PCOS-MEDICATION Messages for April, 2001: Thanks Dr Sam

Thanks Dr Sam - a followup question if I can

From: Joy (anonymous@obgyn.net)
Sat, 28 Apr 2001 14:50:39 -0500 (CDT)

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Hi Dr. Sam - thanks for the information. It may be that my doctor is trying to get me started on a basic dose - see how I tolerate it - and then consider raising it as needed. He only gave me enough metformin for this first month, and then I go back to him for a followup consult and a longer term prescription. Could you tell me what signs you would look for in your patient to determine if she needs to be increased from 1000 to 1500 (or possibly higher.) Is it determined through additional blood work - like another fasting insulin test - to see if levels are coming down appropriately?

Many thanks for your thoughts!

--
Joy

At Sat, 28 Apr 2001, =?iso-8859-2?q?Zalányi wrote:
>
>Hi Joy,
>
>It is alway prudent to start a med slowly and gradually, but stopping it at 1000 mg/day seems to be somewhat overcautious. I use 500mg2X a day as a starting dose with my patients and increase it after the first cycle if needed.
>
>Sam
>
>> Hi - My doctor started me on Metformin this week and I was surprised at
>> his doseage instructions cause I had not seen this sequencing posted in
>> other messages I read.  Here is what I was told:
>>
>> The goal is to get me to 1000 mg of met daily - taken in two doses (500
>> mg each dose).  To get there I do this:
>>
>> 1/2 pill daily for five days (meaning 250 mg/day for 5 days)
>> 1/2 pill twice daily for 5 days (meaning 250 mg/twice for 500 mg/day)
>> 1/2 pill three times a day for 5 days (meaning 250 mg/three times for
>> 750 mg/day)
>> 1 tablet twice a day thereafter (500 mg/twice for 1000 mg/day)
>>
>> Most posts I read speak of a total daily dosage of 1500-2000 mg
>> administered in 3-4 daily doses - but this tops out with two doses for a
>> total of 1000 mg.  My fasting insulin was 30 (higher then normal
>> certainly but lower then many I have read).  It certainly sems a
>> reasonable place to start but I am wondering if others went through this
>> "ramping up" process to get to their desired dose.
>>
>> Thanks for any input you might have
>>
>> Joy

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