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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Is The Dosage Of Metformin HCL In An Elderly Person?

My husband is taking Metformin HCL 500mg tablet .He is taking 1 tablet twice a day. Today his Doctor called and wanted him to take 2 in the morning and 2 in the evening. I have heard to many other diabetics say this has caused them other problems . He is 81 years old. I see that their are quite a few law suits. What are the lawsuits about?.
Mon, 8 Jan 2018
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Internal Medicine Specialist,  's  Response
The major toxicity of metformin- lactic acidosis, is very rare and can be prevented by careful patient selection. Conditions which increase lactate production [alcohol intoxication, low-flow states, congestive heart failure (CHF), respiratory failure] combined with impaired renal clearance will potentially result in lactic acidosis.
The most common adverse effects are diarrhoea and decreases in vitamin B12 levels.Vitamin B12 levels are ~30% lower during metformin
treatment.
Metformin should not be used in patients with renal insufficiency
(glomerular filtration rate [GFR] of acidosis, unstable congestive heart failure (CHF), liver disease, or
severe hypoxemia.
Hence serum creatinine should be monitored during metformin therapy.
Metformin is contraindicated if Serum creatinine >1.5 mg/dL (men)
>1.4 mg/dL (women).
These are the main issues with metformin;otherwise it is safe to treat DM type 2 with metformin.
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What Is The Dosage Of Metformin HCL In An Elderly Person?

The major toxicity of metformin- lactic acidosis, is very rare and can be prevented by careful patient selection. Conditions which increase lactate production [alcohol intoxication, low-flow states, congestive heart failure (CHF), respiratory failure] combined with impaired renal clearance will potentially result in lactic acidosis. The most common adverse effects are diarrhoea and decreases in vitamin B12 levels.Vitamin B12 levels are ~30% lower during metformin treatment. Metformin should not be used in patients with renal insufficiency (glomerular filtration rate [GFR] of acidosis, unstable congestive heart failure (CHF), liver disease, or severe hypoxemia. Hence serum creatinine should be monitored during metformin therapy. Metformin is contraindicated if Serum creatinine 1.5 mg/dL (men) 1.4 mg/dL (women). These are the main issues with metformin;otherwise it is safe to treat DM type 2 with metformin.