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Glucophage (metformin) is an antidiabetic treatment for use in type 2 diabetes. The medication reduces levels of glucose in the blood. Its effectiveness, ease of use, and low cost has made it one of the most widely-used diabetes treatments in the world.

As with all diabetes treatments, eating an appropriate diet and engaging in regular exercise will further enhance results, and in some case are effective enough to eliminate the need for medication altogether.

Understanding Glucophage

This medication takes three approaches to lowering glucose levels:

• Inhibits glucose secretion by the liver;
• Inhibits glucose absorption from food;
• Promotes glucose absorption by muscle and fat tissues.

In ideal cases, with reduced glucose entering the bloodstream, naturally-occurring insulin will be sufficient to keep blood sugar levels within normal ranges. The medication does not replace insulin, and should not be used as a substitute in persons with type 1 diabetes or diabetic ketoacidosis. Glucophage alone may not be sufficient in all type 2 diabetics, and other medications may be needed in addition, such as insulin or exenatide.

This product provides a number of benefits over other diabetes treatments:

• Does not require injections;
• Tablets are easy to transport and use discreetly;
• No association with weight gain from treatment, as often happens with other diabetes medications;
• Many patients experience weight loss while taking Glucophage;
• Serious side effects are remarkably rare;
• Tablets are considerably less expensive than most other treatments.

While dangerous side effects are extremely unlikely, about 50 percent of patients do experience mild gastrointestinal effects, including nausea, diarrhea, stomach cramps, and so forth. In most cases these symptoms fade away as treatment continues; but some individuals find they do not. If side effects are persistent, taking Glucophage MR instead of regular tablets may resolve the issue.

Dosage & Administration

The medication is easy to take once the ideal dosage has been discovered. Patients are typically started on low doses, gradually increased if needed:

• Start with 500 mg twice per day for 10 to 14 days.
• If not effective, increase by 500 mg each dose; 1000 mg twice per day for another 10 to 14 days.
• Continue increasing by 500 mg increments every 10 to 14 days until the effective dosage is found or maximum dose is reached.
• Do not exceed 2550 mg in one day.
• Each dose should be taken with a meal.
• Large daily doses may be split into three smaller doses if desired.

Slowly increasing dosage levels allows the body to adjust to treatment, reducing the severity of stomach-related side effects. Glucose levels should be checked frequently whenever dosage is adjusted, as well as during times of illness or stress. Because the medication doesn't actually add insulin, low blood sugar (hypoglycemia) is very unlikely with Glucophage alone even at higher-than-necessary doses, but it may be a concern if other medications are being taken.

Treatment typically continues indefinitely, unless lifestyle changes are sufficient to control the condition.

Warnings Before Use

Individuals with a history of kidney or liver issues, cardiac problems, or severe respiratory conditions should discuss risks with a doctor before use; the medication may produce dangerous side effects in these cases.

It is generally accepted that Glucophage should not be used in children under 10; since it passes through breast milk, this includes nursing infants. Safety in pregnancy is somewhat disputed; parents should discuss potential risks with a trusted doctor before use.

In addition to other diabetes medications, Glucophage may interact with other prescription and non-prescription drugs, causing unexpected side effects or reducing effectiveness. Talk to a pharmacist before mixing treatments if unsure of the consequences.

As mentioned above, this product is not a substitute for insulin in type 1 diabetes.

This ships from the UK

Glucophage MR (metformin) is the modified-release (MR) version of regular Glucophage tablets, formulated to slowly release small amounts of the medication over time. Both tablets are used to reduce levels of glucose in type 2 diabetics.

The most significant benefit of Glucophage MR over the regular version is the reduction in the severity of gastrointestinal side effects, which, while not dangerous, can be very uncomfortable and disruptive.

Glucose Management Made Easy

Glucophage MR enhances the body's naturally occurring insulin by:

• Inhibiting glucose secretion by the liver;
• Inhibiting glucose absorption from food;
• Promoting glucose absorption by muscle and fat tissues.

For many patients, Glucophage MR alone is sufficient to keep glucose levels in normal ranges, without additional medications such as insulin injections. In overweight patients, it has shown to be every bit as effective as lifestyle changes, including diet and exercise; of course, lifestyle changes will only further enhance treatment and may be enough to eventually cease taking the medication altogether.

This treatment provides a number of benefits over other diabetes medications:

• It is administered orally once daily, no injections are required;
• Patients do not tend to gain weight during treatment, as often happens with insulin;
• Many patients experience mild to moderate weight loss during treatment, even without lifestyle changes;
• The medication is extremely unlikely to produce serious side effects if used properly;
• It is considerably less expensive than most other antidiabetic treatments.

Glucophage MR is the easiest to take of all forms of metformin:

• Start with 500 mg once per day for 10 to 14 days.
• If not effective, increase by 500 mg; 1000 mg once per day for another 10 to 14 days.
• Continue increasing by 500 mg increments every 10 to 14 days until the effective dosage is found or maximum dose is reached.
• Do not exceed 2000 mg in one day.
• Do not crush, split, chew or otherwise damage MR tablets.
• Each dose should be taken with the evening meal.

The gradual increase in dosage, aside from determining the ideal dosage for long-term management, should help reduce the frequency, severity and duration of any side effects, if they occur at all. Starting treatment with large doses is likely to produce gastrointestinal side effects.

Blood sugar should be tested frequently whenever dosage changes. Gastrointestinal side effects may develop whenever dosage is increased. Treatment with Glucophage MR will likely continue indefinitely if lifestyle changes are not sufficient to manage the condition.

Side Effects

As mentioned above, Glucophage is somewhat notorious for producing gastrointestinal side effects, experienced by about half of all users:

• Diarrhea
• Bloating
• Gas
• Constipation
• Heartburn
• Stomach pain
• Nausea
• Metallic taste in mouth

These effects should be should be mild and transient, fading away completely after several weeks of treatment, particularly if using Glucophage MR. If symptoms are still severe or persistent, there are a few additional things to try:

• Eat live culture yogurt;
• Eat fewer fatty or fried foods;
• Eat a larger meal when tablets are taken;
• If taking tablets at the start of the meal, switch to taking them at the end, and vice versa.

A few individuals find side effects never seem to disappear; in these cases alternative options should be explored.

Before Use

Patients with kidney or liver issues, a history of cardiac problems, or major respiratory conditions should discuss risks with a doctor before use, as the risk of serious side effects is much greater.

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Glucophage MR may interact with other prescription and non-prescription drugs, causing unexpected side effects or reducing effectiveness. Talk to a pharmacist before mixing treatments if unsure of the consequences.

Safety in pregnancy is somewhat disputed; parents should discuss potential risks with a trusted doctor before use.