.

This would be my take on it Lucy, and bear in mind I haven't ever used either medication, and I have no idea how bad your Metformin experience was last time.

In your shoes would be inclined to have a go at the ordinary Metformin again, starting on a very low dose. My rationale would be: As I understand it, you'll know within a couple of weeks whether you're going to be able to get along with it. I would want to start nice and slow - I'd maybe even take a tablet every other day to begin with, then, provided it's going OK (whatever that means) titrate up very slowly.

The reason I would prefer that over Empagliflozin would be three-fold - firstly the increased urinary output, which I think I would find inconvenient, and secondly the potential for thrush. I've had thrush twice and didn't like it one bit. As someone who drives, also I wouldn't fancy the increased potential of hypos, or thirdly, the albeit small risk of DKA.

On the upside, it would seem likely there would be a provision of a meter and strips, if hypos are a potential.

I imagine whichever route you take, if your first choice didn't work out, you could always try the other?

@woollygal has taken Flozins, if I recall correctly.

Edited to correct typos and make it make sense

 

[lucylocket61]

Hi @lucylocket61

forgive me if I misunderstood, but I thought you had been prescribed the Metformin because of pcos?
If that is the case, the insulin resstance lowering property (and maybe a bit of appetite supression) of Met are likely to be the goal.

did your nurse explain what relevance she thought empaglifozene has for pcos? Because I am unaware of any.

She says that losing weight will help my hormone levels, which will help my pcos, as my insulin resistance is stopped me losing weight. It was a 5 min telephone appointment.

 

[Energize]

Hi @lucylocket61

My suggestion would be to try the standard Metformin, lower dose initially (as already suggested above), crush them up, mix with something tasty and take with/straight after food. If you then get same issues as previously, ie gut problems, then ask to try the liquid form as, as previously mentioned above, there will be less fillers etc and you may tolerate it better.

Only as a last resort would I accept the Empaglifozene and only if I'd tried everything possible to reduce carb intake etc. I say this, not because of any experience, but the potential side effects plus having to be careful re glucose levels, Hyper/hypo, will be a lot for you to take on, bearing in mind your current depression etc.

I'm sure, once you're back on the wagon again, your levels will drop really well and you won't be needing any of these meds, seeing as you've done so well up until your recent losses. You'll get there, eh? There's light at the end of the tunnel

{{{Hugs}}}

 

[woollygal]

Hmmmmm.

This would be my take on it Lucy, and bear in mind I haven't ever used either medication, and I have no idea how bad your Metformin experience was last time.

In your shoes would be inclined to have a go at the ordinary Metformin again, starting on a very low dose. My rationale would be: As I understand it, you'll know within a couple of weeks whether you're going to be able to get along with it. I would want to start nice and slow - I'd maybe even take a tablet every other day to begin with, then, provided it's going OK (whatever that means) titrate up very slowly.

The reason I would prefer that over Empagliflozin would be three-fold - firstly the increased urinary output, which I think I would find inconvenient, and secondly the potential for thrush. I've had thrush twice and didn't like it one bit. As someone who drives, also I wouldn't fancy the increased potential of hypos, or thirdly, the albeit small risk of DKA.

On the upside, it would seem likely there would be a provision of a meter and strips, if hypos are a potential.

I imagine whichever route you take, if your first choice didn't work out, you could always try the other?

@woollygal has taken Flozins, if I recall correctly.

Edited to correct typos and make it make sense

I took dapaglifozin if that’s the same thing.

the increased urine was difficult but don’t know if that’s just because I’m in car all day. now I’m not on them the difference is huge. I’m drinking way less because I’m no longer as dehydrated but I can have longer times without so much discomfort.

Never got thrush.

mind told me I couldn’t get hypos but that I could get lower blood sugars so I was always bit more careful. The only thing they said about higher was make sure it comes down. Nothing about dka
Used to get a lot of nausea didn’t realise it was those but I get occasional now but it was every morning after breakfast.
It made me very brain foggy. Couldn’t remember anything couldn’t work anything out. Most basic things and my brain just couldn’t move in different directions to solve it.
Think it made me quite depressed as well. But to be honest this was when I started taking them again after I stopped short while I’m summer.
Suicidal thoughts. Not doing but I’d go under a bridge and think how I could dye etc. This really only cane on towards the end and I didn’t realise till I was off and all that nonsense has gone for the most part. Still get mood swings but they are normal crying like a banshee upset not dying upset. oh and the sheer levels of exhaustion. I believe made worse in the summer months. I can’t remember them being so bad when I first started in August 18.

Having said that they did the job. I went down ftom87 to 54.
A lot of the side effects I seem to have had weren’t listed in all honesty. also used to get a lot of pain in bottom of stomach and back etc. Again pretty much gone.

Metformin however I took for 2 days (slow release) and I was so I’ll my dr took me off them immediately

 

[lucylocket61]

I took dapaglifozin if that’s the same thing.

the increased urine was difficult but don’t know if that’s just because I’m in car all day. now I’m not on them the difference is huge. I’m drinking way less because I’m no longer as dehydrated but I can have longer times without so much discomfort.

Never got thrush.

mind told me I couldn’t get hypos but that I could get lower blood sugars so I was always bit more careful. The only thing they said about higher was make sure it comes down. Nothing about dka
Used to get a lot of nausea didn’t realise it was those but I get occasional now but it was every morning after breakfast.
It made me very brain foggy. Couldn’t remember anything couldn’t work anything out. Most basic things and my brain just couldn’t move in different directions to solve it.
Think it made me quite depressed as well. But to be honest this was when I started taking them again after I stopped short while I’m summer.
Suicidal thoughts. Not doing but I’d go under a bridge and think how I could dye etc. This really only cane on towards the end and I didn’t realise till I was off and all that nonsense has gone for the most part. Still get mood swings but they are normal crying like a banshee upset not dying upset. oh and the sheer levels of exhaustion. I believe made worse in the summer months. I can’t remember them being so bad when I first started in August 18.

Having said that they did the job. I went down ftom87 to 54.
A lot of the side effects I seem to have had weren’t listed in all honesty. also used to get a lot of pain in bottom of stomach and back etc. Again pretty much gone.

Metformin however I took for 2 days (slow release) and I was so I’ll my dr took me off them immediately

Thanks. Given that I have depression and ME your input is helpful.

 

[woollygal]

Thanks. Given that I have depression and ME your input is helpful.

Don’t forget everyone is different. I used to suffer from depression so perhaps I was just more susceptible.
good luck