Metformin Treatment Plan

This treatment plan reviews the risks and benefits of the treatment we recommend. Please make sure to read this as well as the manufacturer’s pamphlet that comes with the medicine. The manufacturer’s pamphlet contains the full information on interactions, side effects, and other information you should know about the medicine before you start.

INSTRUCTIONS:

The clinician would have prescribed Metformin, which you must take;

Two (2) Metformin 500 mg tablets, orally, once a day, for ninety (90) days.

Alternatively,

If the clinician prescribed Metformin Extended Release (ER) instead, you must take:

Two (2) Metformin ER 500 mg tablets, orally, once a day, for ninety (90) days.

 

IMPORTANT NOTES REGARDING YOUR TREATMENT:

Drinking alcohol increases your risk of developing lactic acidosis or may cause a decrease in blood sugar.

Risk factors for metformin-associated lactic acidosis include renal impairment, concomitant use of certain drugs (e.g. carbonic anhydrase inhibitors such as topiramate), age 65 years old or greater, having a radiological study with contrast, surgery and other procedures, hypoxic states (e.g., acute congestive heart failure), excessive alcohol intake, and hepatic impairment.

ACTIVE INGREDIENTS:

This medicine contains the following active ingredient. If you are allergic to any of these components, similar components, or any of the other components listed in the manufacturer’s pamphlet, please do not take it.

  • Metformin Hydrochloride

CONDITIONS:

We evaluate your health history and the specific health information you provide us; however, if anything changes and you develop or discover that one of these conditions applies to you, please stop taking this medicine and seek care in person:

  • Severe renal impairment
  • Hypersensitivity to metformin
  • Acute or chronic metabolic acidosis, including diabetic ketoacidosis

PREGNANCY AND BREASTFEEDING:

Because of the potential for complications, a decision should be made whether to discontinue nursing or to discontinue the medication(s), taking into account the importance of the drug(s) to the mother. This decision should be made with direction from your primary care physician or another source of local medical care.

EMERGENCY SIDE EFFECTS:

This medicine can cause dangerous and potentially life-threatening side effects. If any of the emergency side effects listed in the manufacturer’s pamphlet or those below happen to you, please stop taking the treatment and call 911 or seek immediate medical help in person:

  • chest pain
  • extreme tiredness, weakness, or discomfort
  • stomach pain
  • decreased appetite
  • deep and rapid breathing or shortness of breath
  • dizziness
  • fast or slow heartbeat
  • feeling cold, especially in your hands or feet

OTHER SIDE EFFECTS:

This medicine can also cause other side effects. If any of the other side effects listed in the manufacturer’s pamphlet or those below happen to you please stop taking the treatment and see your doctor in person:

  • diarrhea
  • nausea
  • stomach discomfort
  • gas
  • indigestion
  • constipation
  • lack of energy or weakness
  • change in sense of taste
  • headache
  • flushing of the skin
  • nail changes
  • muscle pain
  • rash

MEDICINES, SUPPLEMENTS, AND FOODS:

We evaluate your health history and the specific health information you provide us; however, if anything changes and you start or discover that you are taking any of the medicines, foods, or supplements listed below, consult with your physician or local care before you take the medicine.

  • Medications that decrease blood sugar: Insulin, glipizide (Glucotrol XL), and repaglinide
  • Medications that increase blood sugar: Prednisone, hydrochlorothiazide (Microzide), and olanzapine (Zyprexa)
  • Topiramate (Topamax): Can increase the risk of lactic acidosis when combined with metformin
  • Herbal medications: Elderberry and gymnema can increase the risk of hypoglycemia when combined with metformin

ACCURATE INFORMATION:

We evaluate the specific health information you provide and make our recommendations based on it. If you incorrectly provide that information, we may misdiagnose or fail to diagnose conditions that you may have which could affect our recommendation for treatment.

TREATMENT FAILURE:

This treatment is not 100% effective. It may not work or may only partially resolve the condition for which you are seeking treatment. If it is an emergency, call 911 or seek immediate medical help in person.

MISDIAGNOSIS OR DELAYED DIAGNOSIS:

There is also a risk that we will misdiagnose or fail to diagnose conditions that you may have which could affect our recommendation for treatment. This risk exists with a doctor in person as well but they may have additional signs and symptoms to aid their evaluation. We use an evidence-based practice and guidelines as well as clinical decision support to try to minimize these risks.

ACCEPTING OR DECLINING OUR RECOMMENDATION:

We recommend this treatment because the potential benefits of treatment outweigh the risks. You should evaluate this information as well as the manufacturer’s pamphlet, and any input from your in-person healthcare team, or other information to decide if this treatment plan is appropriate for you. You are free to decline our treatment recommendations although, doing so may prolong symptoms and be associated with negative outcomes.

OTHER TREATMENTS:

We have based our recommendation on your specific case and medical guidelines, but there may be alternative treatments or strategies that may be helpful to you. Some may be more or less effective than what we provide. Some treatments may require an in-person exam or procedure which we can’t provide.

SHARE WITH YOUR IN-PERSON HEALTHCARE TEAM:

You can access your records anytime. We strongly recommend that you update your in-person doctor, pharmacist, and the rest of your healthcare team to let them know about any new medicines you are taking or other changes in your health.