Re: Glucophage Side effects - Long
From: Jennifer (anonymous@obgyn.net)
Thu, 23 Mar 2000 07:54:21 -0600 (CST)
Paula,
I did not have time to read all the articles that you posted yet, but
thank you.
You should know that a percentage has nothing to do with the number of
people. If 10 percent of the people taking a drug have reactions to it,
then it is 10 % no matter if there are 10 people taking it or a million
people taking it. The percentage stays the same. The percentage of
people who would have reactions to Metformin would be consistant, but
the actual number of people would be larger (not smaller) since more
people are taking it.
At Wed, 22 Mar 2000, Paula wrote:
>
>I know that met and glucophage are the same meds...
>I take 2000 mg of met a day as part of my diabetes
>treatment.
>
>The point I was trying to make here is that Met has
>problems too just like Rezulin does. and that the only
>reason the percentages are smaller on the met is that
>more people are taking it.
>
>I've included part of a post relating to some research
>I did on met a couple weeks ago a couple weeks
>ago when someone on another list said that met hadn't killed
>any one.
>
>---begin quote -----
>However, when Kelley made the statement above I started searching
>to see how many people have died since Metformin was introduced
>in 1995. I couldn't find a specific number from the FDA web site and
>I also queried Dr. O. by e-mail. His response is below:
>
>"The FDA, of course, knows - but a lot of info is also in
>the medical literature. At least 50 deaths have been
>reported, but since millions more people are taking
>Metformin than Rezulin, the overall percentage is much
>smaller.
>
>Metformin is not an innocuous drug."
>
>Then I went and did bit of searching on
>metformin on Medscape and NEJM and found
>the following articles(If the URLS don't
>work properly you need to join them at
>the line break)
>
>http://endocrine.medscape.com/ABFP/JABFP/1998/v11.n03/fp1103.10.huli/fp1103.
>10.huli-01.html
>
>http://www.nejm.org/content/1998/0338/0004/0265.asp
>The above article cited the incidence of lactic Acidosis
>(the most talked about side-effect of met on the PCOlists) as
>being 5 per 100,000. The Authors cited 47 cases of lactic
>Acidosis induced by the use of metformin
>of which 20 people (or just less than 50% of the reported
>cases died. You can see the same numbers by clicking on the
>reference to Table 1 in the first paragraph)
>
>http://www.nejm.org/content/1996/0334/0024/1611b.asp
>This editorial talked about Metformin-Associated Mortality
>in U.S. Studies. It described the studies and stated taht
>1 person died in the closed clinical trials while 6 died in
>the open trials.
>
>http://www.medscape.com/adis/DTP/1999/v14.n05/dtp1405.05/dtp1405.05-01.html
>
>http://www.medscape.com/medscape/CNO/1999/EASD/EASD-04.html
>
>The last article above was very good and discussed a number of
>therapies. The article was very interesting because it had this
>to say about to say about metformin (Note: Phenformin was a
>diabetes drug in the same family as Metformin and I believe was
>banned because it caused a higher incidence of lactic acidosis):
>
>"Metformin (and previously phenformin) enjoys widespread use in the United
>Kingdom, with metformin being the drug of choice in overweight type 2
>diabetics in the UK (it was approved in the United States in 1995). The
>investigators analyzed an electronic database (DARTS/MEMO) of diabetic
>patients in Tayside, Scotland, where out of a total population of
>approximately 350,000 people, roughly 7900 individuals had diabetes (2.3%
>prevalence) and 89% of those had type 2 diabetes. The objectives of this
>study were to examine the pattern of metformin use in Tayside during
>1993-1995 and to determine the incidence of coexisting conditions that would
>contraindicate metformin use in those patients.
>
>Analysis of the data revealed that approximately 26% of type 2 diabetics in
>the population (1847 patients) were undergoing treatment with metformin. Of
>these patients, 3.5%, 4.1%, and 4.7% patients experienced acute myocardial
>infarction, heart failure, and renal failure, respectively. Similar to the
>experience in Germany, lactic acidosis was rarely observed (one episode in
>4600 patient-years). A significant finding of this analysis was that
>although 25% of patients on metformin therapy had a coexisting condition
>that was classified as a contraindication to its use (especially renal
>impairment), treatment was continued. Dr. Emslie-Smith concluded that
>adherence to metformin prescribing guidelines is poor. Considering the
>widespread use of this drug in type 2 diabetes, a critical re-examination of
>metformin's safety needs to be undertaken."
>
>and
>
>"
>Summary: Implications for Clinical Practice
>The potential of increased cardiovascular risk for patients on
>sulfonylurea-metformin combination therapy needs to be considered during
>diabetes management.
>
>Careful attention should be paid to continuing metformin treatment in
>patients with coexisting conditions that are contraindications to its use."
>
>So my question after reading this is Why aren't they scrutinizing Metformin
>use if it can cause lactic acidosis (a condition that has a morbidity rate
>of
>50%), acute myocardial infarction, heart failure, and renal failure?
>If you are saying that rezulin shouldn't be used because it can cause liver
>failure shouldn't you be saying the same about met since it has caused
>deaths too?
>
>----End Quote-----
>
>I guess my logic is a person is a person and if they are scrutinizing
>one drug because of the deaths it has caused in the few years it has
>been released why aren't they scrutinizing other drugs that have
>caused almost as many deaths??? Just because the percentages are smaller
>doesn't mean that there aren't people grieving because of the lives lost
>from taking the medication.
>
>For the person who asked about lactic acidosis, this means that the
>lactate levels in your blood greater than 5 mmol/L, you have a
>decreased blood pH, and you have an electrolyte disturbance. It
>makes it so that your liver and kidneys can't clear it out of your
>system if I was understanding the Patient insert correctly.
>
>Paula
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