Metformin
Options
genmon00
Posts: 604 Member
Hello my fellow T2ds or pre-Ds! Having a wierd issue with metformin... ok I've been taking it forever and is the only med I'm using to help with bs control. Now, I used to get my rx filled at this one pharmacy for a couple of years but they moved to an out of the way place of town so I changed my rx to Costco. I picked up my rx on Monday but since then every time I take my evening dose, after about an hour I start to get sharp stomach pains, kind of like gas pains sorry TMI lol. It keeps me up, off and on at night. Do you think costco makes a different form of met? Has anyone experienced this before? TIA!
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I bet it is the generic made by a different vendor. It is different in some way and you can tell. I have not had this experience, but I can believe it is valid and not just something else.1
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Absolutely, the manufacturer can be different. Even at Costco, you should be able to request the information. @RalfLott has some experience with knowing the different products in the "inactive ingredients" section. The manufacturer "should" be on your label, but if it's not, you can call and request the info, as well as from your old pharmacy. If Costco can't order the one you've been using, might be worth seeing if the old pharmacy can do mail order for you or something.
EDITED TO ADD: For me, it's often dyes or sweeteners that do that to me. The bulking agent is another possible red flag.2 -
Is your evening dose your only dose? If not, you might also look at what foods you're pairing with that dose. My biggest triggers with generic Met were dairy and sugar. If you're having more of something with an evening meal, it might be related, but even then, it's still likely to be a slight difference in the inactive ingredients.2
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FWIW, my metformin is made by Zydus.1
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Sad to say, I think it's a matter of trial and error. Some of the stuff works like a charm, some of it like gunpowder.
Dr. Bernstein is pretty emphatic about switching to brand Glucophage XR, if you can swing it.
http://community.myfitnesspal.com/en/discussion/10394798/t2d-glucophage-name-brand-metformin-generic
I've been the mouse in the maze with a couple different prescription carriers; the key to finding the exit was having my doctor fill out their bloody forms using the magic words, "Multiple generic versions of the product could not be tolerated and created a health risk from their side effects."
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For reference, if anyone cares, my brand named Glucophage is manufactured by BMS. Dose is XR 500 mg.0
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<refresh> for new members0
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@RalfLott - have you had any success in going through the different generic formularies yet?0
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KnitOrMiss wrote: »@RalfLott - have you had any success in going through the different generic formularies yet?
Howdy. I haven't had the need yet, as the brand Glucophage is still (barely) within my flex account budget.
But if you're interested, I can get started early. 0 -
I was just curious. I'm still waiting with bated breath to see if the exception request my doc sent through will be viable for my next refill...0
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KnitOrMiss wrote: »I was just curious. I'm still waiting with bated breath to see if the exception request my doc sent through will be viable for my next refill...
If my experience is typical, daily follow-up calls may be necessary.
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Well, I'm with BCBS. My doc's office just notified me last week that they sent the appeal on my behalf. I figure I'll give them a couple days to make sure it's processed, and then I'll start the nagging/calling process. But thanks for the advice!0
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Gotcha. BCBS also has your prescription coverage?
Note that BCBS covers ketone test strips for diabetics.....0 -
Yes, Options plan for both Medical and Rx coverage... I pay $30.18 right now for 30 pills of Gluco. That's the different between the cost of the generic and brand name coverage ($25). When the # of pills doubled, so did the cost, as it's a per pill cost over the brand name coverage when generic available, etc. So, when this goes through as approved, I'll pay $25 for the update 2 pills a day/60 pill Rx, theoretically. That's the goal. Metformin is in the $10 ish range...I don't think # of pills/dosage makes much difference there.
EDITED TO ADD - I'm barely prediabetic, @RalfLott . It got added to my chart recently, with a fasting glucose of 78, A1C of 5.4%, and insulin of 7.8. Still don't know why it was added.0 -
KnitOrMiss wrote: »Yes, Options plan for both Medical and Rx coverage... I pay $30.18 right now for 30 pills of Gluco. That's the different between the cost of the generic and brand name coverage ($25). When the # of pills doubled, so did the cost, as it's a per pill cost over the brand name coverage when generic available, etc. So, when this goes through as approved, I'll pay $25 for the update 2 pills a day/60 pill Rx, theoretically. That's the goal. Metformin is in the $10 ish range...I don't think # of pills/dosage makes much difference there.
EDITED TO ADD - I'm barely prediabetic, @RalfLott . It got added to my chart recently, with a fasting glucose of 78, A1C of 5.4%, and insulin of 7.8. Still don't know why it was added.
Hmm. If your fasting glucose is 78 but your A1c is 5.4 (average BG of around 115 per http://rajeun.net/HbA1c_glucose.html), theoretically, you'd at least be pre-diabetic, because your BG would be running higher than 115 enough of the time to pull your average up.
But that assumes that A1c is a reliable test, and there are all sorts of factors that can distort the A1c result. Frequent spot BG testing yields better information.0 -
What should the spot BG be? How many hours post eating? My dr swears I'm nowhere close to diabetes, yet my numbers are worse than Knit's (and I'm already on the max dose of metformin.)1
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What should the spot BG be? How many hours post eating? My dr swears I'm nowhere close to diabetes, yet my numbers are worse than Knit's (and I'm already on the max dose of metformin.)
Different people have different ideas of acceptable blood glucose levels. Personally, I prefer Dr. Bernstein's approach - if they're higher than the BG levels of non-diabetics, they're too high. Why? Because "higher than normal" is when your risk for heart disease, Alzheimer's, kidney trouble, etc., begins to rise.
So my aim is to get my A1c under 5.0 with the assistance of Metformin only (because it generally doesn't cause hypoglycemia and has a long history & good safety profile). This will probably never happen, of course..... (I'm still spooked from the days when my BG was way too high and I figure I'd better do what I can at this point to drive the odds as far as I can away from complications.)
I'm guessing your doctor is in a different camp. If your insurance permits, you may want to find an endocrinologist to work with. You also have to bear in mind that the overwhelming majority of people in our group are far more motivated, engaged, and knowledgeable than most of the patients GPs and endcrinologists tend to see in their daily practices. But for us, the goal is to be as healthy as we can be, not healthier than the next patient!
Dr. Bernstein's "Diabetes University" videos on YouTube are great.
These links may be helpful:
http://rajeun.net/HbA1c_glucose.html
https://chriskresser.com/how-to-prevent-diabetes-and-heart-disease-for-16/
https://www.youtube.com/watch?v=da1vvigy5tQ
https://www.youtube.com/watch?v=SCzk66CQKEg
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Fwiw, also check the insulingenic foods you are consuming. This will help you control your BG as a well. I'll have to research the site again and post it. Sorry.
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Found it. Key up: optimisingnutrition.com/tag/insulingenic-foods/
Hope this helps.
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KnitOrMiss wrote: »Yes, Options plan for both Medical and Rx coverage... I pay $30.18 right now for 30 pills of Gluco. That's the different between the cost of the generic and brand name coverage ($25). When the # of pills doubled, so did the cost, as it's a per pill cost over the brand name coverage when generic available, etc. So, when this goes through as approved, I'll pay $25 for the update 2 pills a day/60 pill Rx, theoretically. That's the goal. Metformin is in the $10 ish range...I don't think # of pills/dosage makes much difference there.
EDITED TO ADD - I'm barely prediabetic, @RalfLott . It got added to my chart recently, with a fasting glucose of 78, A1C of 5.4%, and insulin of 7.8. Still don't know why it was added.
Hmm. If your fasting glucose is 78 but your A1c is 5.4 (average BG of around 115 per http://rajeun.net/HbA1c_glucose.html), theoretically, you'd at least be pre-diabetic, because your BG would be running higher than 115 enough of the time to pull your average up.
But that assumes that A1c is a reliable test, and there are all sorts of factors that can distort the A1c result. Frequent spot BG testing yields better information.
@RalfLott - that 78 is absolutely a blip. It has NEVER been that low before, as far back as I have recorded numbers. And it was fasting, but it was not first thing. I'd always been told, nothing after midnight. My appt was at 8 am, blood labs were to be drawn at 9 something, and they refused, because it hadn't been 12 hours for the cholesterol test. So I went home and took a nap, got up at 12:30 pm or so, went, and waited at the hospital until almost 1:45 pm to draw the lab. I wasn't hungry when they drew it, and in fact, didn't eat until, maybe 3:00 or 3:30 pm... So it wasn't first thing. My normal fasting is 89-91 or so. the 89 had a A1C of 5.2%, the 91 had 5.4% - and insulin of 11.3 and 9.9 respectively (the 11.3 was what prompted me to get back on glucophage). The 7.8 of this test was why my doc wanted to have me take it twice a day.
And yes, I know that the A1C shows that obviously my glucose runs higher at some points to bring up the average, but I can't seem to isolate it fully.0
