What is Glumetza?
Glumetza is an extended-release formulation of metformin hydrochloride, a medication from the biguanide class. It is a prescription medication used in addition to diet and exercise to improve glucose control in adults with type 2 diabetes mellitus (T2DM). Controlling hyperglycemia prevents downstream complications such as kidney damage, loss of limbs, blindness, heart attack, stroke, or nerve problems. Glumetza is not recommended for the treatment of type I diabetes mellitus (T1DM) or patients with diabetic ketoacidosis.
How does Glumetza work?
Glumetza is an oral antidiabetic agent that works by decreasing fasting and postprandial plasma glucose (morning and post-meal blood sugars). Metformin’s exact mechanism is not well understood, but a few methods have been postulated. Metformin decreases absorption of glucose in the intestine, lowers hepatic production of glucose, and increases insulin sensitivity by elevating peripheral glucose utilization.With Glumetza, insulin secretion does not change, however, all-day plasma insulin response and fasting insulin levels can decrease.
Side Effects
Common side effects include:
- Diarrhea
- Flatulence
- Nausea and vomiting
- Vitamin B12 deficiency
- Dyspepsia
- Asthenia
- Abdominal distress
- Headache
- Heartburn
- Loss of appetite
- Abdominal bloating or gas
- Belching
- Fullness or early satiety
Warnings & Precautions
Lactic acidosis
There have been rare but serious reports of lactic acidosis with metformin use, some being fatal cases. The onset was typically gradual with symptoms including muscle pain, abdominal pain, drowsiness, and respiratory distress. More severe cases of acidosis included symptoms such as hypothermia, hypotension, and bradyarrhythmia. The signs and symptoms were accompanied by increased blood lactate concentrations, anion gap acidosis, and an elevated lactate/pyruvate ratio. There are multiple risk factors that increase an individual’s chance of developing lactic acidosis while on metformin, which include:
- Renal impairment – In post-marketing cases, lactic acidosis caused by metformin mostly occurred in patients that had significant renal impairment. Do not use in patients with an eGFR of less than 45 mL/min/1.73 m2. Monitor eGFR annually in patients taking Glumetza. In patients at greater risk for developing renal dysfunction, such as the elderly, more frequent monitoring of renal function is recommended.
- Drug interactions – Be cautious when using Glumetza with other drugs influencing renal function, hemodynamics, metformin uptake, and acid-base balance to prevent the development of lactic acidosis. Consider monitoring patients more frequently.
- Age 65 or greater – Older patients are at a higher risk for developing renal impairment. Therefore, renal function should be assessed more often in the elderly who are on Glumetza.
- Radiological studies with contrast – Iodinated contrast agents in patients on metformin have caused acute reductions in renal function and therefore lactic acidosis. Discontinue Glumetza before an iodinated contrast imaging procedure in patients with an eGFR of 30 to 60 mL/min/1.73 m2, in patients with hepatic impairment, alcoholism, or heart failure, or for patients receiving intra-arterial iodinated contrast. Assess eGFR 48 hours after the procedure and reinitiate Glumetza once renal function has stabilized.
- Surgery – Restricted food and fluids during surgical procedures can elevate the risk for volume depletion, hypotension, and renal impairment. Pause Glumetza while patients have restricted food and fluid intake.
- Hypoxic states – Stop Glumetza when hypoxic states occur, such as in acute congestive heart failure, cardiovascular collapse, acute myocardial infarction, and sepsis.
- Alcohol – Avoid excessive alcohol intake, as alcohol increases the effects of metformin on metabolism of lactate. Warn patients of the dangers of drinking large amounts of alcohol while on Glumetza.
- Hepatic impairment – Patients with hepatic impairment are at higher risk of developing lactic acidosis when taking Glumetza. Do not use Glumetza if a patient exhibits signs of hepatic disease
Drug Interactions
Vitamin B12 Deficiency
Studies have shown a decrease in vitamin B12 levels with the use of metformin. Monitor hematologic measures annually and vitamin B12 parameters every 2 to 3 years for patients taking Glumetza. If abnormalities are present, manage appropriately with Glumetza discontinuation or vitamin B12 supplementation.
Hypoglycemia with Concomitant Use of Insulin Products
Glumetza can cause hypoglycemia when used in combination with other products that lower blood glucose, such as insulin. Dose adjustments to insulin may be required to prevent the development of hypoglycemia.
Macrovascular Outcomes
Decreased macrovascular risk with Glumetza has not been proven in any clinical studies.
Carbonic Anhydrase Inhibitors (CAI)
Carbonic anhydrase inhibitors can lower serum bicarbonate and cause non-anion gap metabolic acidosis. When used concomitantly with Glumetza, this combination can elevate an individual’s risk of developing lactic acidosis. Patients who are taking these drugs in combination should be frequently monitored. Examples of CAIs include topiramate and acetazolamide.
Drugs that Decrease Clearance of Glumetza
Medications that interfere with the renal elimination of metformin should be avoided. Drugs like ranolazine, dolutegravir, and cimetidine can increase a patient’s systemic exposure to metformin and elevate the risk of lactic acidosis.
Alcohol
Patients should avoid excessive alcohol intake. Alcohol has been shown to increase metformin’s effect on lactate metabolism, causing an increased risk for lactic acidosis.
Other Drugs Affecting Glycemic Control
When used in combination with other drugs that can cause hypoglycemia, the risk for developing hypoglycemia with Glumetza is increased. Patients should be monitored for signs of hypoglycemia when on concomitant glucose-altering agents such as steroids, diuretics, and phenytoin.
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Buy Canadian Insulin helps eligible U.S. patients access prescription medications through participating licensed pharmacy partners.
Glumetza may be available at lower pricing compared with some U.S. retail pharmacy prices. Pricing may vary depending on strength, quantity, pharmacy availability, and exchange rates.
Patients can request up to a 3-month supply when permitted by prescription and pharmacy policies.
A valid prescription is required before any order can be reviewed and processed.
Prescription and Pharmacy
A valid prescription from a licensed healthcare provider is required before Glumetza can be reviewed or dispensed through participating pharmacy partners.
Buy Canadian Insulin works with participating licensed pharmacy partners to help eligible customers access prescription medications. Prescription orders are subject to pharmacy review and verification requirements.
Pharmacist consultation may be available through participating pharmacy partners for questions regarding medication use, side effects, drug interactions, dosage instructions, and storage requirements.
Prescription products may be dispensed by licensed pharmacy partners located in Canada or other approved international fulfillment locations depending on product availability, pharmacy source, and applicable regulations.
Have a Prescription?
Customers with a valid prescription may submit a Glumetza order request through Buy Canadian Insulin.
Available services may include:
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- Multiple quantity options when available
- Customer support by phone, email, or live chat
- Pharmacy partner fulfillment based on availability
- Pricing visibility before checkout
Product availability, pricing, pharmacy source, and shipping timelines may vary.
Shipping and Storage Information
Glumetza tablets are generally shipped according to pharmacy handling procedures and do not require refrigerated shipping.
Shipping timelines may vary based on prescription review, pharmacy processing times, product availability, destination, carrier operations, customs processing, and weather conditions.
Customers should review all product packaging and storage instructions upon delivery.
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Frequently Asked Questions
Disclaimer
Buy Canadian Insulin provides educational information about medications and health conditions for informational purposes only. This content is not intended to replace professional medical advice, diagnosis, or treatment. Prescription medications require valid prescription review and processing through participating pharmacy partners. Product availability, pricing, and shipping timelines may vary. Consult your healthcare provider or pharmacist before starting, stopping, or changing any medication.
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