PCOS Messages for June, 2002: Re: Some ?'s about Glucophage

Re: Some ?'s about Glucophage

From: Sonnet (anonymous@obgyn.net)
Tue, 11 Jun 2002 22:19:03 -0500 (CDT)

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Reply: Eve: "Re: Some ?'s about Glucophage"

Lactic Acidosis is very, very, very rare. Almost all women with PCOS can take Metformin safely. The only thing that would cause concern is if you already had a problem that would predispose you to lactic acidosis.

This is from the Bristol-Myers-Squibb prescribing info for Glucophage:

"Lactic Acidosis:

Lactic acidosis is a rare, but serious, metabolic complication that can occur due to metformin accumulation during treatment with GLUCOPHAGE or GLUCOPHAGE XR; when it occurs, it is fatal in approximately 50% of cases. Lactic acidosis may also occur in association with a number of pathophysiologic conditions, including diabetes mellitus, and whenever there is significant tissue hypoperfusion and hypoxemia. Lactic acidosis is characterized by elevated blood lactate levels (>5 mmol/L), decreased blood pH, electrolyte disturbances with an increased anion gap, and an increased lactate/pyruvate ratio. When metformin is implicated as the cause of lactic acidosis, metformin plasma levels >5 µg/mL are generally found.

The reported incidence of lactic acidosis in patients receiving metformin hydrochloride is very low (approximately 0.03 cases/1000 patient-years, with approximately 0.015 fatal cases/1000 patient-years). Reported cases have occurred primarily in diabetic patients with significant renal insufficiency, including both intrinsic renal disease and renal hypoperfusion, often in the setting of multiple concomitant medical/surgical problems and multiple concomitant medications. Patients with congestive heart failure requiring pharmacologic management, in particular those with unstable or acute congestive heart failure who are at risk of hypoperfusion and hypoxemia, are at increased risk of lactic acidosis. The risk of lactic acidosis increases with the degree of renal dysfunction and the patient’s age. The risk of lactic acidosis may, therefore, be significantly decreased by regular monitoring of renal function in patients taking GLUCOPHAGE or GLUCOPHAGE XR and by use of the minimum effective dose of GLUCOPHAGE or GLUCOPHAGE XR. In particular, treatment of the elderly should be accompanied by careful monitoring of renal function. GLUCOPHAGE or GLUCOPHAGE XR treatment should not be initiated in patients þ 80 years of age unless measurement of creatinine clearance demonstrates that renal function is not reduced, as these patients are more susceptible to developing lactic acidosis.

In addition, GLUCOPHAGE and GLUCOPHAGE XR should be promptly withheld in the presence of any condition associated with hypoxemia, dehydration, or sepsis. Because impaired hepatic function may significantly limit the ability to clear lactate, GLUCOPHAGE and GLUCOPHAGE XR should generally be avoided in patients with clinical or laboratory evidence of hepatic disease. Patients should be cautioned against excessive alcohol intake, either acute or chronic, when taking GLUCOPHAGE or GLUCOPHAGE XR, since alcohol potentiates the effects of metformin hydrochloride on lactate metabolism. In addition, GLUCOPHAGE and GLUCOPHAGE XR should be temporarily discontinued prior to any intravascular radiocontrast study and for any surgical procedure."

At Tue, 11 Jun 2002, Eve wrote: >
>Hello, I wanted to know if anyone is as concerned as I am with taking
>glucophage. I just learned since I am new to taking this medication
>that I have the risk of getting lactic acidosis or something like that.
>I have a cousin that died of that very thing in 2000. He had a family
>disease that can do that to you. I am very scared now that I read up on
>glucophage. Can anyone let me know if it is very rare and I have
>nothing to worry about, or some advice would be greatly appreicated.
>Thank you so much for responding. Also I have finally started a period
>since I started taking provera again. It has been almost a year and a
>half since I have had one! I am soo excited! My friends laugh at me but
>hey it is a good sign to me if i do get one :) My next goal is to get
>pregnant and try to have a baby! Any luck would do me good. Thank you
>all!
>
>--
>Peace and Love ~Eve~
>

--
email always welcome: sonnet_fitz@hotmail.com

Next message: Belle: "Jane Adams!!!"
Previous message: Belle: "Re: Diane 35 and Metformin, PCOS --worried a lot"
In reply to: Eve: "Some ?'s about Glucophage"
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Reply: Eve: "Re: Some ?'s about Glucophage"

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