[CARPA] Fwd: Re: swapping to Metformin XR
Christine.Connors at nt.gov.au
Christine.Connors at nt.gov.au
Thu Apr 19 10:11:31 EST 2007
feedback to date from most Top end DMO's is that few are using it
Rosemary Lee did try it, but found patients struggled with the size of tablet
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
MichaelW.Nixon at nt.g
ov.au
Sent by: To
carpa-bounces at ozdoc Central Australian Rural Practitioners
it.org Association <carpa at ozdocit.org>
cc
19/04/2007 09:24 AM Subject
Re: [CARPA] Fwd: Re: swapping to
Metformin XR
Please respond to
Central Australian
Rural Practitioners
Association
<carpa at ozdocit.org>
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
To
carpa at ozdocit.org
18/04/2007 09:36 PM cc
Subject
Please respond to [CARPA] Fwd: Re:
Central Australian Rural Practitioners swapping to Metformin XR
Association <carpa at ozdocit.org>
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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