A1,
A2,
B,
C1,
C2,
D,
E,
F,
G-H,
I-K,
L,
M,
N,
O,
P1,
P2,
Q-R,
S,
T,
U-V,
W-Z
Riomet Patient, Information, Instructions - Metformin Hcl
Riomet Patient, Information, Instructions - Metformin Hcl
PATIENT
INFORMATION
Patients should be informed of the potential risks and benefits
of RIOMET and of alternative modes of therapy. They should also be informed
about the importance of adherence to dietary instructions, of a regular exercise
program, and of regular testing of blood glucose, glycosylated hemoglobin, renal
function, and hematologic parameters.
The risks of lactic acidosis, its symptoms, and conditions
that predispose to its development, as noted in the WARNINGS
and PRECAUTIONS sections, should be explained
to patients. Patients should be advised to discontinue RIOMET immediately and
to promptly notify their health practitioner if unexplained hyperventilation,
myalgia, malaise, unusual somnolence, or other nonspecific symptoms occur. Once
a patient is stabilized on any dose level of RIOMET, gastrointestinal symptoms,
which are common during initiation of metformin therapy, are unlikely to be
drug related. Later occurrence of gastrointestinal symptoms could be due to
lactic acidosis or other serious disease.
Patients should be counselled against excessive alcohol intake,
either acute or chronic, while receiving RIOMET.
Metformin alone does not usually cause hypoglycemia, although
it may occur when metformin is used in conjunction with oral sulfonylureas and
insulin. When initiating combination therapy, the risks of hypoglycemia, its
symptoms and treatment, and conditions that predispose to its development should
be explained to patients and responsible family members.
Laboratory Tests
Response to all diabetic therapies should be monitored by periodic
measurements of fasting blood glucose and glycosylated hemoglobin levels, with
a goal of decreasing these levels toward the normal range. During initial dose
titration, fasting glucose can be used to determine the therapeutic response.
Thereafter, both glucose and glycosylated hemoglobin should be monitored. Measurements
of glycosylated hemoglobin may be especially useful for evaluating long-term
control (see also DOSAGE AND ADMINISTRATION).
Initial and periodic monitoring of hematologic parameters (e.g.,
hemoglobin/hematocrit and red blood cell indices) and renal function (serum
creatinine) should be performed, at least on an annual basis. While megaloblastic
anemia has rarely been seen with metformin therapy, if this is suspected, Vitamin
B12 deficiency should be excluded.
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