Table of Contents
Why is metformin contraindicated in elderly?
The use of metformin as a treatment should be avoided in patients over 80 years of age because of declining kidney function. Insulin therapy is an option but as hypoglycaemia is related to advancing age, patients should be monitored carefully for the development of hypoglycaemia.
Why is metformin contraindicated?
Contraindication includes hypersensitivity, chronic heart failure, metabolic acidosis with or without coma, diabetic ketoacidosis (DKA), severe renal disease, abnormal creatinine clearance resulting from shock, septicemia, or myocardial infarction and lactation.
What are the contraindications for sulfonylureas?
Contraindications to the use of sulfonylureas include hypersensitivity to sulfonylureas and drugs that have similar structures (see earlier) and pregnancy. Caution should be exercised in cases of reduced renal or hepatic function. Patients with ketoacidosis should receive insulin, not an oral antihyperglycemic agent.
What contraindications are there to a patient taking a sulfonylurea drug such as glyburide?
Sulfonylurea Precautions Sulfonylureas shouldn’t be taken by people with type 1 diabetes or diabetic ketoacidosis (a dangerous condition that can occur if high blood sugar is left untreated). People with liver or kidney problems may not be able to take sulfonylureas.
Which sulfonylurea is best in elderly?
Elderly patients who lack contraindications like renal impairment or heart failure are able to safely take metformin. For those with a contraindication or intolerance to metformin, a short-acting sulfonylurea like glipizide is recommended as initial therapy.
How is diabetes treated in the elderly?
Elderly patients should be treated with the principle of “start low and go slow”. Oral antidiabetic drugs and insulin are used in the treatment of diabetes in the elderly.
What patients Cannot take metformin?
Intolerance and contraindications to metformin These include renal impairment with elevated serum creatine levels (i.e. more than 136 mmol/l in men and 124 mmol/l in women) or abnormal creatinine clearance, congestive heart failure requiring pharmacologic treatment, and advanced age (more than 80 years of age).
What are some of the drug drug interactions of metformin?
Most frequently checked interactions
- Aspir 81 (aspirin)
- Aspirin Low Strength (aspirin)
- Crestor (rosuvastatin)
- Cymbalta (duloxetine)
- Fish Oil (omega-3 polyunsaturated fatty acids)
- Januvia (sitagliptin)
- Lantus (insulin glargine)
- Lasix (furosemide)
What are sulfonylurea medications?
Sulfonylurea: A class of oral hypoglycemic agents (medications that lower the level of blood glucose) taken by people with type 2 diabetes. The sulfonylureas increase the secretion of insulin by the pancreas. There are two generations of sulfonylureas.
What medications interact with sulfonylureas?
Aspirin – Aspirin may potentiate the effects of sulfonylureas.
What is the most common side effect from sulfonylurea medication?
Sulfonylureas are usually well tolerated. The most common side effect is hypoglycemia, more common with long-acting sulfonylureas such as chlorpropamide and glibenclamide [23–25]. However, all sulfonylureas may cause hypoglycemia, usually due to an excessive dosage.
Can you take metformin and sulfonylurea together?
Patients treated with sulfonylureas alone or in combination with metformin appeared to have an increased RR of adverse cardiovascular outcomes compared with those treated with metformin alone.