Side effects with increased dose of Sukkarto

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Felinia

Felinia

Well-Known Member
Relationship to Diabetes
Type 2
I am on slow release Sukkarto. For the first 4 weeks on 500gm a day I had side effects - queasy, retching, foul taste, some stomach cramps and constipation followed by the runs. But I persevered and slowly the symptoms eased. After 4 months, I just got the odd queasy day and irregular movements. So my DSN doubled the dose to 1000gm a day. For the first 3 days there was no problem. But then I started with terrible cramps and the runs which have just got worst and worse over the last week. I've also started with retching, queasiness, foul taste and complete loss of appetite. This is far worse than the side effects I first experienced, but my DSN wants me to persist for 4 weeks again. I don't feel I can go anywhere or do anything, as I just get doubled up and have to "keep on running" 24 hours a day. I felt so ill yesterday I did not take the pills and just went to bed. I have felt more comfortable today - the symptoms are still there but not so violent. I dread having to start taking them again.

Has anyone got any advice to offer, to minimise the symptoms? I really don't want to take Gliclazide, as it will affect my ability to drive. Who knows when the DVLA would get round to processing me and I need my car as I live in a rural area. The other medication considered needs good renal function, and although my function is now in the normal ranges following my illness, it is apparently not normal enough.

Thanks
 
Experimenting with meals and timings of the medication in relation to food, or switching to slow release may help.

What do you mean about not wanting gliclazide because you need your car? You don’t need to tell the DVLA if you take gliclazide and there’s no restrictions or conditions on your licence, so I don’t follow why gliclazide would impact your ability to drive?

Edited to add: Unless you mean you drive something like a bus or lorry and so need a group 2 licence? In that case you do need to inform the DVLA
 
Could be worth a chat with your nurse, @Felinia .

I think in your shoes, provided I still had access to the 500mgr tablets, I might be tempted to take one on alternate days and two on the others, so a slower, gentler increase. Assuming unwanted symptoms faded, increase again in a few weeks to the full 2000 mgr a day.

You might need to go back to 5gr per day for a couple of weeks to allow your tummy to settle.

As I say, that's what I'd try.
 
Lucyr said:
Experimenting with meals and timings of the medication in relation to food, or switching to slow release may help.

What do you mean about not wanting gliclazide because you need your car? You don’t need to tell the DVLA if you take gliclazide and there’s no restrictions or conditions on your licence, so I don’t follow why gliclazide would impact your ability to drive?

Edited to add: Unless you mean you drive something like a bus or lorry and so need a group 2 licence? In that case you do need to inform the DVLA
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Thanks for the reply. Sukkarto is the slow release version. I was prescribed that because I have Diverticular Disease and it was thought ordinary Metformin would be too harsh.

I was told if you take Gliclazide you have to test every time before you drive and then every 2 hours, because of the risk of hypos. And I was told that because there is the risk of hypos, DVLA has to be informed, regardless of what you drive, and your licence has to be reviewed. I have already been waiting 2 months for my licence renewal, and am driving under Section 88, with my GP's written approval. I am just so confused now with all the conflicting information.
 
AndBreathe said:
Could be worth a chat with your nurse, @Felinia .

I think in your shoes, provided I still had access to the 500mgr tablets, I might be tempted to take one on alternate days and two on the others, so a slower, gentler increase. Assuming unwanted symptoms faded, increase again in a few weeks to the full 2000 mgr a day.

You might need to go back to 5gr per day for a couple of weeks to allow your tummy to settle.

As I say, that's what I'd try.
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That's an idea. I certainly want to give my bowels a rest at the moment. My DSN wants to speak to me in 4 weeks time.
 
Felinia said:
Thanks for the reply. Sukkarto is the slow release version. I was prescribed that because I have Diverticular Disease and it was thought ordinary Metformin would be too harsh.

I was told if you take Gliclazide you have to test every time before you drive and then every 2 hours, because of the risk of hypos. And I was told that because there is the risk of hypos, DVLA has to be informed, regardless of what you drive, and your licence has to be reviewed. I have already been waiting 2 months for my licence renewal, and am driving under Section 88, with my GP's written approval. I am just so confused now with all the conflicting information.
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This information leaflet on driving when taking non insulin medication is on the DVLA website. It’s always sensible to test if you feel low but there’s no need to inform the DVLA or licence restrictions unless you have one of the complications listed or you drive a bus or lorry.

 

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Hi. You don't refer to your diet in the post? This is always the first stop when it comes to controlling T2. Do you have a low-carb diet? If not then do look at controlling the carbs. Sukkarto is a brand name for Metformin. The SR version usually avoids symptoms but you are one of the unlucky ones and it may be worth stopping it. Gliclazide is a completely different drug and best for T2s who have an underperforming pancreas as it stimulates the beta cells to produce more insulin. A T2 if overweight will usually have too much insulin but insulin resistance will prevent the body using it effectively. There are other drugs which may help but do ensure you are keeping the carbs down anyway. BTW I was on Glic for many years and didn't tell the DVLA as I was never advised to. The DVLA are quite relaxed about diabetes tablets. You should tell them but you will find they only really worry about insulin.
 
You really should not be being pressured into taking tablets which make you feel ill.
I had similar symptoms, but on just one tablet, but I found that I could control my blood glucose perfectly well by not eating much carbohydrate - and there was no temptation to eat more - just the thought of Metformin made it impossible to fail.
 
Lucyr said:
This information leaflet on driving when taking non insulin medication is on the DVLA website. It’s always sensible to test if you feel low but there’s no need to inform the DVLA or licence restrictions unless you have one of the complications listed or you drive a bus or lorry.

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Thank you. That is so helpful and I've saved it with all the other DVLA leaflets people have pointed me to. When I speak to my DSN I might be willing to give Gliclazide a go, if Sukkarto continues to trouble me.
 
DaveB said:
Hi. You don't refer to your diet in the post? This is always the first stop when it comes to controlling T2. Do you have a low-carb diet? If not then do look at controlling the carbs. Sukkarto is a brand name for Metformin. The SR version usually avoids symptoms but you are one of the unlucky ones and it may be worth stopping it. Gliclazide is a completely different drug and best for T2s who have an underperforming pancreas as it stimulates the beta cells to produce more insulin. A T2 if overweight will usually have too much insulin but insulin resistance will prevent the body using it effectively. There are other drugs which may help but do ensure you are keeping the carbs down anyway. BTW I was on Glic for many years and didn't tell the DVLA as I was never advised to. The DVLA are quite relaxed about diabetes tablets. You should tell them but you will find they only really worry about insulin.
Click to expand...
Hi and thanks
I have been on a low carb diet (around 90gm per day) ever since I was diagnosed and it was successful in controlling my diabetes. (I have an app and monitor daily). Then I was ill for 4 months, lost 11kg and my HbA1c shot up. I was told to take Sukkarto when my kidney function returned to normal, which is when I started taking Sukkarto. My latest HbA1c showed a substantial decrease, but my DSN said it was still too high which is why the dose was increased.

I think the support everyone has shown is prompting me to give Gliclazide a go and hope I don't get any side effects.
 
Glucophage (an alternative SR met) might have also been an option if there was something specific in Sukkarto that was causing this more dramatic reaction (though I confess I don’t know if there are any/many differences in the formulation).

Hooe you find an effective dose and type of meds that works for you and is kind on your tum @Felinia
 
It's been more than 72 hours since my last tablet, and I've woken with greatly reduced stomach cramps, and an appetite. I hope another 24 - 48 hours will see me feeling back to normal, and I can then try a slower build up as suggested by AndBreathe. If I get the same side effects, again, it will be Plan B - a different medication.
 
everydayupsanddowns said:
Glucophage (an alternative SR met) might have also been an option if there was something specific in Sukkarto that was causing this more dramatic reaction (though I confess I don’t know if there are any/many differences in the formulation).

Hooe you find an effective dose and type of meds that works for you and is kind on your tum @Felinia
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@Felinia I take 2000mg Glucophage SR without side effects (I also have diverticular disease) In a cost cutting exercise the surgery changed my prescription to Sukkarto with disastrous effects. I got them to change it back to Glucophage and back to normal! As Mike says above I suggest you ask to change to Glucophage SR and see if that helps
 
I'm now on day 5 of just one 500mg Sukkarto, as I build up again. I'll up it to 1000mg on Tuesday and see if I get the side effects back again. SO I'll have something either positive or negative to feed back to the DSN.
 
Well, it's 2 weeks since my 2nd attempt to up my Sukkarto to 1000mg a day, and for the last 36 hours I have yet again been doubled up with cramps, constipation and diarrhoea, with no sign of easing. I didn't take any pills yesterday, and have been unable to go very far from the smallest room (tmi - sorry) all this time. I've had to cancel my Aqua of course.

It seems clear to me that my system simply can't take more than 500mg Sukkarto, so I've messaged my DSN and am awaiting a reply. I expect she will suggest Gliclazide, but I'll wait and see. I just seem to be super sensitive to most medications - most antibiotics, all statins, most BP medications :(
 
So sorry to hear this @Felinia. You've got a lot going on but you've tried your best. You can't live like this. Hope your nurse can provide a satisfactory solution.
 
Felinia said:
Hi and thanks
I have been on a low carb diet (around 90gm per day) ever since I was diagnosed and it was successful in controlling my diabetes. (I have an app and monitor daily). Then I was ill for 4 months, lost 11kg and my HbA1c shot up. I was told to take Sukkarto when my kidney function returned to normal, which is when I started taking Sukkarto. My latest HbA1c showed a substantial decrease, but my DSN said it was still too high which is why the dose was increased.

I think the support everyone has shown is prompting me to give Gliclazide a go and hope I don't get any side effects.
Click to expand...
90gm is over 2 days carbs for me - The effects of the tablets made me so miserable and embarrassed, actually frightened to go out a lot of the time.
Eating under 40 gm of carbs a day means I don't need tablets and am free to go out all day and have a life.
 
An update - I've just had my consult with my DSN, fully expecting to be put on Gliclazide, but instead she has suggested Canaglifloxin, and passed it to my GP to authorise. I'm happy about that, and we will review again in 2 weeks.
 
It must be your lucky day -

journals.lww.com

Gliclazide monotherapy increases risks of all-cause... : Medicine

esign. Total 195,235 subjects were included in the study who were ≥20 years’ old and prescribed monotherapy for at least 1 year as a first-line therapy for incident diabetes from January 01, 2009 to December 31, 2013 in the National Health Insurance Service Claim data. Incidence and hazard...
journals.lww.com journals.lww.com
 
I gave up on Metformin for 6 months after having Allergic reaction to Sukkarato . Now back on Glucophage SR from Merck .
 
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