Metformin

[mamahen]

I've been type 2 for a year.I take 3 X metformin 500mg a day.
I find if I take any in the morning, by 3pm I have upset stomach & diarrhoea.
However, if I take all 3 after my evening meal, I have no side effects.
My diabetic nurse assures me it's OK to take them all at once, at night, but it just seems wrong to not space them throughout the day. My mind is telling me I should be taking 1 at breakfast, 1 at lunch & 1 at dinner!
Any opinions anyone?

 

[cugila]

You should discuss this with the GP NOT the Nurse. It is not meant to be taken all at once !!!

Dose
•Diabetes mellitus, adult and child over 10 years initially 500 mg with breakfast for at least 1 week then 500 mg with breakfast and evening meal for at least 1 week then 500 mg with breakfast, lunch and evening meal; usual max. 2 g daily in divided doses

•Polycystic ovary syndrome [unlicensed], initially 500 mg with breakfast for 1 week, then 500 mg with breakfast and evening meal for 1 week, then 1.5–1.7 g daily in 2–3 divided doses

Source : BNF60

 

[Talos]

They are supposed to react with the meal just had, they can't do that if you don't take them, and taking them all at once with one meal is likely to cause an over reaction at that time. Explain to you GP he may be able to prescribe someting else you are not sensitive to.
Dont tell him you have been taking them all at once he might shout at you

 

[louiseb]

They are supposed to react with the meal just had, they can't do that if you don't take them, and taking them all at once with one meal is likely to cause an over reaction at that time. Explain to you GP he may be able to prescribe someting else you are not sensitive to.
Dont tell him you have been taking them all at once he might shout at you

sorry but i think the they should be honest with your gp as to when they are taking there medication.
how can a gp shout at a patient who has been wrongly advised by a nurse?

you can get a slow realease version of metformin that does cause the symptoms of upset stomache etc

 

[RichardL]

I always take them after a meal and only get wind. Try taking them 10 minutes before each meal see if it makes a difference!

 

[Unbeliever]

I have been old by both docors and nurses hat it is OK to take slow or modified release metformin
all at once.
I have never done so but now take 2 1000mg one with breakfast and one with my evening meal.
his is just for convenience.
I was giving the immediate release metformin at first but it had the most dreadful side effects. not just the stomach problems but balance problems and dizziness. When I was given the modified release I coninued to have the stomach problems but not so badly as before and the other problems disappeared.
I think that the reason for taking the M?R with food is to minimise these somach problems.
The doctor asked why I did not take tthe full dose at once as they would continue to work when needed but when I tried his my bg went up at night.
I still find that I have problems if i have low carbs. The diabetic nure old me that the hospital consultant advised paients who had problems with metformin to take them at nigh while the gut was quiet. In my case this seemed to result in them not working for me at all but - strangely enough my stomach symptoms did not return for a long time afterwards. They are not so bad now after almost four years but i still seem to need to eat more carbs than I would wish so I just grin and bear it.
Taking the tablets at night seems to be perfecly acceptable o the medical establishment. I hope it works for others. . The alternative can be prey miserable I know.

 

[Talos]

If you Google "metformin" you will obtain more information

 

[cugila]

Instead of Google......

Why don't you just check out 'Metformin information' and Metformin Questions & Answers' which are posted in the Diabetes Medication and Drugs section here where this thread is situated. Loads of information in those posts........

Dose instructions for Slow release or MR/XR :

Dose initially 500 mg once daily, increased every 10–15 days, max. 2 g once daily with evening meal; if control not achieved, use 1 g twice daily with meals, and if control still not achieved change to standard-release tablets

Dose instructions for standard release Metformin :

•Diabetes mellitus, adult and child over 10 years initially 500 mg with breakfast for at least 1 week then 500 mg with breakfast and evening meal for at least 1 week then 500 mg with breakfast, lunch and evening meal; usual max. 2 g daily in divided doses

•Polycystic ovary syndrome [unlicensed], initially 500 mg with breakfast for 1 week, then 500 mg with breakfast and evening meal for 1 week, then 1.5–1.7 g daily in 2–3 divided doses

Those above are the instructions from the BNF60, the Dr's prescribing 'bible.' If your dose differs from the above then ask your GP/Nurse etc WHY ?

 

[bowell]

Talos wrote:
They are supposed to react with the meal just had, they can't do that if you don't take them, and taking them all at once

What i was told :?:
it works over a long time also need to build up level in body to work properly

Thats why it still works with some one on one 850mg SR tablet a day

extract from http://www.centremedsurg.com/Forms/Metformin (Glucophage).pdf

How to take metformin: Metformin is best taken with food to limit some of the unpleasant side-effects
described below. However, metformin works in the body for a long time and
does not work just on the meal that it is taken with. It can even just be taken all at once for the day,