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Discussion Starter #1
I'm going to try switching from Januvia to Metformin ER (plain Metformin didn't agree with me and Januvia may cause Pancreatic cancer)

Why does metformin ER need to be taken in the evening as opposed to the morning?

What does the 2nd sentence in bold mean?

The usual starting dose of metformin hydrochloride extended-release tablets is 500 mg once daily with the evening meal. Dosage increases should be made in increments of 500 mg weekly, up to a maximum of 2000 mg once daily with the evening meal.
 

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Don't know about why taking it in the evening. But do know that most people start off with a small dose and increase gradually in order to let the body get used to it and hopefully prevent gastric difficulties.

Good luck with it this time. People do report much less problems with the ER version.
 

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I have been on Metformin 2,000mg for over 9 years. I recall for the first few months 3-4, when I took it, I got gas and a little bit of an upset stomach. But after a time, that mostly stopped. I now only get a little gas, and not stomach upset.

I was on Januvia for about 2 year. Did nothing for my blood sugar but damn near killed me! I kept getting severe upper respiratory infections, that I had never had before. They came on like wild fire, I would get a thick feeling in my throat and by the next day, I was having trouble breathing. Each time I ended up on antibiotics to get well. But it would get me 3-4 times a year...! I finally figured out it was being caused by Januvia.....! Stopped it, my BS stayed the same and since I stopped 7-8 years ago, I have had -0- respiratory infections! Be careful about Januvia...it has a very long list of side affects...!
 

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a guess would be that they want you to take it with the biggest meal of the day (and possible the last meal) to make hopefully reduce stomach issues
 

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Taking metformin at night is preferred as it stops liver dumps, and improves insulin resistance. This is more beneficial at night as it improves your FBG and can also help any Dawn Phenomom issues. I think that the way XR/ER works is its better absorbed through the night were you go longer without eating.

I would think that you do not need to build up the XR/ER metformin if you were already taking the regular. Be aware tha The max of if XR/ER is 2000, so 550 mg less than regular. When I took extended release, I took 1000 at night and 1000 in the morning.

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I'm on the extended release and recently switched from taking it at night to taking it in the morning. Haven't noticed any change at all in my fasting numbers. :D
 

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I was prescribed 1000 mg EX a day and was told to start out taking 500 mg once a day for seven days with food at night, on the eight day to add another 500 mg in the morning with food. Doc said you body needs to get use to met, he also said the reason for taking it twice a day was to keep more of an even keel in system.

I agree with Papa, if you've been taking regular met you don't need to ease into the EX unless they increased your dosage. If they increased your dosage go ahead and take what you did before and then add 500 mg a week until new dosage is reached. This is just what I would do, you should ask your doctor so you're following his advice. I don't always agree with my doc but at the same time I don't want make her mad, I still need her to right scripts and take blood draws :)

Now going from ex to regular I would ease into it. I was accidentally given regular met when I had been on EX for a couple of years and within a few days my stomach was upset and I felt anxious and dizzy. I always double check before I leave the pharmacy to make sure I have EX.
 

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I've been on ER for a few years after having a poor response (nausea ++) to regular metformin when I first was prescribed it.

I've recently had to switch back, because supplies in Australia (at least at the pharmacies near me) have dried up, at all dose levels :( I'll go back on it when it reappears, but interestingly I have had zero issues with regular metformin this time around.
 

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And having said that, I'll now say this: a week down the track and its happening again. What to do... Still no ER supplies in town.
 

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Discussion Starter #10
I switched to Metformin ER (Glumetxa in Canada).
The doc gave me two weeks of 1000mg samples (they are huge oval pills).
The prescription is only for 500mg pills.
I'm taking my BG every morning so I'll have numbers for the 2 weeks of 1000mg and 2 weeks of 500mg.
 

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Good thing script is for 500s, I hear the costs of the the 1000 mg pills are bad expensive, yet the 500s are cheap. How much does your prescription say to take? Usually 1000 mg is smallest dosage and that is 2 500s.
 

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I take Met XR, 1000 MG in the Am and 1000 mg in the PM Its extended release so it dont matter when you take it.
 

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Discussion Starter #13 (Edited)
The prescription is for 500mg OD.
I'm kinda annoyed that the samples ones are 1000mg and then I am supposed to go down.
I feel nauseous and kinda dizzy, hopefully that goes away.
My BG is really good in the morning with this (5.5, sorry non-Canadians, I wish there was an international standard of measuring it).
I really don't want to back to Januvia (I had no problems with it but there is a possible link to Pancreatic cancer).
 

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Discussion Starter #14
Good thing script is for 500s, I hear the costs of the the 1000 mg pills are bad expensive, yet the 500s are cheap. How much does your prescription say to take? Usually 1000 mg is smallest dosage and that is 2 500s.
Not in Canada. :)
Januvia 100mg:
90 - $318.28

Glumetza 500mg (Metformin Extended Release):
30 - $30.70
90 - $71.18

Glumetza 1000mg (Metformin Extended Release):
30 - $50.95
90 - $132.90
 
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Not in Canada. :)
Januvia 100mg:
90 - $318.28

Glumetza 500mg (Metformin Extended Release):
30 - $30.70
90 - $71.18

Glumetza 1000mg (Metformin Extended Release):
30 - $50.95
90 - $132.90
Sorry I missed your response.
Is that after insurance? Still not as bad as I've heard a couple of others mention before.
I'm still glad I can take the regular 500mgX60 for $4 at Walmart.
 

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Discussion Starter #16
Sorry I missed your response.
Is that after insurance? Still not as bad as I've heard a couple of others mention before.
I'm still glad I can take the regular 500mgX60 for $4 at Walmart.
Those are the prices before insurance (Ottawa, Ontario, Canada).
It is covered by OHIP so I don't know what it would cost (probably cheaper than my work insurance).
 

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I'm on the extended release and recently switched from taking it at night to taking it in the morning. Haven't noticed any change at all in my fasting numbers. :D
I have actually been testing this over several months now.

What I have tried.

Take it all at night.
Take it all in the morning.
Take half at night and half in morning.
Take half at 2 pm and half at night.

Guess what I found out after all that testing?

FOR ME: It made absolutely no difference. :vs_laugh:
 

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FOR ME: It made absolutely no difference.
That was my experience also, so I picked the time I was most likely to remember (right before bed) and stuck w/ it.
 
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Discussion Starter #19
I take other drugs in the morning and evening so I don't have a problem remembering.
 

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The reason why they have you start it in the evening is because many people get slight nausea and it's not usually bothersome to them in the evening. Stepping up the dosage reduces the chance that you will have nausea.

Unfortunately, for some of us, even extended release causes problems over time. I was getting severe gut pain after 5 years of using it. Tried again a few months ago after a 6 month break and that ended yesterday. Gut pain and nausea are definitely not the same thing.
 
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