I'm seeing quite a few posts on BBSes from people who are having problems with metformin because of side effects that could be eliminated if they were taking the extended release form of this drug. For some reason, many family doctors don't seem to be aware that there is a ER version of this drug that has such benefits. This is probably because metformin is a cheap generic and isn't promoted by herds of beautiful ex-cheerleaders turned drug company salespushers who "educate" doctors about far more expensive--and less effective--newer drugs. Here are the facts: Metformin (also sold under the brand name Glucophage) comes in a regular version which is taken at meal time, three times a day, and an extended release form (marketed as ER or XR) which is taken once a day. Almost always, when people report diarrhea or intense heartburn with metformin, they are taking regular version. It was very disturbing because the pain was localized over my heart and felt just like the description of a heart attack you read in articles. My doctor assured me it was coming from the metformin, but that didn't make it any easier to live with because I kept wondering how, if I were having a real heart attack, I'd know it wasn't a pain from the drug? The ER version releases the drug more slowly and this usually eliminates the gastrointestinal problems. If you examine your claims data, you’ll likely discover that among your “Top 50 Most Expensive Drugs” is a line item for generic “metformin HCL ER”. Metformin HCL is a longstanding, very inexpensive diabetes treatment. There metformin HCL ER treatments that are very inexpensive. So the question is: Why would this line item be among your “Top 50” most expensive drugs? The answer: There are certain generic forms of metformin HCL ER that are absurdly expensive, while others bear the low-costs that you’d expect. But it’s reasonably likely that many (if not most) of your beneficiaries are unknowingly using the high-cost forms of this drug. To help you understand what is taking place, we provide you with the following Chart, reflecting, first, the “immediate release” version of metformin, and then the 3 “extended release” generic versions of this drug. Our 3 columns for each drug identify each of the dosage strengths, the GSN identifiers, and the per ‘unit’ cost based on current retail Average Acquisition Costs (AACs).
Ponce de Leon completed medical school at the University of Texas at Houston and general surgery training at Baylor University Medical Center in Dallas. He is a pioneer in advanced laparoscopic surgery, having recently performed the first single-incision adrenolectomy in Texas. He also specializes in bariatric surgery, including the LAP-BAND® system. Ponce de Leon is a fluent Spanish speaker and stays active in the Hispanic community. Most people think diabetes comes from pancreas damage, due to autoimmune problems or insulin resistance. But for many people diagnosed “Type 2,” the big problems are in the liver. What are these problems, and what can we do about them? The liver is one of the most complicated organs in the body, and possibly the least understood. It plays a huge role in handling sugars and starches, making sure our bodies have enough fuel to function. When there’s a lot of sugar in the system, it stores some of the excess in a storage form of carbohydrate called glycogen. When blood sugar levels get low, as in times of hunger or at night, it converts some of the glycogen to glucose and makes it available for the body to use. Easy to say, but how does the liver know what to do and when to do it?
Glock Talk is the #1 site to discuss the world’s most popular pistol, chat about firearms, accessories and more. As our membership continues to grow we look forward to reading your stories and learning from your experiences. So what can be done about these outrageous price increases? I’ve had type 1 diabetes for 53 years. I don’t ever remember price gouging like this!