T2D - Glucophage (name brand) > Metformin (generic) ?
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Thanks, @midwesterner85, @KenSmith108 , and @nvmomketo
I've brought coupons from the drug company in to my Walgreens before, when I did not have insurance (I was in between being covered by MinnesotaCare and my private health insurance) and the most they could do was knock $100 off the cost of it, so a months supply of Lantus pens was still $370.00. I cannot afford it, even with that discount. My MinnesotaCare covered almost everything, all I did was pay $1 for generic oral meds, $3 for brands, and $0 for supplies/testing/insulin. Now I have to pay almost the same as out of pocket cost for insulin even though I'm insured.
I know I can get more Relion (Novolin type) vials at $25/vial at Walmart to tide me over - I just don't like going there because it's out of my way and I also am not someone who likes to give my money that corporation, to begin with. And now I forget if it's Novolin R or N.
I make enough to pay my bills, run my business, and eat. I'm not poor, just very frugal, so the added expense is ridiculous, and I don't want to use my credit card on that stuff. I've already devoted myself to cleaning my entire home of bad carbohydrates and invested money in this WOE. And like I said, I thought I was heading in the right direction by starting a strict path to this WOL.
PS - I want you to know I finally listened to (most of) that Dr. Bernstein video while doing my chores today. Some of it was eye-opening, so thanks for that, @RalfLott1 -
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When I say most, I mean I played it all, but sort of ignored some of the answers to questions about gestational, etc. It was valuable info.0
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I hate insurance!
I have a fridge full of insulin pens, both long and fast acting that my daughter doesn't use anymore. I can't bring myself to throw them away though. Lol
Don't know anyone they could help out.1 -
I'd pay you to ship them to me LOL0
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Dr. Bernstein's latest video is on side effects of oral diabetes meds.
The final discussion is on metformin. In addition to the usual admonitions to start slowly - with a low dose of the XR version, preferably name-brand Glucophage, at the end of a meal - he also mentions the possibility of metformin affecting Vitamin B-12 levels and recommends periodic blood tests.
The metformin discussion starts around 21:00.
https://youtu.be/rc8cLPpS-h4 3 -
Please note @bjwoodzy , an interaction between statin meds, and diabetes medication, is being seen! Making the diabetes meds not work! My dad took a leap of faith and dropped his statin meds. His A1c went from 8.1 to 5.5 from last November to March of this year! I learned this after reading "Cholesterol Clarity". I'm NOT telling you to stop any medication, only telling you about new drug interactions that are being seen! Please look this up! Could help you be able to get off of some of those expensive medications! Hugs!!3
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Please note @bjwoodzy , an interaction between statin meds, and diabetes medication, is being seen! Making the diabetes meds not work! My dad took a leap of faith and dropped his statin meds. His A1c went from 8.1 to 5.5 from last November to March of this year! I learned this after reading "Cholesterol Clarity". I'm NOT telling you to stop any medication, only telling you about new drug interactions that are being seen! Please look this up! Could help you be able to get off of some of those expensive medications! Hugs!!
@Karlottap - Do you recall which statin(s) and diabetes drug(s) were involved? (Some of them might play nicer than others....)
Thx!2 -
@Karlottap - thanks, I'll look into it
I'm on Atorvastatin and Fenofibrate for cholesterol, Losartan for hypertension. I need to say that my cholesterol panel came back normal and my A1C is a few points higher than it was last May (7.9), but I have not been on any diabetes meds for awhile. My doctor said she needs me to report my BG readings to her weekly and how much insulin I'm taking, but I'm not any of it.
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@Sunny_Bunny_ - were you kidding about that? I seriously would pay to have you send them to me...depending on what type they are.0
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My dad was on Lopid, and lipitor, Januvia, and glypizide. The book doesn't mention specific medication. It's a blanket statement that says this interaction can occur with diabetes meds, and statins. The drug companies lag in telling our physicians about these interactions. Continuing the same rhetoric, selling their medications!
My advice says to watch for these potential interactions. If you are on statins, and use medication for type 2 diabetes, and have continued blood sugars that are in the high range, you may want to evaluate this for yourself!1 -
I was on Lipitor (atorvastatin) until mid-April, when I decided I didn't want the increasing debilitation of hip and knee pain. My doc was NOT happy... but my hip is functional again. I also stopped using my insulin, as it didn't bring down my BG, even when increasing doses every time they checked my A1c. (The insulin I was prescribed wasn't covered Novolin, so I asked for Humulin N and that was acceptable.) I am still on metformin 1000 x2.
LCHF has my BG going down by about 100 points, but not yet "normal", dumped the water on my legs (I have ankles!), and helped me lose 40 lbs. since April 1st.
Not sure if any of this information helps. 7 -
@Karlottap - That's a pretty potent combination. Glad your Pa was able to get his A1c under control - do you think stopping Lipitor was the key?
Even subtracting the diabetes meds from the original combo, the two cholesterol meds (Lopid and Lipitor) carry a major drug interaction warning. Apparently fibrates and statins don't always coexist peacefully.
I've searched high and low for interactions between Metformin, Crestor, and Lisinopril and not found much other than reports of unpleasant side effects. Fortunately (knock on wood), switching from Lipitor to Crestor and magnesium seems to have taken care of those nasty nocturnal leg cramps I got soon after I'd started on Lipitor.
But if there are long-term health risks, I'd sure like to know about them!1 -
Another month down, and the results are holding steady so far:
Glucophage XR, 1500mg, gives about the same BG results as generic metformin XR, 2000mg, with substantially reduced GI special effects.
In fact, I'm almost ready to start thinking about wearing white pants in public without asbestos undergarments. Never thought I'd see the day....3 -
My prescription insurance co - for no apparent reason (surprise!) - rolled over and agreed to cover name-brand Glucophage for 12 months.
It won't explain the underlying institutional reasoning, but I suspect some undetected, friendly code buried in its IT system might have played a role.3 -
Bump for recent metformin discussions.
Things are still going smoothly with Glucophage XR on my end. A huge improvement over some of the generic versions of metformin (and that's an understatement)!5 -
Here are a couple new bits of information I came across. I'll add the links if/when I find them.
- There's a recent study suggesting that taking metformin before meals (not during or after), is more effective for post-prandial BG control. While that's really surprising (assuming it's the immediate-release variety), but it does suggest experimenting with different timings of food & metformin - such as taking a metformin with a small pre-meal snack to buffer your stomach before your meal.
Of course, if it's possible to take Glucophage instead of generic metformin, so much the better, as it will reduce the amount of food buffering needed by people whose digestion has been known to ignite when fed too much metformin..... - Dr. Bernstein specifically mentioned taking Glucophage IR before a meal in one of his recent videos. This suggests the possibility of using a combination of IR and XR versions. I haven't looked at the curves for both types of metformin, but that might be an interesting thing to do before the self-experimentation starts!
3 - There's a recent study suggesting that taking metformin before meals (not during or after), is more effective for post-prandial BG control. While that's really surprising (assuming it's the immediate-release variety), but it does suggest experimenting with different timings of food & metformin - such as taking a metformin with a small pre-meal snack to buffer your stomach before your meal.
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1. An interesting new perspective on metformin/glucophage as an anti-aging agent.
(Heard during Dr. Rhonda Patrick's fascinating interview of Dr. Valter Longo on her FoundMyFitness YT channel.)
2. Another monthly teleseminar by Dr. Bernstein, another round of emphatic urging to switch away from generic metformin to name-brand Glucophage, whether or not generic metformin seems to be working for you. As he tends to say at every opportunity, the differences can be dramatic. Certainly that's been my experience so far...
In my n=1, name-brand Glucophage is still beating the pants off generic Metformin (at least the generic I was taking before I switched).
Highlights:- 1000-1500mg Glucophage is more effective for keeping BG down than 2000mg of generic Metformin.
- Imodium requirements are down to 1-3 per day.
Approx. effective cost per month:- Glucophage - $22 + Imodium $3 = $25
- Generic met - $10 + Imodium $10 = $20
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Does anyone know:
- whether the same holds true for other generic - name-brand combinations, such as anti-hypertension medications or statins?
- are there reliable web sites that publish reviews of generic equivalents? Is the FDA a good source of information?
Thank you.2 -
KetoTheKingdom wrote: »Does anyone know:
- whether the same holds true for other generic - name-brand combinations, such as anti-hypertension medications or statins?
- are there reliable web sites that publish reviews of generic equivalents? Is the FDA a good source of information?
Thank you.
Generic are supposed to be the same active ingredient as name brand. Metformin is used by so many people and its results shared in so many fora that a pattern for less reliability of the generic form emerged.
I know there is a site where users can share their perception and side effects of the medication they take but I can't search for it right now.
I trust the FDA when they say something is bad, not so much when they say it's safe.
::flowerforyou::2 -
KetoGirl83 wrote: »KetoTheKingdom wrote: »Does anyone know:
- whether the same holds true for other generic - name-brand combinations, such as anti-hypertension medications or statins?
- are there reliable web sites that publish reviews of generic equivalents? Is the FDA a good source of information?
Thank you.
Generics are supposed to be the same active ingredient as name brand. Metformin is used by so many people and its results shared in so many fora that a pattern for less reliability of the generic form emerged.
I trust the FDA when they say something is bad, not so much when they say it's safe. Bingo.
::flowerforyou::
@KetoGirl83 and @KetoTheKingdom. Here's my armchair take on it.....
Most of the metformin-bashing I've seen has been aimed at the whole ball of wax, not merely the generic - possibly because Glucophage has been off-patent for so long that most folks don't have a basis for comparison. Dr. Bernstein, however, can compare the two across a large number of patients.
For statins and blood pressure meds, I think the scene is a little different. If there are passable substitutes, many of our US insurance policies won't cover drugs under patent without several rounds of mud-wrestling. And of course, win or lose, the pig still enjoys it......
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I took Metformin 500mg for 2 weeks and I thought I was dying. Rushing to the bathroom, gas pain that was unbearable. Stopped that and a week later started Metformin XR 500mg. Been taking that for 1.5 weeks and I am having muscle pain. First I thought it was electrolytes, I'd been slacking on potassium a bit, added another cup of broth, upped my magnesium. Just today it hit me - it's gotta be the med. I think I'm over trying medications.
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Rainqueen77 wrote: »I took Metformin 500mg for 2 weeks and I thought I was dying. Rushing to the bathroom, gas pain that was unbearable. Stopped that and a week later started Metformin XR 500mg. Been taking that for 1.5 weeks and I am having muscle pain. First I thought it was electrolytes, I'd been slacking on potassium a bit, added another cup of broth, upped my magnesium. Just today it hit me - it's gotta be the med. I think I'm over trying medications.
1. Start with name-brand Glucophage XR, 500mg only, for as long as necessary to have tolerable GI effects.
2. Increase your dose of Glucophage XR to 1500 mg gradually, only as tolerated.
3. Spread the Glucophage XR over the course of the day. It takes 4-8 horse to reach peak blood levels.
4. Evaluate your BG again after you've been on 1500mg for a few weeks.0 -
Not sure they will ever prescribe that. I asked for it last time and she gave me the metformin XR. Next appointment isn't until February. Hopefully I won't even need it by then.0
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Another recommendation (other than Dr. Bernstein) for name-brand Glucophage XR to relieve GI distress from generic metformin.
http://www.diabetesincontrol.com/sometimes-you-gotta-use-the-brand-name-metforminMany of our patients have intolerable GI side effects from metformin. We use ER to try to decrease these, but that doesn’t always work. If they have these symptoms, I recommend they take it slow and take it after they eat. If they still have problems, I recommend they break the tablet to 250mg, even though the label may say one shouldn’t break the tablet. It still works. When it works, I recommend they increase the dose very slowly. Once there are no further GI side effects for a week, then increase to a whole tablet. Then in one week, increase by 1/2 tablet. This continues until they reach max dose for management with little or no untoward side effects.
There are those patients who just can’t tolerate the generic form. In that case I recommend Glucophage XR (Brand). For the most part, we recommend it as above and most patients do well. Some insurance companies will cover it, no prior auth needed. Some will need a prior auth. And, some won’t cover at all, but most of my patients have found the price to be reasonable and are willing to pay more for it.
Express Scripts reported re Valiant’s price gouging: One product in particular, Glumetza® (metformin HCL extended-release tablets), experienced a price jump greater than 800% in 2015. We no longer recommend Glumetza due to the cost…they did us wrong by raising the price.
Lessons Learned:- When patients have untoward GI side effects from metformin, lower the dose, and recommend to take after a full meal.
- It usually works to break the tab, even though it is not recommended to do so.
- Increase slowly.
- When patients still don’t tolerate, change to Glucophage XR Brand and slowly increase, still after a full meal.
- Be aware of the price of the medicine. Ask pharmacist to let patient know out-of-pocket price before filling. Patient can then decide whether they want to pay for it.
- Be aware of price gouging of some pharmaceutical marketing companies, and decide whether or not you want to use their products. These costs affect us all.
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Bumping for newbies.0
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Dr. Bernstein's most recent admonishment that metformin generics "are not nearly as potent" as brand Glucophage (starts around 35'30"):
https://youtu.be/A1QyXWy1_SQ 2 -
Dr. Bernstein's most recent admonishment that metformin generics "are not nearly as potent" as brand Glucophage (starts around 35'30"):https://youtu.be/A1QyXWy1_SQ
Omg! You just reminded me that I missed the teleseminar! I think it was yesterday! I asked a question on it I was hoping he would answer! Do you know if they put those up so you can still listen afterward?0 -
Sunny_Bunny_ wrote: »Dr. Bernstein's most recent admonishment that metformin generics "are not nearly as potent" as brand Glucophage (starts around 35'30"):https://youtu.be/A1QyXWy1_SQ
Omg! You just reminded me that I missed the teleseminar! I think it was yesterday! I asked a question on it I was hoping he would answer! Do you know if they put those up so you can still listen afterward?
I think this video is the January teleseminar, since it was just posted and he announces February's date & time at the end.
There's a lot of T1D discussion (and the obligatory, gratuitous jab at LCHF, which he seems to think entails LP.....)
My Qs have never gotten on; hope yours met a better fate!1 -
@RalfLott - I took the plunge. I picked up my Rx last night. I know the pharmacy called me when my Doc sent it in, and read the description as, "Patient prefers brand name Glucophage if cost is reasonable" and they wanted to tell me what the 90 day price was...I opted to do a 30 day Rx to start. It's far more expensive than Metformin, but if I can avoid the digestive drama I'll be good. I took it last night after dinner, and haven't yet exploded, though it's been too short a time to tell.
I had quite forgotten about how much I will need to supplement the B12. My levels had dropped below 300 WITH supplementation before when I was on Met, and I have a few permanent nerve damage spots that surfaced before I had any idea what was going on... Thanks for that reminder...
I am concerned, though, after reading the insert before taking the med last night, about the warnings about kidney strain. My kidney (basic) tests have been getting progressively worse, though not in the "really get worried" category yet, and I've been struggling to figure out what the HECK is up with my dehydration issues (which also are warned to massively worse with Met)... I don't see how this is going to be a good thing -- UNLESS the kidney and dehydration issues have been related to a slowly elevating blood glucose situation that had not yet reared it's ugly head, which I've started to suspect.
Frankly, the whole situation has me concerned, but I know a lot of that is my own mental F....er...hiccups... Until I get my thyroid better controlled, I'm terrified to drop my carbs all that much... And I know I overthink a lot of things... But, mainly I just wanted to say:
Thank you to @RalfLott @cstehansen @Sunny_Bunny_ @genmon00 @bjwoodzy @Dragonwolf and all you others who've been keeping the topic of blood glucose levels, T2D, IR, all your struggles, and all related discussions kept up front and center on this forum - along with all the amazing links you've shared out. It really was a wakeup call for me to get out in front of this whole situation, because I'd been kind of in that denial/feedback loop of congratulating myself for not being a diabetic yet, and learning to be thankful that so far my obesity was protecting me from the progression of the blood sugar issues, and thinking that I was okay so far, the whole "it won't happen to me" thing... I was deluding myself, and I thank you for not allowing me to continue lying to myself that I was "under control."
Because even though I need to get my thyroid leveled out before dropping my carbs much more, I can stop at the ongoing (silent) background damage to everything by getting back onto this medication... I'm still missing one of the anchor pieces to my "life/health" puzzle, but this is one step further in refusing to let it get even worse before leveling out or improving...
My sincerest thanks.2
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