Starting Metformin reaction

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Gwyn

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Relationship to Diabetes
Type 2
Recently diagnosed with diabetes with a blood sugar reading of 62, and prescribed metformin with a 2+2 dosage. Tried to start slowly, with a week of 1+1, with occasional mild nausea, then switched to 2+1. That resulted in loose bowels, but manageable till 3am today, when it developed to vomiting and diarrhoea, repeating every couple of hours or so!

Local diabetes nurse is off till next Thu, so can‘t do anything about the prescription till then but planning to stop(*) tablets till a stable digestive system then try starting 1+1 again, but intrigued if anyone else has had the same and how long it took to get the stomach back under control?

(*) No option at the moment, as everything’s either coming back or going straight through…. Definitely boosted the weight loss though!
 
I had almost exactly the same ... tied to the loo for about 3 weeks.
Chucked the tablets in the bin, changed what I ate completely and 7 years later still in remission.
My hBA1c on diagnosis was 87 mmol/mol ...
 
Make sure you're keeping hydrated if you're struggling to keep anything down - frequent small sips is likely to be better than infrequent large drinks. Hope that you are feeling better soon
 
5 years ago to the day I binned the Metformin and Atorvastatin tablets as things were very bad indeed.
When tested at 80 days from diagnosis I was no longer diabetic, and in normal numbers at 6 months - from which results I decided I never needed to take the tablets in the first place and have refused to do so ever since.
With a violent reaction to the Metformin, you could suggest that ou are intollerant and ask to see if diet alone is enough. My days taking Metformin are a bit of a blur, but it is not anything I'd want to try again.
I did get a professional quality carpet/upholstery cleaner as a result though.
 
Sorry to hear you are having a tough time with the gastric upheaval @Gwyn

Metformin doesn’t suit everyone, but many members have started with an upset stomach but found it settled after a while.

I wonder if it might be worth progressing more slowly between dose increases? Some members have had success with this as a strategy on other meds.
 
Sounds like you’ve been increasing the dose too quickly, it’s usual to start on one tablet a day and increase by one more a day once you’ve got through any side effects. Sounds like you started on 2 a day then increased to 3 not long after even though you still had nausea on 2
 
When you say 2+2, is that two tablets twice a day? If so, what strength tablets?

As @Lucyr said, it would be more usual to start on a low dose of one or two 500mg tablets per day & increase slowly if necessary, in conjunction with further HbA1c testing. If you don't have them already, there's a slow release version of Metformin that you may tolerate better.

www.nhs.uk

How and when to take metformin

NHS medicines information on dosage for metformin, how to take it and what to do if you miss a dose or take too much.
www.nhs.uk www.nhs.uk
 
Thanks for the comments - things settled down by evening, so will start again gradually till I can talk to the nurse next week.

Just to clarify, I started with 1week of 1x500mg tablet morning and evening, with the mild nausea on day 2/3 only then went to 2 tablets mornings, keeping to 1 in the eve on day 8, which didn’t seem to be overly ambitious…. It then took 6 days till the major reaction…
 
I started off on one tablet a day and then increased it by one tablet per week to reduce the risk of serious upset, up to a max of 4 per day on week 4.

It also really helps to take the tablets mid meal with a substantial amount of food to mitigate some of the digestive upset, so your third tablet might be best with your evening meal rather than breakfast.... when/if you get back to that dose level. I would start at just one though since you are obviously having a significant reaction to it at the higher level and give your body longer. to adjust.
 
Caveat in that like most here, I'm not medically qualified. But as per the link I posted, I'd limit increase in dose to one tab per week or so & always with food. When I went back to Metformin after going onto insulin I was advised to increase by one 500mg tab per month.

As already said, & the link bears out, it's quite unusual to be prescribed the maximum dose straight away. So a conversation with the prescriber to be had. But try to make it a "Help me understand" rather than "The Internet says you're wrong!" 😉
 
Thanks, thats useful as while the instructions were to take it slowly and build up, there was no indication as to what “slowly” meant, so will give it another go over a longer interval and see how that goes…
 
best to take 500mg to start with and ask for the modified release tablets
 
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