Metformin does not augment insulin secretion, does not produce weight gain (although modest weight loss may occur) and is rarely associated with hypoglycemia when used alone. Use of metformin, particularly in patients with marked hyperglycemia and baseline hyperlipidemia, results in a moderate (10% to 20%) reduction in triglycerides, a small decrease (5% to 10%) in total cholesterol and a small increase in high density lipoprotein cholesterol. These improvements in lipid profile are independent of the improvement in gly-cemic control.
Metformin is initially associated with gastrointestinal intolerance in up to 30% of patients. These gastrointestinal adverse effects include nausea, anorexia, abdominal pain, metallic taste and diarrhea. Although malabsorption of vitamin B12 may occur, development of anemia during metformin therapy is rare. Initial use of a low dose, with gradual dose escalation, tends to improve its tolerability. Your online shopping for Buy Claritin online is going to be as advantageous as never before.
Lactic acidosis is a potentially fatal complication of metformin therapy. Fortunately this occurs very rarely when metformin is judiciously prescribed, with observance of the official contraindications and precautions. Metformin must be avoided in patients with renal or hepatic impairment, cardiorespiratory insufficiency and alcoholism.
To reduce gastrointestinal upset metformin should be taken with meals. Metformin has traditionally required tid administration but availability of the new 850 mg tablet allows bid dosing in many patients. Although available gen-erically as 500 mg, the cost of metformin still exceeds that of the generic sulphonylureas.