[CARPA] Fwd: Re: swapping to Metformin XR

Thu Apr 19 09:54:41 EST 2007

I am finding such a lot of non-compliance amongst the Aboriginal diabetic 
population and I'm slowly changing all my patients over to SR metformin 
(up to 2gms) in the hope that there may be more compliance by a once daily 
dose in the morning - to be had with their weetbix or porridge! - So far 
seems to be working. Just watch the Kidneys! - Mike.

Dr Michael W Nixon
DMO Reg.  Rm 126,  Block 4, RDH
(Chair MSHR, Ethics Research Committee)
Box 40596
CASUARINA NT 0811
Ph 892 28358 Mob 0427 618 915

"Alex Hope" <wombat at octa4.net.au> 
Sent by: carpa-bounces at ozdocit.org
18/04/2007 09:36 PM
Please respond to
Central Australian Rural Practitioners Association <carpa at ozdocit.org>

To
carpa at ozdocit.org
cc

Subject
[CARPA] Fwd: Re: swapping to Metformin XR

Would be good to have input from a few more people on this topic.
I haven't tried it with any of my patients yet.
Alex
(scroll down for email exchange)
Dr Alex Hope

Community GP,
Ltyentye Apurte Community Government Council Health Centre,
CMB Santa Teresa,
via Alice Springs,
NT 0872.

Ph  08 8956 0911
Fax 08 8956 0910
Mobile 0408 085 143

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***********Here Followeth a  Forwarded Message***********

On 18/04/2007 at 8:18 PM Ciara.OSullivan at nt.gov.au 
<Ciara.OSullivan at nt.gov.au> wrote:

>Hi there
> 
>The recommended maximum dose of metformin XR is 2 g daily, which is 
pretty
>much in line with the total dose of standard metformin we are mostly 
using
>now.
> 
>Ideally metformin XR is taken nocte ... but this is not very practical 
and
>I think we just have to compromise over this detail.
> 
>Cheers - Ciara
>
>-----Christine Connors/THS/NTG wrote: -----
>
>To: Ciara O'Sullivan/THS/NTG at NTGeMAG
>From: Christine Connors/THS/NTG
>Date: 04/16/2007 10:01AM
>cc: Alan Evans/THS/NTG at NTGeMAG, Heinz Deiter/THS/NTG at NTGeMAG, John
>Hester/THS/NTG at NTGeMAG, Louise Elliott/THS/NTG at NTGeMAG, Nick
>Tyllis/THS/NTG at NTGeMAG, russell.thompson at wynhealth.org.au, Stephen
>Brady/THS/NTG at NTGeMAG, Stephen Foster/THS/NTG at NTGeMAG, 
wombat at octa4.net.au
>Subject: Re: swapping to Metformin XR
>
>so what is other people's experience
>will patients take the 4 tabs to make 2gm daily or do they prefer the
>usual 1gm bd?
>
>Ciara: apart from the obvious issue of big tablets, is there any issues
>taking metformin XR as 3gm single daily dose?
>
>
>Dr. Christine Connors
>Program Director PCD
>NT Department of Health & Community Services
>Phone: (08) 8922 8218
>Fax: (08) 8922 7714
>Mobile: 0401 116 121
>email: christine.connors at nt.gov.au
>
>
>
>
>
>
>
> Ciara O'Sullivan/THS/NTG
>
>
>Ciara O'Sullivan/THS/NTG 
>
>14/04/2007 07:31 PM
>To
>
>Alan Evans/THS/NTG at NTGeMAG, Stephen Foster/THS/NTG at NTGeMAG, John
>Hester/THS/NTG at NTGeMAG, Louise Elliott/THS/NTG at NTGeMAG, Nick
>Tyllis/THS/NTG at NTGeMAG, Heinz Deiter/THS/NTG at NTGeMAG,
>russell.thompson at wynhealth.org.au
>
>cc
>
>Christine Connors/THS/NTG at NTGeMAG, wombat at octa4.net.au, Stephen
>Brady/THS/NTG at NTGeMAG
>
>Subject
>
>Re: swapping to Metformin XR
>
>
>
>Hi team
> 
>Metformin XR is now available in most remote clinics.
> 
>I would like to emphasise that metformin XR and standard metformin 500 mg
>tablets are equivalent and when swapping from a usual treatment dose of
>standard metformin of 1 g bd, you need to prescribe metformin XR 4 
tablets
>daily. No down-titration is needed with subsequent up-titration.
> 
>YES!!! The metformin XR tablets are pretty big and are actually the same
>size (but bulkier) than metformin 1 g tablets. You need to show the
>patients what they are getting as some patients are horrified and refuse
>to swap. 
> 
>I think using metformin XR in usual treatment doses of 2 g per day is 
very
>useful for patients on few other tablets. However use of metformin XR
>poses some real problems for us as clinicians; on the one hand we want to
>provide convenient once daily medications (improves compliance) but on 
the
>other hand, prescribing 4 whoppers in addition to a handful of other
>morning medications is very off putting for many patients (reduces
>compliance).
> 
>This is the doctors' s dilemma. However, the solution is not to prescribe
>half the previous standard dose of meformin (ie swapping from metfrormin 
1
>g bd to metformin XR 1 g od) which potentially deprives the patient of
>useful treatment, and this is what I am seeing on a lot of the scripts at
>the moment!
> 
>Cheers - CIara

*********** END FORWARDED MESSAGE  ***********
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