New studies released today found that many who take the popular diabetes medication metformin find the odor off-putting, and some have trouble taking the medication.
The “fishy” odor is especially noticeable in the immediate release versions.
“Metformin is an excellent drug, but the immediate-release formulation may have an odor to it. The smell is fishy or like the inside of an inner tube, and in a patient’s mind, because it smells like something that has gone bad, they may think the drug isn’t good,” explained one of the letter’s authors, J. Russell May, a clinical professor at the University of Georgia College of Pharmacy at the Medical College of Georgia.
However, May said, “some metformin products on the market are extended-release and the drug is embedded and released slow, over time. These products have much less smell, if any.”
May and his colleagues wrote the letter to the journal to raise awareness of this issue, especially because nausea is a commonly reported side effect of metformin. “Is it nausea from the medication, or is it because it smells bad?” May said.
The drug’s odor may make it seem like it has gone bad, but doctors have reassured patients that it is just something in the formula of the medication, and the drug is still affective at treating diabetes and is not dangerous.
Bristol-Meyers Squib who is one of the major producers of metformin released a statement saying,
Bristol-Myers Squibb is aware that the inherent characteristics of metformin have been associated with a mild odor upon opening of the bottle, so these type of reports are not unexpected. It’s important to note there has been no correlation between an odor and the efficacy of metformin, which has been on the market in the U.S. since 1995.
Some of the brand versions of metformin that may give off this “fishy” odor are: Glucophage, Glumetza, Fortamet, and Riomet.
Patients prescribed metformin should continue on their regular regiment, but should certainly let their doctor know if they are affected by the smell. They may be able to switch to the extended release version or possibly another brand.
The Type 2 diabetes drug Januvia has become a source of controversy after the drug’s maker, Merck, funded a letter to doctors by CVS Caremark, the pharmacy benefits manager, urging the physicians to add the drug to specific patients’ treatment regimens.
Januvia costs as much as 10 times the price of older diabetes drugs such as metformin and glipizide. (Note: Januvia purchased from a Canadian pharmacy costs about half as much as from a U.S. pharmacy — though it is still significantly more expensive than metformin and glipizide.)
Beyond the apparent conflict of interest in CVS Caremark’s letter, the question most important to patients is whether Januvia’s superiority over older, cheaper diabetes drugs makes it worth the additional cost.
The answer is, it depends.
Amy at Diabetes Mine points out that Merck has been pushing the drug very hard, and that while it appears to be effective, there are also concerns about safety and side effects.
If you have Type 2 diabetes and are considering Januvia, or your doctor has already recommended it to you, make sure to discuss the pros and cons thoroughly — and don’t be afraid to remind your doctor of Januvia’s additional cost. Physicians often forget to factor cost into their decisions on which drugs to prescribe, so it’s important to speak up.
And if you do end up taking Januvia, be sure to ask for free samples whenever you visit your doctor.
-
Cary Byrd, President of eDrugSearch.com
-
Medi-Share: Christian Health Insurance Alternative
