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). Carefully follow the special meal plan your doctor gave you. This is a very important part of controlling your condition, and is necessary if the medicine is to work properly. Also, exercise regularly and test for sugar in your blood or urine as directed. Metformin should be taken with meals to help reduce stomach or bowel side effects that may occur during the first few weeks of treatment. Swallow the tablet or extended-release tablet whole with a full glass of water. While taking the extended-release tablet, part of the tablet may pass into your stool after your body has absorbed the medicine. Measure the oral liquid with a marked measuring spoon, oral syringe, or medicine cup. The average household teaspoon may not hold the right amount of liquid. Use only the brand of this medicine that your doctor prescribed. You may notice improvement in your blood glucose control in 1 to 2 weeks, but the full effect of blood glucose control may take up to 2 to 3 months.
Metformin (brand names Glucophage, Glucophage XR, Riomet, Fortamet, Glumetza) is a member of a class of medicines known as biguanides. (By comparison, metformin has been used in Europe since the 1960’s.) The U. Food and Drug Administration (FDA) required large safety studies of metformin, the results of which demonstrated that the development of lactic acidosis as a result of metformin therapy is very rare. This type of medicine was first introduced into clinical practice in the 1950’s with a drug called phenformin. This situation most likely slowed the approval of metformin, which was not used in the U. (A finding that has been confirmed in many other clinical trials to date.) Of note, the FDA officer involved in removing phenformin from the market recently wrote an article highlighting the safety of metformin. Unfortunately, phenformin was found to be associated with lactic acidosis, a serious and often fatal condition, and was removed from the U. Metformin works primarily by decreasing the amount of glucose made by the liver. It does this by activating a protein known as AMP-activated protein kinase, or AMPK. This protein acts much like an “energy sensor,” setting off cellular activities that result in glucose storage, enhanced entry of glucose into cells, and decreased creation of fatty acids and cholesterol. A secondary effect of the enhanced entry of glucose into cells is improved glucose uptake and increased storage of glycogen (a form of glucose) by the muscles. Additionally, the decrease in fatty acid levels brought about by metformin may indirectly improve insulin resistance and beta cell function. * Impacts only claims paid by the Vendor Drug Program: traditional Medicaid, CSHCN, HTW, and KHC Programs. † To learn about traditional Medicaid claim pricing and PPG pricing incentives please refer to the Drug Pricing & Reimbursement (PDF) chapter of the VDP Pharmacy Provider Procedure Manual. ‡ Please review the lists of DUR board-approved clinical prior authorizations that apply to traditional Medicaid and those that health plans may use. The Pharmacy Clinical Prior Authorization Assistance Chart (PDF) shows the prior authorization each health plan uses and how those authorizations relate to the authorizations used for traditional Medicaid claim processing. Refer to the MCO Resources for links to each health plan's active clinical prior authorizations.
Dec 10, 2018. Metformin Extended Release Tablets official prescribing information for. Extended-release tablets 1,000 mg white-colored tablets imprinted. In another randomized, double-blind, parallel trial comparing metformin IR 500 mg twice daily vs ER 1000 mg or ER 1500 mg once daily, A1c.