Best time of day to take Metformin ER and Glimperide?

[brendak1254 10]

Morning or bedtime, and why. I'm going back on Metformin ER and want to ease into it.

 

 

Thx for your help.

 

Brenda

[tabathadolley 10]

When I started out I found nighttime to be better with dinner because I would sleep through the worst symptoms. I also found 500mg to be easier twice a day than 1000 at once.

[jims_forum 1,250]

For me; I take 500 mg doses - 1 at 1 hour before each meal and then one 500mg Dose at 10:00pm and one at 12:00 am midnight. Those last two doses cut off dawn phen.

 

One big dose is waste of pills and in fact the two late evening doses if combined do not shut off dawn phen.

 

For what it is worth; here is latest findings(not theories) on how met actually works.

 

Science News

... from universities, journals, and other research organizations

 

Most-Used Diabetes Drug Works in Different Way Than Previously Thought

Jan. 6, 2013 — A team, led by senior author Morris J. Birnbaum, MD, PhD, the Willard and Rhoda Ware Professor of Medicine, with the Institute for Diabetes, Obesity, and Metabolism, Perelman School of Medicine, University of Pennsylvania, found that the diabetes drug metformin works in a different way than previously understood. Their research in mice found that metformin suppresses the liver hormone glucagon's ability to generate an important signaling molecule, pointing to new drug targets. The findings were published online this week in Nature.

________________________________________

For fifty years, one of the few classes of therapeutics effective in reducing the overactive glucose production associated with diabetes has been the biguanides, which includes metformin, the most frequently prescribed drug for type 2 diabetes. The inability of insulin to keep liver glucose output in check is a major factor in the high blood sugar of type 2 diabetes and other diseases of insulin resistance.

"Overall, metformin lowers blood glucose by decreasing liver production of glucose," says Birnbaum. "But we didn't really know how the drug accomplished that."

Imperfectly Understood

Despite metformin's success, its mechanism of action remained imperfectly understood. About a decade ago, researchers suggested that metformin reduces glucose synthesis by activating the enzyme AMPK. But this understanding was challenged by genetic experiments in 2010 by collaborators on the present Nature study. Coauthors Marc Foretz and Benoit Viollet from Inserm, CNRS, and Université Paris Descartes, Paris, found that the livers of mice without AMPK still responded to metformin, indicating that blood glucose levels were being controlled outside of the AMPK pathway.

Taking another look at how glucose is regulated normally, the team knew that when there is no food intake and glucose decreases, glucagon is secreted from the pancreas to signal the liver to produce glucose. They then asked if metformin works by stopping the glucagon cascade.

The Nature study describes a novel mechanism by which metformin antagonizes the action of glucagon, thus reducing fasting glucose levels. The team showed that metformin leads to the accumulation of AMP in mice, which inhibits an enzyme called adenylate cyclase, thereby reducing levels of cyclic AMP and protein kinase activity, eventually blocking glucagon-dependent glucose output from liver cells.

From this new understanding of metformin's action, Birnbaum and colleagues surmise that adenylate cyclase could be a new drug target by mimicking the way in which it is inhibited by metformin. This strategy would bypass metformin's affect on a cell's mitochondria to make energy, and possibility avoid the adverse side effects experienced by many people who take metformin, perhaps even working for those patients resistant to metformin.

[jwags 9,219]

Metformin ER is time released so it should not matter when you takey it. The regular metformin is different and I find separating it into smaller doses timed to when you spike the most works. I take 850 when I wake up, 850 around 9:30 am and the last 850 right before bed.

[PATRIC 11]

My experience with the Met dosing has been an ongoing process since I started in Sept `12. Doc started me on 1x500 at my request to lower BGs to help heal Foot Neuropathy. I had already dropped 30#,A1c to 5.7 from 8.8 and FBG to 155 from 268 at DX in 7 months . I was supposed to return in 90 days but lost insurance so that hasn`t happened.

Luckily I have kinfolk ,1 a Diabetic Educator and long time RN for advice and support. The DE told me early to take Met at suppertime since it was supposed to counter the Liver activity overnite that cause the Dawn Phenom. After the Pharmacy screwed up and gave me Met 500 ER instead of regular (I didn`t know the difference) by looking at it. I wasn`t seeing a lot of change and asked My DE ,she said most people don`t see a whole lot of difference till they get to 2000mg daily. So I upped the dose over about 6-7 weeks to 2000 and was seeing about 7-9 drop with each increase in dosage, 500 at at time. Had no side effects at all. When I went to get a refill he gave met regular Met instead of the ER like before. It did cause some problems but finally got adjusted. Got a new RX and got 750 ER this time and still had a bunch of the 500 regulars left so recently I have been taking 1250 about 7 pm with supper and 750 before bedtime about 11pm. With regular Met I was trying to take one in the afternoon with late lunch and then the other 1500 at 7 pm with supper. That schedule had my FBG down to about 120 really consistently. With the schedule to the 750`s and one at 11 my numbers have dropped on down to 110-115 consistently. The only thing I can attribute to the drop is the change in schedule.

If you do the numbers on the Met having a half-life of about six hours and space 500mg out over 4x24 hours after a couple of days you are up to 1000 in your system and after that the increase is extremely slow. By taking the Met late in the day you get the near full dosage over the course of the time that it is actually needed...overnite when the liver does it`s thing. The numbers back up the schedule in my little pea brain.

[jwags 9,219]

I just noticed Glimperide in your title. Glimperide works by overstimulating pancreas to produce lows. You may want to take this earlier in the day, so you can deal with the lows. You do not want to go low overnight while you are sleeping.

[TX_Clint 18,472]

I am on Metformin ER and take 1000 early in the morning and 1000 late in the evening. However, I have changed the times around and have seen little if any change with the Merformin ER. It does make dosing easier.

[tabathadolley 10]

I just noticed Glimperide in your title. Glimperide works by overstimulating pancreas to produce lows. You may want to take this earlier in the day, so you can deal with the lows. You do not want to go low overnight while you are sleeping.

 

I second that. If you start getting lows in this med, talk to your doctor because that's the point where mine said it's time to get off of it.

[SueM 40]

Morning or bedtime, and why. I'm going back on Metformin ER and want to ease into it.

 

 

Thx for your help.

 

Brenda

 

Does the leaflet supplied with the ER Metformin not tell you to take it in the evening?

[princesslinda 2,839]

I have problems with my a.m. blood sugars, so I take metformin 500 mg ER 1 at bedtime (around 10 pm) and then another on waking (around 6 am). I'm not troubled by side effects, so taking it before I have breakfast doesn't bother me. If you don't know how you'll tolerate it, I wouldn't try it on an empty stomach.