Fortamet

1 What is Fortamet?

Brand: Fortamet, Glucophage, Glucophage XR, Glumetza, Riomet

Generic: Metformin

Fortamet is a hypoglycemic agent used alone or in combination with other oral antidiabetic drugs for the treatment of hyperglycemia caused by type 2 diabetes. Insulin produced by the pancreas cannot facilitate sugar into the cells of the body in type 2 diabetes. Type 2 diabetes can be controlled with diet and exercise.

The amount of metformin you take must be balanced against the amount and type of food you eat and the amount of exercise you do in order for the drug to work.

This drug will not work on type 1 diabetes due to the inability of pancreas to secret insulin. Insulin injections are required for type 1 diabetes. This drug requires a prescription.

2 What to Know Before Using

Before using Fortamet, the risks and benefits for your body should be discussed with your healthcare provider. Inform your healthcare provider for any allergic reactions to these drugs or any other drugs, foods, dyes, preservatives, or animals.

Carefully read the label of non-prescription drugs for any possible allergic reaction or contraindications. Studies in children 10 to 16 years of age have not demonstrated any pediatric-specific problems that would limit the utility of metformin oral solution and tablets.

However, safety and efficacy of metformin extended-release tablets in the pediatric population have not been established. Studies in elderly regarding the correlation of age to the effects of metformin have not been performed while geriatric-specific problems are not anticipated to limit the utility of metformin in the elderly.

Adjustments in the dose of the elderly may be required since they are more likely to have age-related kidney problems. This drug is contraindicated for use in patients 80 years of age and older who have kidney problems. No indications of harm to the fetus have been reported in animal studies but studies in pregnant women or animals are still inadequate. Risks to fetuses have not been reported in studies of pregnant women.

This drug poses minimal risk to the infant when used during breastfeeding. Drugs should not be taken together to prevent any interactions but in necessary cases inquire your healthcare provider regarding the adjustments in dosage or any other necessary precautions to prevent any unwanted side effects. Inform your healthcare professional if you are taking any other drugs such as Acetrizoic Acid, Diatrizoate, Ethiodized Oil, Iobenzamic Acid, Iobitridol, Iocarmic Acid, Iocetamic Acid, Iodamide, Iodipamide, Iodixanol, Iodohippuric Acid, Iodopyracet, Iodoxamic Acid, Ioglicic Acid, Ioglycamic Acid, Iohexol, Iomeprol, Iopamidol, Iopanoic Acid, Iopentol, Iophendylate, Iopromide, Iopronic Acid, Ioseric Acid, Iosimide, Iotasul, Iothalamate, Iotrolan, Iotroxic Acid, Ioversol, Ioxaglate, Ioxitalamic Acid, Ipodate, Metrizamide, Metrizoic Acid, Tyropanoate Sodium, Acetazolamide, Balofloxacin, Besifloxacin, Bupropion, Ciprofloxacin, Dichlorphenamide, Dofetilide, Dolutegravir, Enoxacin, Fleroxacin, Flumequine, Gatifloxacin, Gemifloxacin, Lanreotide, Levofloxacin, Lomefloxacin, Moxifloxacin, Nadifloxacin, Norfloxacin, Octreotide, Ofloxacin, Pasireotide, Pazufloxacin, Pefloxacin, Prulifloxacin, Rufloxacin, Sparfloxacin, Tosufloxacin, Vandetanib, Zonisamide, Acebutolol, Atenolol, Betaxolol, Bisoprolol, Bitter Melon, Carteolol, Carvedilol, Celiprolol, Esmolol, Fenugreek, Furazolidone, Glucomannan, Guar Gum, Iproniazid, Isocarboxazid, Labetalol, Levobunolol, Linezolid, Methylene Blue, Metipranolol, Metoprolol, Moclobemide, Nadolol, Nebivolol, Nialamide, Oxprenolol, Penbutolol, Phenelzine, Pindolol, Practolol, Procarbazine, Propranolol, Psyllium, Ranolazine, Rasagiline, Rifampin, Safinamide, Selegiline, Sotalol, Timolol, or Tranylcypromine.

Intake of specific food or using alcohol or tobacco with this drug is associated with an increased risk of certain side effects. Your healthcare professional can give you special instructions about the use of food, alcohol, or tobacco.

Inform your healthcare professional if you have any other medical problems such as excessive use of alcohol, underactive adrenal glands, underactive pituitary gland, undernourished condition, weakened physical condition, any other condition that causes low blood sugar, anemia, Vitamin B12 deficiency, congestive heart failure, dehydration, heart attack, hypoxemia, kidney disease, liver disease, sepsis, shock, diabetic ketoacidosis, metabolic acidosis, type 1 diabetes, fever, infection, surgery, or trauma.

3 Proper Usage

To use Fortamet correctly, you must follow all instructions as directed in the label or as prescribed by your healthcare professional. The special meal plan given to must be followed as this is a very important part of controlling your condition, and is necessary if the drug is to work properly.

Regular exercise and tests to monitor your sugar in your blood or urine is recommended. To help reduce stomach or bowel side effects that may occur during the initial treatment, it is recommended to take this drug with meals. The extended-release tablet must be swallowed whole with a full glass of water. Crushing, breaking, or chewing is not recommended. The oral liquid must be measured with a marked measuring spoon, oral syringe, or drug cup. The brand of this drug that your healthcare professional prescribed must be used, since different brands may not work the same way.

Improvements in your blood glucose control may be noticed in 1 to 2 weeks, while it may take up to 2 to 3 months for the full effect of blood glucose control to happen. The dose of this drug will be variable for different patients. The directions on the label or the prescription by your healthcare professional should be followed. The dosage of this drug you take depends on the medical problem for which you are using this drug.

Adults with type 2 diabetes are initially given 1000 milligrams of metformin once a day taken with the evening meal. Your healthcare professional may increase your dose if needed until your blood sugar is controlled. The dose must not exceed 2500 mg per day. Adults using GlucophageВ® XR or GlumetzaВ®, are initially given 500 mg once daily with the evening meal. Your healthcare professional may increase your dose if needed until your blood sugar is controlled.

The dose must not exceed 2000 mg per day. Your healthcare professional will determine the dose of each drug if you are prescribed metformin with a sulfonylurea. Adults using metformin with insulin are initially given 500 mg once a day. Then, your healthcare professional may increase your dose by 500 mg every week if needed until your blood sugar is controlled. The dose must not exceed 2500 mg per day. Use and dose in children must be determined by your healthcare professional.

Adults using the oral solution of metformin alone are initially given 5 milliliters two times a day, or 8.5 mL once a day with meals. Your healthcare professional may increase your dose if needed until your blood sugar is controlled. The dose must not exceed 25.5 mL per day. The dose of adults using the oral solution of metformin with a sulfonylurea will be determined by your healthcare professional. Adults using metformin with insulin are initially given 5 mL once a day.

Your healthcare professional may increase your dose if needed until your blood sugar is controlled. The dose must not exceed 25 mL per day. Children 10 to 16 years of age are initially given 5 mL two times a day with meals. Your healthcare professional may increase your dose if needed until your blood sugar is controlled.

The dose must not exceed 20 mL per day. Use and dose in children younger than 10 years of age must be determined by your healthcare professional. Adults using metformin alone are initially given 500 milligrams two times a day taken with the morning and evening meals, or 850 mg a day taken with the morning meal. Your healthcare professional may increase your dose if needed until your blood sugar is controlled.

Your healthcare professional may want you to take 500 or 850 mg two to three times a day with meals. The dose must not exceed 2550 mg per day. The dose of adults using metformin with a sulfonylurea will be determined by your healthcare professional.

Adults using metformin with insulin are initially given 500 mg a day. Your healthcare professional may increase your dose by 500 mg every week if needed until your blood sugar is controlled. The dose must not exceed 2500 mg per day. Children 10 to 16 years of age are initially given 500 mg two times a day taken with the morning and evening meals. Your healthcare professional may increase your dose if needed until your blood sugar is controlled. The dose must not exceed 2000 mg per day. Use and dose in children younger than 10 years of age must be determined by your healthcare professional.

A missed dose should be taken as soon as possible. However, skip the missed dose and go back to your regular dosing schedule if it is almost time for your next dose. Store the drug in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing. Keep out of the reach of children. Dispose any outdated or expired drugs and ask your healthcare professional for the proper disposal of the drugs.

4 Precautions to Take

In using Fortamet, you must be careful and take some precautions as advised by your doctor.

Regular visits should be made to your healthcare provider to track your progress and to monitor the effectiveness and unwanted effects of the drug. Unwanted effects can be screened using blood and urine tests. The dye used for an X-ray or CT scan may be affected by this drug.

You will be advised to stop taking this drug before having any medical exams or diagnostic tests that might cause less urine output than usual. You may be advised to start taking the drug again 48 hours after the exams or tests if your kidney function is tested and found to be normal. Inform any healthcare professional or dentist that you are using this drug, as you may need to stop using this drug several days before having surgery or medical tests. Hypoglycemia may be caused by alcohol intake.

Discuss this with your health care team. Consult with your healthcare professional before you take other drugs such as nonprescription drugs such as aspirin, and drugs for appetite control, asthma, colds, cough, hay fever, or sinus problems. Patients with diabetes may need special counseling about diabetes drug dosing changes that might occur with lifestyle changes, such as changes in exercise or diet.

The problems that can occur in pregnancy for patients with diabetes may require counseling on birth control and pregnancy. Always carry a recent prescription and your medical history with you. Be prepared for an emergency as you would normally. Make allowances for changing time zones and keep your meal times as close as possible to your usual meal times.

Emergency help may be needed for complications caused by your diabetes. You need to be prepared for these emergencies. It is recommended to wear a medical identification bracelet or neck chain, and an ID card in your wallet or purse that says that you have diabetes and a list of all of your drugs.

Lactic acidosis has been associated with excessive use of metformin under certain conditions. Consult with your healthcare professional if you have symptoms of lactic acidosis such as a heart attack or kidney failure, abdominal or stomach discomfort, decreased appetite, diarrhea, fast or shallow breathing, a general feeling of discomfort, severe muscle pain or cramping, and unusual sleepiness, tiredness, or weakness.

Taking this drug can cause hypoglycemia, which can also occur if you delay or miss a meal or snack, drink alcohol, exercise more than usual, cannot eat because of nausea or vomiting, take certain drugs, or take metformin with another type of diabetes drug. Hypoglycemia must be treated before they lead to unconsciousness.

Seek immediate medical attention if you experience symptoms of hypoglycemia such as anxiety, behavior change similar to being drunk, blurred vision, cold sweats, confusion, cool, pale skin, difficulty with thinking, drowsiness, excessive hunger, fast heartbeat, headache, nausea, nervousness, nightmares, restless sleep, shakiness, slurred speech, or unusual tiredness or weakness.

It is recommended to eat glucose tablets or gel, corn syrup, honey, or sugar cubes, or drink fruit juice, non-diet soft drink, or sugar dissolved in water if these symptoms occur. In emergency situations glucagon is used to treat severe symptoms such as seizures or unconsciousness. It is recommended to have a glucagon kit available, along with a syringe or needle, and know how to use it.

The members of your household also should know how to use it. Uncontrolled diabetes can lead to hyperglycemia. Consult with your healthcare professional if you have symptoms of hyperglycemia such as blurred vision, drowsiness, dry mouth, flushed, dry skin, fruit-like breath odor, increased urination, ketones in the urine, loss of appetite, sleepiness, stomachache, nausea or vomiting, tiredness, troubled breathing, unconsciousness, or unusual thirst. Hyperglycemia happens if you do not exercise as much as usual, have a fever or infection, do not take enough or skip a dose of your diabetes drug, or overeat or do not follow your meal plan.

Check your blood sugar level and then call your healthcare professional for instructions if hyperglycemia occurs. This drug is only part of a complete program for controlling diabetes. It is recommended to always eat a healthy diet, monitor your weight, and get regular exercise.

5 Potential Side Effects

As with many medications, there are several potential side effects associated with Fortamet.

Side effects may vary for each individual and prompt medical attention should be given if they occur. Seek advice from your healthcare professional immediately if you experience any unusual symptoms such as abdominal or stomach discomfort, cough or hoarseness, decreased appetite, diarrhea, fast or shallow breathing, fever or chills, general feeling of discomfort, lower back or side pain, muscle pain or cramping, painful or difficult urination, sleepiness, anxiety, blurred vision, chest discomfort, cold sweats, coma, confusion, cool, pale skin, depression, difficult or labored breathing, dizziness, fast, irregular, pounding, or racing heartbeat or pulse, feeling of warmth, headache, increased hunger, increased sweating, nausea, nervousness, nightmares, redness of the face, neck, arms, and occasionally, upper chest, seizures, shakiness, shortness of breath, slurred speech, tightness in the chest, unusual tiredness or weakness, wheezing, behavior change similar to being drunk, difficulty with concentrating, drowsiness, lack or loss of strength, restless sleep, or unusual sleepiness.

Some side effects may occur that usually do not need medical attention. As your body adjusts to the drug, the side effects will slowly disappear. Ask your healthcare professional about ways to prevent or reduce some of these side effects. If any of the following side effects persists, or are inconvenient, or if you notice any other effects, or if you have any questions about them, consult with your health care professional. Report any side effects to the FDA hotline at 1-800-FDA-1088.

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