# just taken my FIRST Metformin 500mg!



## cheddar (Dec 12, 2011)

Hi ALL
I have been newly diagnosed type 2 and this morning had a perscription from my gp for 500 mg once a day. I've just taken it after my main evening meal. Wondering what to expect.
 I have sorted out a different kind of eating regime which has enabled me to lose some weight.
 My Gp has made an appointment with the diabetic nurse, for a chat. Also blood tests for chloresterel and blood pressure with another nurse. Then I need to see my GP again.
 He has suggested he may put me on statins and ramipril to prevent the occurence of strokes and heart attacks.
 I am very apprehensive to go on even more tablets.
 I have been Hypothyroid (75mg Levothyroxine) for 3 years.
 Anyone else in this situ?


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## Dizzydi (Dec 12, 2011)

cheddar said:


> Hi ALL
> I have been newly diagnosed type 2 and this morning had a perscription from my gp for 500 mg once a day. I've just taken it after my main evening meal. Wondering what to expect.
> I have sorted out a different kind of eating regime which has enabled me to lose some weight.
> My Gp has made an appointment with the diabetic nurse, for a chat. Also blood tests for chloresterel and blood pressure with another nurse. Then I need to see my GP again.
> ...



Hi cheddar, your at the start of a long journey with the d and getting it under control and to get yourself feeling well. Once you have seen the dsn and had more bloods done your gp will be able to decide for definate on the statins and ramipril. I can't give any advice or insight on these as I don't take them. 

Good luck with the change in eating and keep asking questions as they arise. This place is brilliant if you need, help or advice.


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## everydayupsanddowns (Dec 12, 2011)

Hope the metformin behaves for you. Some folks find it quite unsettling on the tum in the first few weeks, but often these symptoms pass. 

Adjusting timing in relation to food can help (ask some of the T2s as I'm not sure of details!). If things get uncomfortable there are 'slow release' formulations that can be tried.

Bear in mind too that it needs to 'ramp up' over a few weeks before it is fully effective.

Let us know what dietary advice you have been given and some of the T2 old hands can offer the benefit of their experience.

In the meantime you might want to pick up a copy of Gretchen Becker's Type 2 Diabetes - The First Year which is very well regarded by forum members : http://www.amazon.co.uk/gp/product/...mp=2506&creative=9298&creativeASIN=1841198048


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## Vicsetter (Dec 12, 2011)

Hi, sounds like fairly standard stuff.  I see you are retired so are in that 'at risk' group.  the ramipril is primarily for high blood pressure so see what your blood pressure reading is (Blood Pressure ideal - between 90/60 and 120/80).  The statin is to lower cholesterol and it's use is disputed (with some on here and elsewhere).  I would try and get any new drug regime phased in so that any side effects can be laid at the door of a particular drug.
Metformin usually starts at 500mg twice a day and increased at 500mg a week to it's maximum.  The main side effect is wind/nausea although not everyone suffers and there is a slow release version (glucophage SR) available.  You might find it better taking it before the meal rather than after.
Have you had an HBa1c yet and what was the reading?


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## SimplesL (Dec 12, 2011)

cheddar said:


> Hi ALL
> I have been newly diagnosed type 2 and this morning had a perscription from my gp for 500 mg once a day. I've just taken it after my main evening meal. Wondering what to expect.
> I have sorted out a different kind of eating regime which has enabled me to lose some weight.
> My Gp has made an appointment with the diabetic nurse, for a chat. Also blood tests for chloresterel and blood pressure with another nurse. Then I need to see my GP again.
> ...



Hi Cheddar

I started on 2 500g metformin (morning & evening after meals) Sept 10 with the wise words of my GP ringing in my ears: " don't worry if you get a bit of gut rot". Anyway I didn't get anysuch thing. We all react differently I found better to take just before I ate mainly so I remembered to take them. I also take 10mg of a statin.

I then went up to 4 500g meformin & had a bit of a reaction; not enough to cause any embarassment but thankful we have 2 loos in the house! This settled and only lasted a short time. Now back to only 2 500g metformin which I take after breakfast & that's me done for the day.

There are sloe release metformin tabs available so if you have any issues which don't clear up then ask GP to switch you.

Good luck


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## cheddar (Dec 12, 2011)

Vicsetter said:


> Hi, sounds like fairly standard stuff.  I see you are retired so are in that 'at risk' group.  the ramipril is primarily for high blood pressure so see what your blood pressure reading is (Blood Pressure ideal - between 90/60 and 120/80).  The statin is to lower cholesterol and it's use is disputed (with some on here and elsewhere).  I would try and get any new drug regime phased in so that any side effects can be laid at the door of a particular drug.
> Metformin usually starts at 500mg twice a day and increased at 500mg a week to it's maximum.  The main side effect is wind/nausea although not everyone suffers and there is a slow release version (glucophage SR) available.  You might find it better taking it before the meal rather than after.
> Have you had an HBa1c yet and what was the reading?



HI Thanks for your reply. I'm having bloods & BP done next week. I'm very wary of taking Ramipril. On research it seems to carry many side effects. Also it is a "cheaper" BP drug on the market.(Maybe why it's been suggested) Will find out HBa1c then and let you know! Regards.


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## Northerner (Dec 12, 2011)

cheddar said:


> HI Thanks for your reply. I'm having bloods & BP done next week. I'm very wary of taking Ramipril. On research it seems to carry many side effects. Also it is a "cheaper" BP drug on the market.(Maybe why it's been suggested) Will find out HBa1c then and let you know! Regards.



I had side effects from ramilpril, mainly nausea, I was changed to a different med - candesartan, so don't be afraid to report adverse reactions


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## GlucoseGary (Dec 12, 2011)

Hi Cheddar from a fellow Devonian newcomer (first 3-month checkup tomorrow!). 

I'm also on metformin & statins. Metformin upset my innards for a couple of weeks but I barely notice it now, though I take it early in the day as my sleep got disturbed when I started it. Statins were absolutely fine for me but my Dad didn't get on with them. You'll see the phrase "YMMV" (Your Mileage May Vary) an awful lot around Diabetes discussions!

Anyway, good luck with it all. You've found a great resource here where people are supportive, informative and almost whatever happens to you, someone here will have got through it already.


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## Graeme (Dec 13, 2011)

Hi Cheddar & Welcome

I'm another relative newcomer to Type 2 & High Blood Pressure.  I've been on the Metformin 2 x 500mg a day, and quickly got into the routine of one just before breakfast & one just before my evening meal, trying to keep them at the same times.  I've been lucky and not had much side effects from the met at all.

I have just introduced a BP med Perindopril 1 x 4mg a day, and take that first thing when I get up, must admit I have been getting a few effects from that, particularly dizziness & sore heads but I'm sure it will calm down.  No idea whre that sits with other BP drugs, although my Dad has been through a few over the years and he hasn't had that one (don't know if thats a good or bad thing!)

Anyway, good luck with the Metformin.

G


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## Jennywren (Dec 13, 2011)

Metformin made me vomit and the feeling of nausea was horrid  ,but i am just one case  and  i know a lot of people have really good results with it especially on here .Hope you get your meds sorted soon


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## margie (Dec 13, 2011)

Hello cheddar and welcome to the forum

Good Luck with the Metformin. If it causes you problems lasting more than a couple of weeks ask for the slow release form Glucophage. It can cause problems too but is tolerated better by some. If you do take the slow release your must swallow it whole.

Metformin in recent years has had some good press in relation to anti-inflammatory action and there have been reports that it may help to protect against breast cancer

http://share.breastcancercare.org.uk/forum/metformin-fights-breast-cancer-for-pennies-t29993.html


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## cheddar (Dec 13, 2011)

Jennywren said:


> Metformin made me vomit and the feeling of nausea was horrid  ,but i am just one case  and  i know a lot of people have really good results with it especially on here .Hope you get your meds sorted soon [[I
> 
> 
> 
> ...


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## HelenM (Dec 13, 2011)

Ramipril is an ACE (angiotensin-converting enzyme . In addition to lowerering BP this type of drug  may helpprevent, delay or  slow the development of kidney disease.  It's common practice for doctors to put people with diabetes on  low doses of one of these drugs to 'protect the kidneys.' even when their blood pressure is normal.


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## cheddar (Dec 15, 2011)

Hi ALL I am now on day three. Symptoms are gripeing pains in my stomach behind my belly button and feeling a bit nauseous. How long does this last and is it the norm! ? I can except that I will have some side effects.  Could taking peppermint oil relieve the symptoms?


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## SimplesL (Dec 15, 2011)

cheddar said:


> Hi ALL I am now on day three. Symptoms are gripeing pains in my stomach behind my belly button and feeling a bit nauseous. How long does this last and is it the norm! ? I can except that I will have some side effects.  Could taking peppermint oil relieve the symptoms?



Poor you

I didn't have too many problems. Did you build up going onto metformin. I took just 1 tablet initailly then went to 2 after about a week. When they upped my dose in March again I phased it in. Thankfully back to 2 a day.

It may be early days but as you have gripping pains why don't you call your GP surgery there is probably a duty doctor who can advise you if you can't speak to your own.

In my surgery you can leave a message & the duty doctor or your own calls you back inbetween patients or at the end of surgery depending on how urgent your need is. Possible they may want you go for a while longer; but they should be able to advise on use of peppermint oil. 

Take care
Lynne


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## karinagal (Jan 23, 2012)

Hi! I've been prescribed Metformin, I'm on 1 tablet a day. Started taking it today so too early to tell if any side effects. My doctor has not mentioned increasing my dose - is it normal to be on just one tablet a day?


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## imtrying (Jan 23, 2012)

karinagal said:


> Hi! I've been prescribed Metformin, I'm on 1 tablet a day. Started taking it today so too early to tell if any side effects. My doctor has not mentioned increasing my dose - is it normal to be on just one tablet a day?



Hi Karina,

I'm sure someone will be along shortly with a definitive answer, but I believe you start on one tablet a day and then increase later.

good luck with it.


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## Mark T (Jan 23, 2012)

karinagal said:


> Hi! I've been prescribed Metformin, I'm on 1 tablet a day. Started taking it today so too early to tell if any side effects. My doctor has not mentioned increasing my dose - is it normal to be on just one tablet a day?


Give it a week I think, but you might turn out to be one of those who gets very mild side effects.

From what I recall it takes a few days to get into your blood stream and something like 2 weeks to a month to have an impact on your BG.

Don't be surprised if they do up the number you take, but I seem to recall that there have been other people only on a single tablet.


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## mcdonagh47 (Jan 23, 2012)

karinagal said:


> Hi! I've been prescribed Metformin, I'm on 1 tablet a day. Started taking it today so too early to tell if any side effects. My doctor has not mentioned increasing my dose - is it normal to be on just one tablet a day?



The standard dose that most T2s seem to be on is 2000 mg.
1500 mg is said to be the minimum effective dose i.e. There is not much to be gained in terms of HbA1c from doses below that.

Because of tummy troubles Met is usually introduced at a low dose (500) and gradually titrated upwards through 1000 to 1500 or 2000.


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## Mark T (Jan 23, 2012)

mcdonagh47 said:


> The standard dose that most T2s seem to be on is 2000 mg.
> 1500 mg is said to be the minimum effective dose i.e. There is not much to be gained in terms of HbA1c from doses below that.
> 
> Because of tummy troubles Met is usually introduced at a low dose (500) and gradually titrated upwards through 1000 to 1500 or 2000.


It?s interesting what you write about the minimum effective dose ? I?m still on 1000mg/day.  When I was discussing with my DSN about my HbA1c and I said I had improved it with diet and exercise she was very quick to say ?don?t forget the medication, that?s played an important part?.

However, I?ve improved by 4.1% (9.9% down to 5.8%) and I believe that is beyond the capabilities of metformin even at its highest dose!  So if I?m not taking the effective dose then my original statement must have been actually fairly accurate.

(there are lots of other reasons why metformin isn?t a bad thing to be on if you can tolerate it, so I?m not looking to come off it right now)


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## mcdonagh47 (Jan 23, 2012)

Mark T said:


> It?s interesting what you write about the minimum effective dose ? I?m still on 1000mg/day.  When I was discussing with my DSN about my HbA1c and I said I had improved it with diet and exercise she was very quick to say ?don?t forget the medication, that?s played an important part?.
> 
> However, I?ve improved by 4.1% (9.9% down to 5.8%) and I believe that is beyond the capabilities of metformin even at its highest dose!  So if I?m not taking the effective dose then my original statement must have been actually fairly accurate.
> 
> (there are lots of other reasons why metformin isn?t a bad thing to be on if you can tolerate it, so I?m not looking to come off it right now)



Hi Mark 

The figures I quoted are of course average/general. An individual such as yourself might repond better or worse to Metformin than the average. I think you must be right overall - your Lifestyle changes have done most of the work but metformin and lifestyle changes must surely complement and enhance each other ?

This is what rxlist has to say ...
"In general, clinically significant responses are not seen at doses below 1500 mg per day. However, a lower recommended starting dose and gradually increased dosage is advised to minimize gastrointestinal symptoms."

It also defines the max dose as 2500 
http://www.rxlist.com/glucophage-drug/indications-dosage.htm

I remember researching the effective doses of metfomin about eight years ago. But I can't find the refs to that. The research findings were saying that HbA1c was improved by something like 0.2 on 500 mg , by 0.6 on 1000 and by 1.2  on 1500 in general for the average T2. There were further gains at 2000 but only a further small gain in HbA1c at 2500.
It is on those kind of findings that the NICE Guidelines on Metformin are based.


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## pippaandben (Jan 24, 2012)

I started on one 500mg Metformin and moved to two a day after 3 months. After another 3 months am now on 2x1000 mg a day which I take before breakfast and before my evening meal. Flatulence has been my only problem!! For past 2 months have been on Diamicron starting at one 30g daily and now up to 3 a day.
I have also now been on statins for a month (Simvastatin 40mg) and have had no problems at all. I am also on 100mg thyroxin and have been for about 5 years. 
Perhaps I am just one of the lucky ones - just feel I am becoming a pill popping junkie but hell - it's keepng me alive. And in myself I now feel absolutely fine.
Good luck on your journey and always come here to ask any questions.


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## Jumbly (Jan 24, 2012)

Just picked up my first prescription from the doctor today - Metformin, Ramipril and Simvastatin - I'll be too full to eat after that lot!

Pills for diabetes, cholesterol and high blood pressure (188/130)... So, it looks like we're in the same boat.


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