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What meds should I avoid when taking metformin?

What foods to avoid while taking metformin

There are no specific foods that you need to avoid while taking metformin however you are recommended to watch what you eat while taking this medication to prevent or reduce the potential side effects.

Here we will discuss what metformin is, how it works, its side effects and interactions, and the foods you should or should not eat.

What is metformin?

Metformin is an FDA-approved first-line treatment for diabetes management in people with Type 2 diabetes mellitus.. It is also used for the prevention of prediabetes. Metformin (brand names include Glucophage) is a generic anti-diabetic medication used as part of a treatment plan for Type 2 diabetes. It can be used alone or in combination with other medications.

Metformin may also be used for the treatment of polycystic ovary syndrome (PCOS), a condition that affects ovulation and may increase androgen production. PCOS increases the risk of developing obesity, depression, infertility, and type 2 diabetes. Metformin has been used to help women with PCOS reduce waist size and help with weight loss. Metformin can also be used for the treatment of metabolic syndrome. Metformin is not recommended for the treatment of type 1 diabetes.

What foods have natural metformin?

Metformin is available naturally in the plant Galega officinalis (French lilac or goat’s rue). It is also present in fruits and vegetables as part of our normal diet and may play a part in the management of diabetes naturally.

How does metformin work?

Metformin is classed as a biguanide and used as a first-line treatment for diabetes because of its mode of action in increasing the body’s insulin sensitivity. Also, metformin does not cause weight gain.

It is used in combination with changes to diet and exercise to improve glycemic control in adults and pediatric patients with type 2 diabetes mellitus. It works by reducing the amount of glucose absorbed from your intestines, decreasing how much glucose is made in your liver, and improving your insulin sensitivity.

Metformin dosage

Metformin is available as an immediate-release or extended-release oral tablet, or as an oral suspension. It is taken with meals, unless your doctor tells you otherwise. Do not crush, chew, or break the extended-release tablet. Swallow it whole. Your doctor may prescribe a glucagon injection kit in case you have severe hypoglycemia. You may also be prescribed extra vitamin B12 while you are taking this medicine.

Always speak with your healthcare provider for medical advice about any changes to your dose so they can monitor and evaluate your condition.

What are the side effects of metformin?

The most common side effects of metformin in clinical trials include:

  • Lower blood sugar levels
  • Gastrointestinal side effects such as nausea and diarrhea

More serious side effects of metformin include

  • Unusual muscle pain
  • Problems breathing
  • Dizziness, feeling faint
  • Feeling tired
  • Stomach pain
  • Vomiting
  • Slow or irregular heart rate
  • Lactic acidosis – symptoms include unusual muscle pain, difficulty breathing, stomach pain, dizziness, feeling cold, or feeling very weak or tired

What happens if you take metformin on an empty stomach?

Upset stomach is the most common side effect of taking metformin and taking metformin on an empty stomach may make this side effect worse.

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Do some foods make the side effects of metformin worse?

Yes, there are some foods that can make the side effects of metformin worse. These include high-fat foods, sugary foods, and alcoholic beverages. Eating these types of foods can also raise your blood sugar levels.

The most common side effects reported by people who take metformin are nausea and diarrhea. Fortunately, you can prevent or reduce these side effects by taking care of what you eat.

People who are taking metformin and experience nausea should consider doing the following:

  • Eating slower
  • Eating smaller meals
  • Eating foods that are bland and light
  • Drinking ice-cold or clear drinks (for example, unsweetened tea or water)
  • Avoiding foods that are sweet, greasy, or fried

What foods make you sick with metformin?

Avoid foods high in sugar, these include cakes, biscuits, juice, fizzy drinks, sweets, chocolates, rich desserts, simple and refined carbs such as white bread, pasta and white rice, saturated and trans fats. These foods will all increase insulin resistance and raise your blood sugar levels.

What foods should I avoid while taking metformin?

There are no specific foods that you need to avoid while taking metformin however it is recommended to watch what you eat while taking this medication to prevent or reduce the potential side effects. Avoid foods that are high-fat, sugary, and calorie-dense:

  • Simple and refined carbs which increase your blood glucose levels. Simple carbs include soda, candy, desserts, white bread, pasta, and white rice
  • Foods high in saturated and trans fats
  • Sodium
  • Avoid large amounts of alcohol as it increases your risk of developing low blood sugar and increases the risk of lactic acidosis (alcohol and metformin together can lead to the build-up of lactic acid in the blood). Reducing alcohol consumption will help to manage your blood sugar levels. Also, drinking alcohol on an empty stomach can reduce your blood sugar. This could be an issue for people using insulin or other diabetes medications that increase insulin levels. One drink per day for women and two drinks per day for men is a safe level of alcohol consumption, however not consuming alcohol may be the best choice
  • Grapefruit juice – animal studies found higher amounts of lactic acid production and increased weight gain
  • Healthy snacks (granola bars or fruit snacks are actually high in sugar)

What foods cause diarrhea with metformin?

Some foods can make the symptoms of diarrhea worse while taking metformin. These foods include vegetables, garlic, onion, dairy products, foods that produce gas, oily or junk food.

Foods to avoid when taking metformin for PCOS

Avoid any foods that can cause a sudden peak in blood sugar levels, such as candy, soda, sweet desserts, chips, white bread, or crackers.

High fiber foods to avoid on metformin

Avoid foods such as avocado, berries, beans, chia seeds, chickpeas, and oatmeal.

Can I eat sugar while taking metformin?

Eating foods high in sugar will essentially work against what the metformin is being taken for. You are recommended to avoid or at the very least try to limit foods high in sugar.

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What are the best foods to eat while taking metformin?

There are no specific foods that you need to eat while taking metformin. However, it is generally recommended to eat a healthy diet that is low in fat, sugar, and calories in order to prevent high blood sugar. This type of diet can help you control your blood sugar levels and lose weight. Focus on meal plans that include eating healthy foods that can raise your blood sugar levels like:

  • Fruits – such as apples, oranges, bananas, and grapes
  • Nonstarchy vegetables such as broccoli, carrots, and leafy greens
  • Complex carbs (carbohydrates) such as oatmeal, whole grain bread, and brown rice, which are high in fiber
  • Legumes – such as beans, and lentils
  • Lean protein – such as chicken, fish, tofu, and beans
  • Healthy fats – such as olive oil, avocados, nuts, and seeds that may help to reduce your risk of a cardiovascular events, including stroke and heart attack

Foods to eat when taking metformin for weight loss

The best advice as with all meals is to maintain a healthy balanced diet, high in protein, and low in fat and carbs. Use whole foods, fruits, vegetables, and grains, and reduce how much processed food you consume.

Metformin and eggs

Eggs are a protein-rich food and that help to manage blood sugar levels in people with diabetes.

Can you eat bananas with metformin?

Bananas contains a combination of carbs that can raise blood sugar, and also beneficial fiber nutrients. The advice is to eat no more than 2 to 3 bananas in a week if you are diabetic.

What to eat for breakfast while taking metformin

Some options for breakfast if you are taking metformin are whole-grain cereal with oatmeal, egg, and flaxseed, or bagels with nut butter, banana, and chia seeds.

Can you drink milk while taking metformin?

You can drink milk with metformin, but to reduce the side effects of diarrhea you are advised to drink either semi-skimmed or low fat milk rather than full fat milk to help limit your carb intake.

Metformin drug interactions

Metformin can interact with other medications. These include:

  • Antibiotics
  • Diuretics
  • NSAIDs
  • Corticosteroids
  • Treatments for heart failure and high blood pressure
  • Contraceptive pills also affect blood sugar levels so a change in dosage may be required
  • Antipsychotics
  • Anticonvulsants
  • Blood thinners
  • Other diabetes drugs

Metformin can interact with other medications. Tell your prescribing physician about all your drugs, including vitamins and dietary supplements.

Metformin contraindications

You should not use metformin if you:

  • Are allergic to metformin
  • Have severe kidney disease
  • Have metabolic acidosis or diabetic ketoacidosis
  • Are younger than 10 years old
  • Are breastfeeding or are planning to breastfeed

Talk to a healthcare professional before using metformin if you:

  • Have kidney disease
  • Have high ketone levels in your blood or urine
  • Have heart disease, or congestive heart failure
  • Have liver disease
  • Use insulin or other oral diabetes medications
  • Have a severe infection
  • Have chronic alcoholism
  • Are 65 or older
  • Are pregnant or are planning to become pregnant
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Who can take metformin?

Metformin is typically prescribed to people with type 2 diabetes. Metformin may not be the right diabetes medication for you if you have certain medical conditions or other risk factors that may affect your health. Talk with your doctor about your health history before taking metformin.

For individuals with diabetes, it is important to monitor low blood sugar to prevent symptoms of hypoglycemia (low blood sugar).

Can I take Ozempic with metformin?

Ozempic and metformin are safe to take together and are often prescribed together for the treatment of type 2 diabetes and weight management.

Speak to your healthcare provider if you are taking any other prescription medications, over-the-counter medications, or supplements while taking metformin.

Medically reviewed

A medical professional has reviewed this article.

Metformin

Metformin may rarely cause a serious, life-threatening condition called lactic acidosis. Tell your doctor if you have kidney disease. Your doctor will probably tell you not to take metformin. Also, tell your doctor if you are over 65 years old and if you have ever had a heart attack; stroke; diabetic ketoacidosis (blood sugar that is high enough to cause severe symptoms and requires emergency medical treatment); a coma; or heart or liver disease. Taking certain other medications with metformin may increase the risk of lactic acidosis. Tell your doctor if you are taking acetazolamide (Diamox), dichlorphenamide (Keveyis), methazolamide, topiramate (Topamax, in Qsymia), or zonisamide (Zonegran).

Tell your doctor if you have recently had any of the following conditions, or if you develop them during treatment: serious infection; severe diarrhea, vomiting, or fever; or if you drink much less fluid than usual for any reason. You may have to stop taking metformin until you recover.

If you are having surgery, including dental surgery, or any major medical procedure, tell the doctor that you are taking metformin. Also, tell your doctor if you plan to have any x-ray procedure in which dye is injected, especially if you drink or have ever drunk large amounts of alcohol or have or have had liver disease or heart failure. You may need to stop taking metformin before the procedure and wait 48 hours to restart treatment. Your doctor will tell you exactly when you should stop taking metformin and when you should start taking it again.

If you experience any of the following symptoms, stop taking metformin and call your doctor immediately: extreme tiredness, weakness, or discomfort; nausea; vomiting; stomach pain; decreased appetite; deep and rapid breathing or shortness of breath; dizziness; lightheadedness; fast or slow heartbeat; flushing of the skin; muscle pain; or feeling cold, especially in your hands or feet.

Tell your doctor if you regularly drink alcohol or sometimes drink large amounts of alcohol in a short time (binge drinking). Drinking alcohol increases your risk of developing lactic acidosis or may cause a decrease in blood sugar. Ask your doctor how much alcohol is safe to drink while you are taking metformin.

Keep all appointments with your doctor and the laboratory. Your doctor will order certain tests before and during treatment to check how well your kidneys are working and your body’s response to metformin. Talk to your doctor about the risk(s) of taking metformin.

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Why is this medication prescribed?

Metformin is used alone or with other medications, including insulin, to treat type 2 diabetes (condition in which the body does not use insulin normally and, therefore, cannot control the amount of sugar in the blood). Metformin is in a class of drugs called biguanides. Metformin helps to control the amount of glucose (sugar) in your blood. It decreases the amount of glucose you absorb from your food and the amount of glucose made by your liver. Metformin also increases your body’s response to insulin, a natural substance that controls the amount of glucose in the blood. Metformin is not used to treat type 1 diabetes (condition in which the body does not produce insulin and therefore cannot control the amount of sugar in the blood).

Over time, people who have diabetes and high blood sugar can develop serious or life-threatening complications, including heart disease, stroke, kidney problems, nerve damage, and eye problems. Taking medication(s), making lifestyle changes (e.g., diet, exercise, quitting smoking), and regularly checking your blood sugar may help to manage your diabetes and improve your health. This therapy may also decrease your chances of having a heart attack, stroke, or other diabetes-related complications such as kidney failure, nerve damage (numb, cold legs or feet; decreased sexual ability in men and women), eye problems, including changes or loss of vision, or gum disease. Your doctor and other healthcare providers will talk to you about the best way to manage your diabetes.

How should this medicine be used?

Metformin comes as a liquid, a tablet, and an extended-release (long-acting) tablet to take by mouth. The liquid is usually taken with meals one or two times a day. The regular tablet is usually taken with meals two or three times a day. The extended-release tablet is usually taken once daily with the evening meal. To help you remember to take metformin, take it around the same time(s) every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take metformin exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Swallow metformin extended-release tablets whole; do not split, chew, or crush them.

Your doctor may start you on a low dose of metformin and gradually increase your dose not more often than once every 1–2 weeks. You will need to monitor your blood sugar carefully so your doctor will be able to tell how well metformin is working.

Metformin controls diabetes but does not cure it. Continue to take metformin even if you feel well. Do not stop taking metformin without talking to your doctor.

Ask your pharmacist or doctor for a copy of the manufacturer’s information for the patient.

Metformin Interactions

There are 359 drugs known to interact with metformin, along with 4 disease interactions, and 1 alcohol/food interaction. Of the total drug interactions, 20 are major, 310 are moderate, and 29 are minor.

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Does metformin interact with my other drugs?

Enter other medications to view a detailed report.

  • View all 359 medications that may interact with metformin
  • View metformin alcohol/food interactions (1)
  • View metformin disease interactions (4)

Most frequently checked interactions

View interaction reports for metformin and the medicines listed below.

  • Major
  • Moderate
  • Minor
  • Unknown
  • Aspir 81 (aspirin)
  • Aspirin Low Strength (aspirin)
  • CoQ10 (ubiquinone)
  • Crestor (rosuvastatin)
  • Cymbalta (duloxetine)
  • Eliquis (apixaban)
  • Fish Oil (omega-3 polyunsaturated fatty acids)
  • Januvia (sitagliptin)
  • Jardiance (empagliflozin)
  • Lantus (insulin glargine)
  • Lasix (furosemide)
  • Lipitor (atorvastatin)
  • Lyrica (pregabalin)
  • Metoprolol Succinate ER (metoprolol)
  • Metoprolol Tartrate (metoprolol)
  • Nexium (esomeprazole)
  • Ozempic (semaglutide)
  • Plavix (clopidogrel)
  • Singulair (montelukast)
  • Synthroid (levothyroxine)
  • Trulicity (dulaglutide)
  • Tylenol (acetaminophen)
  • Victoza (liraglutide)
  • Vitamin B12 (cyanocobalamin)
  • Vitamin C (ascorbic acid)
  • Vitamin D2 (ergocalciferol)
  • Vitamin D3 (cholecalciferol)
  • Xanax (alprazolam)
  • Zoloft (sertraline)
  • Zyrtec (cetirizine)

Metformin alcohol/food interactions

Metformin disease interactions

There are 4 disease interactions with metformin which include:

  • lactic acidosis
  • cardiovascular risk
  • hypoglycemia
  • B12 deficiency

Report options

  • Email this report to a friend, doctor, or patient
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More about metformin

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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.

MajorHighly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
ModerateModerately clinically significant. Usually avoid combinations; use it only under special circumstances.
MinorMinimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
UnknownNo interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

How to Prevent Deadly Drug Interactions

Some mixtures of medications can lead to serious and even fatal consequences.

Drug Status
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