Sorry to hijack this thread again, but I decided to give metformin a try. 500mg once per day. I will report on any benefits I see in my Journey thread.
Is there a generic or metformin?
Metformin is the generic drug. The branded drug is Glucophage. The branded drug is very costly to self-pay, and most health insurance plans will not cover it except in very unusual circumstances. Some patients find the branded drug to be more effective than the generic. I have used both and did not see a tremendous difference in effectiveness between the two.
Unless your doctor has a specific reason to use the standard quick-release version, most patients report better success with the extended-release version of Metformin (usually referred to as Metformin XR or Metformin ER). In particular, it tends to cause less gastric distress, especially diarrhea, the most common side effect along with upset stomach and flatulence.
The typical protocol suggested by most doctors is to titrate the dose up gradually. The usual initial dose is 500 mg a day. This is then increased no faster than 500 mg. a week until a therapeutic dose is reached (i.e., one which lowers blood sugars in some significant amount).
Most adult males will not see any significant effects from Metformin until the dose reaches 1500 mg. a day. Some effect is usually seen after three days or so at a therapeutic level, with the full effect of a given dosage generally reached after three weeks. The current maximum recommended dose is 2000 mg. a day for the extended-release version, 2250 mg. a day for the quick-release version.
I had elevated fasting blood sugars upon awakening, and so I was prescribed the extended-release version to be taken in the evening because it reaches its highest blood concentration in between four and eight hours. Some patients prefer to take evening Metformin with dinner, I prefer to take mine at bedtime. I started with 500 mg. of the extended-release version each night. I began to see a noticeable drop in morning fasting blood sugars once I got to 1500 mg. each night, but an even more significant effect at 2000 mg., which is where I have remained.
Metformin is a good drug with a good track record. Perhaps its most serious noted side effect is lactic acidosis, although that is probably of greatest concern to those with compromised kidney function. Metformin has occasionally been linked in the literature to a decrease in serum Vitamin B-12, so one might want to have that tested when starting Metformin to have a baseline for future tests to be compared against (and perhaps take a low-dose B-complex vitamin or multivitamin with Bs if you don’t already; high doses of B-12 probably aren’t necessary).
Metformin is most effective when combined with a low-carbohydrate diet. It usually will not bring blood sugars down to anything like truly normal levels if carbohydrates remain unrestricted.
You should consult your doctor before taking any medication, including Metformin.