Re: Some ?'s about Glucophage
From: Eve (anonymous@obgyn.net)
Wed, 12 Jun 2002 10:42:46 -0500 (CDT)
I want to thank you all for letting me know the facts, it helps me so
much. I am so happy I found this board and all of you. I know I dont
write much but I do read most of the posts to keep informed as much as
possible. Thank you all once again!!
P.S. The disease my cousin's family has is only on the mothers side and
I am through the fathers side so it has no connection to me.
At Tue, 11 Jun 2002, Sonnet wrote:
>
>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."
>
>>
>--
>email always welcome: sonnet_fitz@hotmail.com
>
--
Peace and Love ~Eve~
unicornluv76@yahoo.com
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