Slow release Metformin or regular?

[gardengnome42]

Why do doctors prescribe the regular Metformin when it can cause such unpleasant side effects? When that happens they quickly change you on to the slow release tablets so why not prescribe them in the first place? Is it a question of price?

A similar thing happened to me when first taking medicine for hypertension. The standard first med is Ramipril which in my case gave me a nasty cough. Evidently that is very common and I was very quickly moved to Losartan. This is so well known you wonder why they start you on it at all.

 

[Guzzler]

They sometimes prescribe a cheaper drug first. Not everyone reacts to drugs in the same way. I was prescribed the ordinary Metformin and have had no adverse effects from it.
Conversely, some people cannot tolerate Metformin in any guise.

 

[ringi]

Normal metformin seems to lower BG a little more then slow release.

 

[Deleted member 308541]

My GP started me with Metformin XR, instead of the quick release one,

 

[Rachox]

I’m on standard Metformin and Ramipril, no problem tolerating either, I’m cheap to keep!

 

[DCUKMod]

Why do doctors prescribe the regular Metformin when it can cause such unpleasant side effects? When that happens they quickly change you on to the slow release tablets so why not prescribe them in the first place? Is it a question of price?

A similar thing happened to me when first taking medicine for hypertension. The standard first med is Ramipril which in my case gave me a nasty cough. Evidently that is very common and I was very quickly moved to Losartan. This is so well known you wonder why they start you on it at all.

My understanding is regular Metformin is cheaper and the majority of those who try it tolerate it, so it seems a reasonable approach, although I'm sure that doesn't help those for whom their relationship with the smallest room becomes deep and meaningful.

 

[Deleted member 308541]

My understanding is regular Metformin is cheaper

PBS prices from the pharmacy I go to are as follows.

Diabex (Metformin) 500mg 100 Tabs $13.50
Diabex (Metformin) 1000mg 90 Tabs $15.99
Diabex-XR (Metformin) 500mg 120 Tabs $13.50
Diabex-XR (Metformin) 1000mg 60 Tabs $15.50

Metformin APO (Diabex/Diaformin) 1000mg 90 Tabs $9.99
Metformin APO (Diabex/Diaformin/Formet) 500mg 100 Tabs $7.50
Metformin XR BTC (Diabex XR) 500mg 120 Tabs $8.50

If you have a concession card they are $6.40 for each Item.

https://assets.bloomsthechemist.com.../03225446/APRIL-2018-PRESCRIPTION-PRICING.pdf

 

[JohnEGreen]

I take regular metformin and as long as I make sure that I take it with food have no problems.

 

[gardengnome42]

I assumed it must be a price thing but just thought I'd ask. I don't actually take either but it is a case of 'Forewarned is Forearmed'!

 

[Ann1982]

I was a lot worse on the slow release version although a nurse at the doctors surgery said that was nonsense! How would she know she was not in the loo all the time with me!

 

[NaijaChick]

I was a lot worse on the slow release version although a nurse at the doctors surgery said that was nonsense! How would she know she was not in the loo all the time with me!

Hi Ann,

Please could you tell me, how much gave you been prescribed and how much are you taking? Also are you following an special diets?

 

[Oldvatr]

I was a lot worse on the slow release version although a nurse at the doctors surgery said that was nonsense! How would she know she was not in the loo all the time with me!

Ditto. I was swapped behind my back to a new variant of Metformin and my bgl control rose by 2 mmol/l almost overnight. I investigated this and discovered that the slow release / extended release pills use different methods of delaying digestion and absorbtion. Normally this is done with natural ingredients such as plastic, but the med I was changed to used shellac varnish.

In conclusion I found that my PPI medication reduced stomach acid, and this meant that I was unable to dissolve the new tabs at all, so the meds did not work, So I am back on standard Metformin which works well for me, I take 2000 mg per day and have done so for many years with only an occasional mishap.

 

[NaijaChick]

Sorry are you saying that XR has plastic in it???? Where did you find this information pls.

 

[Oldvatr]

Sorry are you saying that XR has plastic in it???? Where did you find this information pls.

Metformin ER has a natural plasticiser agent forming the gel matrix. It is a polymer, so it is correct to call it plastic, but it is derived from cellulose, and is biodegradeable, and is not to be confused with modern petroleum or benzene based polymers as found in the oceans, Nevertheless it is pliable and not immediately dissolvable, so it is normally excreted via the bowel as a waste product. It is sometimes visible as a white patch within the stool. The actual polymer used varies from manufacturer to manufacturer.

https://www.drugs.com/pro/metformin-extended-release-tablets.html

 

[Ann1982]

Hi Ann,

Please could you tell me, how much gave you been prescribed and how much are you taking? Also are you following an special diets?

I was on the maximum dose but stopped it altogether and am following a LCHF diet although some problems at the moment due to under active thyroid. But feeling much better having stopped the metformin and I am on insulin.