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Suggest Treatment For Gas, Constipation And Diarrhea After Taking Generic Drugs

Posted on Wed, 10 Dec 2014

Question: Express scripts has substituted two of my drugs with generic.
Normally I take Lyrica for fibromyalgia and it has been substituted with gabapentin.
Also I normally take glumetza and now substituted with santarus.
I have unbelievable gas, constipation and/or diarrhea. I'm crying all the time and have abnormal thinking.
Which go these are causing all these side effects? I can't continue this.
Thanks so much. XXXXX DOB 00/00/00. Not overweight, don't smoke, rarely have a glass of wine.

Answered by Dr. Chintan Solanki (40 minutes later)

Brief Answer:
what is there in santarus? it is likely culprit

Detailed Answer:
Hello XXXX,

Thanks for writing to us.

Lyrica and gabapentin are used almost for the same indications.None of them cause such gastrointestinal side effects generally.

Glumetza (metformin) can cause such side effects but you are taking it regularly so it is not responsible for problem.
Now the only remaining thing is santarus.I can not get the exact content of it. But it is likely anti diabetic medicine as it is substituted for glumetza. And anti diabetic drugs are realted to gastrointestinal system and can cause stomach upset.

Symptoms of thinking, hot flushes and crying suggest some psychological disturbance.

Please revert back to me with detail dose and frequency of the drugs you are taking.
Please let me know any stress if you have. It may be social, economical or emotional stress.

Waiting for your reply.

Regards,
De.Chintan Solanki.

Above answer was peer-reviewed by : Dr. Ashwin Bhandari

Follow up: Dr. Chintan Solanki (4 hours later)

Normally my glumetza is 500 mg.
I just looked at this new script more closely. It IS Glumetza ER 500 mg. but the
MFR is Santarus. I guess when I looked at the bottle, I thought it was a different drug.
Hmmm so this can't be the culprit.
Now the other one.
I have taken Lyrica 75 mg.. For 4-5 years without difficulty.
This Gabapentin is 300 mg.
Can this be the reason I am having these symptoms...due to increase in milligrams?
I'm crying because I'm so sick!! No psychological reason otherwise.

Answered by Dr. Chintan Solanki (4 hours later)

Brief Answer:
No,not due to gabapentine milligrams

Detailed Answer:
Hi XXXX,

Thanks for follow up and info.

Equivalent dose of 75 mg lyrica to gabapentine is around 300 mg. So it is appropriate dose, mg doesn't matter while comparing the drug. It is individual drug potency that matters.Maximum dose recommended for pregabalin is about 600 mg while for that for gabapentine is 3600 mg.I have never found such side effects with gabapentine in my practice. And I even could not find any such article on net. gabapentine is useful somewhat in anxiety features.So in my opinion ,gabapentine is not responsible.

But yes Metformin can cause such stomach upset. So changing brand/formulation may cause such problem. You can ask your doctor to stop MFR for a while and see the effects or you can revert back to previous formulation.

Another possibility is some gastric infection and indigestion problem.
(If after above suggested measures for MFR and ruling out gastric infection and indigestion your situation persist, then only stop gabapentine considering a rare side effect of it)
Hope I have answered your query, I will be happy to answer more.

Regards,
Dr.Chintan Solanki.
http://bit.ly/drchintansolanki

Note: For further guidance on mental health, Click here.

Above answer was peer-reviewed by : Dr. Yogesh D