T2D - Glucophage (name brand) > Metformin (generic) ?
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KnitOrMiss wrote: »Be mad at the pharmaceutical industry. They're the ones who allow generics to use whatever crap they want... Like gluten in thyroid medications. Soy, dairy, sugar, too... In almost everything.
That is a pisser, all right. The FDA has pretty tough sledding, but still, better quality control would be in the mix if the FDA served us lowly consumers and not the pharmaceuticals that have the ears of Congress, the FDA, ADA, AHA, etc.
And the unregulated state of supplements is a major hole that doesn't look like it'll be plugged any time soon.
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"but those things don't matter" so they should be able to use whatever... Only, they do matter, so where does that leave us? I've found certain generics of allergy meds actually work BETTER for me than the brand name, so it is possible. It just wish it weren't so hard to keep ourselves from being contaminated when we're fighting everything that passes our lips....0
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Well, you can't poison someone who won't eat.
Of course, there are still a few glitches to be worked out in that approach....0 -
Dümp0
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@RalfLott - so I was looking through this again, but I keep getting distracted, and have only made it back through the first page.
Since I am the exception to the rule and seem to have more of a glucose/insulin spike with meals, regardless of content (I spike more WITH crap food or too many calories, period, but I still spike with pretty much everything somewhat), and less problems regulating fasting glucose, my Endo agreed to try the IR instead of ER. However, the cost came back as $90 due to a "patient pays the difference" rider in my current insurance formulary. The generic is $15 or something...
Since the $90 is absolutely NOT doable this month (after 8/1, might be willing to deal with it through new FSA stuff with my company), my options are to keep my current 500 XR Glucophage once per day, get generic IR Metformin 500 pills with Doctor instruction to break them in half and start with 1-2 meals, aiming for 3 meals over the course of the day as end goal - IF I CAN FIGURE OUT WHICH GENERIC OF METFORMIN IS SAFEST TO TRY, or something else that hasn't occurred to me yet...
So, long store short, the question is 1) do you know which of the generics you were inclined to believe were "safer..." or which you yourself had ruled out? Or have any idea where I can look?
I have a day or two before I HAVE to fill it...but I'd rather only make one trip, and I have two others to grab while there...
Head is spinning from this...0 -
KnitOrMiss wrote: »@RalfLott - so I was looking through this again, but I keep getting distracted, and have only made it back through the first page.
Since I am the exception to the rule and seem to have more of a glucose/insulin spike with meals, regardless of content (I spike more WITH crap food or too many calories, period, but I still spike with pretty much everything somewhat), and less problems regulating fasting glucose, my Endo agreed to try the IR instead of ER. However, the cost came back as $90 due to a "patient pays the difference" rider in my current insurance formulary. The generic is $15 or something...
Since the $90 is absolutely NOT doable this month (after 8/1, might be willing to deal with it through new FSA stuff with my company), my options are to keep my current 500 XR Glucophage once per day, get generic IR Metformin 500 pills with Doctor instruction to break them in half and start with 1-2 meals, aiming for 3 meals over the course of the day as end goal - IF I CAN FIGURE OUT WHICH GENERIC OF METFORMIN IS SAFEST TO TRY, or something else that hasn't occurred to me yet...
So, long store short, the question is 1) do you know which of the generics you were inclined to believe were "safer..." or which you yourself had ruled out? Or have any idea where I can look?
I have a day or two before I HAVE to fill it...but I'd rather only make one trip, and I have two others to grab while there...
Head is spinning from this...
Well........
I'm afraid I'm not going to be of much help.
1. 1x ER daily does not seem sufficient to maintain a constant level. I try to time my daytime dose 6-8 hours before my first meal, so right when I get up.
2. Dr. Bernstein recommends taking IR before a meal, if you can stomach it.
3. I have no firm idea about generics at this point, as I was still eating, or recovering from eating, too many carbs when I took them. Teva ER seemed to be a problem at the time, but I might not have a problem with it now.
(I never took IR; Dr. Bernstein says brand ER is easiest to take for many people.)
So....
Try adding more brand XR? My insurance gives me the same $60 copay
whether I take 500 or 2500mg per day (so I get 2500 but usually take only 2000).
You could at the same time also experiment with generic IR (cheap or free from chain pharmacies) and see how it goes.
You're already aware of phthalates in various generic forms of ER...
Good luck & keep us posted!0 -
We have a "benefit" that "patient pays the difference." So essentially, I pay by the pill. 30 pills of Glucophage costs me $30.18. 60 is around $60, and 90 pills is around $90. Doesn't matter if IR or ER. If Glucophage, I'm paying a premium per pill.
So that really isn't much of an option... BUT... I'm thinking that I might be able to see if they will do 30 pills instead of 90, IR instead of ER, and at least I could split doses on my own, as doc suggested.
Going to read through to comments and linked page for any suggestions on this... http://diabetesupdate.blogspot.com/2011/02/differing-brands-of-generic-metformin.html?m=1
Oh, and @RalfLott - Doc has been wanting me to take the 500 XR twice a day since April, but my FSA ran out in March, so I haven't been able to justify the cost difference.
One other thing did occur to me. I was NOT taking Digestive Enzymes when I took generic Metformin before. I AM taking them now, with brand name Glucophage. Does the digestive portion, and how the medication is metabolized, affect the side effects? Does anyone know?
P.S. As I'm getting digestive response from the Iron I've added, I honestly don't know how much worse Metformin could be added on top of it, though I really probably don't want to know.0 -
Here is the secondary site where he summarizes it all! http://www.phlaunt.com/diabetes/14045911.php0
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Dang! An insurance >Gotcha!<
That linked page is interesting. Looks like Teva XR was fine for the author, at least in 2011.
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KnitOrMiss wrote: »Here is the secondary site where he summarizes it all! http://www.phlaunt.com/diabetes/14045911.php
That would be "she" (Jenny Ruhl. Her "101" books are good, as you might expect.) 0 -
The author of the original article was a man. I didn't realize until after I posted it that he had linked to a separate site.
Decided to get a week of the brand name Rx. Doc wants me to break the pills in half, at least to start, as they apparently don't make 250 in non ER... So starting with that, tomorrow, as my pharmacy had to order it out for me. 1 week of Rx'd 500 mg 3x daily (as the end goal) but starting with split in half 2x a day should make one week stretch enough to give it a good trial run!1 -
KnitOrMiss wrote: »The author of the original article was a man. I didn't realize until after I posted it that he had linked to a separate site.
Decided to get a week of the brand name Rx. Doc wants me to break the pills in half, at least to start, as they apparently don't make 250 in non ER... So starting with that, tomorrow, as my pharmacy had to order it out for me. 1 week of Rx'd 500 mg 3x daily (as the end goal) but starting with split in half 2x a day should make one week stretch enough to give it a good trial run!
Aha gotcha. It will be interesting to see how the IR works for you!0 -
Have you tried using the GoodRx app? They are also online. It's free and I have been getting really cheap prices for my meds. They may have a coupon for name brand Glucophage. I am finding it cheaper to find the prices through them and go to other pharmacies, then go to my "required" in network, CVS.
The Free Metformin (generic) from Publix Grocery was Ascend Lab. Two days ago, they switched to Time-Cap Labs. I had no problems with Ascend. We'll see how it goes with the new supplier.0 -
Generic metformin vs brand name Glucophage is a minor consideration.
Far more important is exercise and a LCHF diet.
IF you are maximizing diet and exercise and you are considering a SECOND medication on top of your generic metformin, that's when you may want to try brand name Glucophage.
I appreciate your insights, but I have to disagree with you on this one. Dr. Bernstein has treated thousands of diabetics and found brand Glucophage to be more effective and more easily tolerated, and that's been my experience.
So if your insurance is cooperative, I see no reason not to start with Glucophage and avoid the possible nightmares with the generics.
(If you're already on a generic that's working well for you, that's a different matter.)0 -
Brand name Glucophage IS more effective vs generic metformin. It's also a lot more expensive. But it's far cheaper than adding a GOOD second DM medication. That's why Dr Bernstein recommends it. And it's why I recommend it before trying a second med.
My second DM med after I try generic metformin and the brand name Glucophage would be victoza or a basal insulin. Both of them are far more expensive vs brand name Glucophage.
Diet and exercise are BY FAR your most important weapons against DM. That's where most DMs blow it. Your meds are a distant third.
Gotcha.
I think you're generally right, but as far as meds go, I'm not convinced they're an also ran for every T2D.
PS. You need to be writing public info brochures for the ADA.2 -
KnitOrMiss wrote: »@RalfLott - so I was looking through this again, but I keep getting distracted, and have only made it back through the first page.
Since I am the exception to the rule and seem to have more of a glucose/insulin spike with meals, regardless of content (I spike more WITH crap food or too many calories, period, but I still spike with pretty much everything somewhat), and less problems regulating fasting glucose, my Endo agreed to try the IR instead of ER. However, the cost came back as $90 due to a "patient pays the difference" rider in my current insurance formulary. The generic is $15 or something...
Since the $90 is absolutely NOT doable this month (after 8/1, might be willing to deal with it through new FSA stuff with my company), my options are to keep my current 500 XR Glucophage once per day, get generic IR Metformin 500 pills with Doctor instruction to break them in half and start with 1-2 meals, aiming for 3 meals over the course of the day as end goal - IF I CAN FIGURE OUT WHICH GENERIC OF METFORMIN IS SAFEST TO TRY, or something else that hasn't occurred to me yet...
So, long store short, the question is 1) do you know which of the generics you were inclined to believe were "safer..." or which you yourself had ruled out? Or have any idea where I can look?
I have a day or two before I HAVE to fill it...but I'd rather only make one trip, and I have two others to grab while there...
Head is spinning from this...
FYI, drugs.com has inactive ingredient lists for some meds. So, for example, for Teva Metformin XR 500, it discloses:
*silicon dioxide
*hypromelloses
*magnesium stearate
*polyethylene glycol
*titanium dioxide
(Despite appearances, it's not classified as a laxative.)
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KnitOrMiss wrote: »The author of the original article was a man. I didn't realize until after I posted it that he had linked to a separate site.
Decided to get a week of the brand name Rx. Doc wants me to break the pills in half, at least to start, as they apparently don't make 250 in non ER... So starting with that, tomorrow, as my pharmacy had to order it out for me. 1 week of Rx'd 500 mg 3x daily (as the end goal) but starting with split in half 2x a day should make one week stretch enough to give it a good trial run!
Aha gotcha. It will be interesting to see how the IR works for you!
@RalfLott - Started Saturday I think... Half a pill so around ~250 with each meal. Stools are looser shortly after a meal, but not as acidic and generally only once after, unless I've been longer between meals (bile trickle constant due to no gallbladder, etc.)... Adding in iron has also loosened my stools recently, so I'm not sure which is to blame. But, so far it is mildly inconvenient/irksome, but not hellish levels of misery or anything that would end the test period early.
This morning, I tried the Gluc. 20-30 minutes before I ate (I think I dropped the time around 20 minutes, because I started getting some heartburn/indigestion which for me is very hard to rebound from right now, so I ate before had intended to), but with around 25 grams of carbs, I still crashed some, so that tells me there was a spike. If I can survive on the half pills until Friday, or even better, the 1st, I'm going to fill the whole Rx and try with each pill 500 per meal, 30 minutes before. I'm going to go through this week on the IR before doing my tests on Saturday, if I can, for my Endo, so he can see the impact...1 -
A related question for you guys. A friend has been prescribed Metformin for insulin resistance and her sister being a pharmacist advices her not to take it, but to try another remedy instead: Berberine, anyone tried this product in place of Metformin?
https://www.healthmonthly.co.uk/swanson_premium_berberine_complex?af=gaw&gclid=CjwKCAjwtdbLBRALEiwAm8pA5Xqrj8aqfc-yWgktouL9TTNY-1uTwVKIhXpXsfQAYKk22EMWoHTM_BoCPIgQAvD_BwE
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