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Riomet
Riomet (generic name: metformin hydrochloride) is an oral medication used to treat type 2 diabetes mellitus. It belongs to a class of drugs known as biguanides and works by improving insulin sensitivity and reducing the amount of sugar produced by the liver. Riomet is typically prescribed to help control blood sugar levels in individuals with type 2 diabetes, especially when diet and exercise alone are not sufficient. It is available as an oral solution and is a liquid formulation of metformin, offering an alternative for patients who may have difficulty swallowing tablets.
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Frequently Asked Questions
How long does it take for Riomet to start working?
Riomet begins lowering blood sugar levels within several days of starting treatment. Full effects may take one to two weeks to be noticeable.
Can Riomet cause weight loss?
Metformin, the active ingredient in Riomet, is associated with modest weight loss in some patients. It is often preferred for patients who are overweight or obese and need to manage their blood sugar levels.
Is Riomet safe for children?
Yes, Riomet is approved for use in children aged 10 years and older for the management of type 2 diabetes. The dosing is adjusted based on the child’s response and needs.
What should I do if I experience diarrhea while taking Riomet?
Diarrhea is a common side effect when starting Riomet, but it usually improves after the first few weeks. Taking the medication with food can help. If diarrhea persists or worsens, contact your doctor.
Can I stop taking Riomet if my blood sugar levels improve?
No, do not stop taking Riomet without consulting your healthcare provider. Even if your blood sugar levels are well controlled, stopping the medication may cause your levels to rise again. Your doctor will guide you on how to manage your treatment.
Comprehensive Drug Guide
How Does Riomet Work?
Riomet works by decreasing glucose production in the liver, reducing the absorption of glucose in the intestines, and improving the body's sensitivity to insulin. This leads to lower blood sugar levels without directly stimulating the production of insulin, reducing the risk of hypoglycemia. Metformin helps patients with type 2 diabetes maintain better control of their blood sugar levels.
What is Riomet Used For?
Common Dosages
- 500 mg/5 mL oral solution.
The dosage is typically individualized based on the patient's response and blood glucose levels.
Typical Dosing
- The usual starting dose for adults is 500 mg (5 mL) twice daily or 850 mg once daily.
- The dose may be increased by 500 mg weekly or 850 mg every two weeks depending on the patient’s response. The maximum recommended daily dose is 2,000 mg to 2,500 mg.
- For children aged 10 years and older, the usual starting dose is 500 mg twice daily with a gradual dose increase based on blood sugar control.
- Riomet should be taken with meals to reduce the risk of gastrointestinal side effects.
Typical Dosing
FDA Approved Indications
- Management of type 2 diabetes mellitus in adults and children aged 10 years and older, particularly when diet and exercise alone are insufficient to control blood sugar levels.
Who Shouldn't Take Riomet?
- Severe renal impairment (eGFR less than 30 mL/min/1.73 m²)
- Metabolic acidosis, including diabetic ketoacidosis
- Known hypersensitivity to metformin or any component of the formulation
- Conditions associated with hypoxemia, such as heart failure or respiratory disease, due to the increased risk of lactic acidosis
Advice From The Pharmacist
- Take Riomet with food to reduce the risk of stomach upset and diarrhea, which are common side effects during the initial weeks of treatment.
- Regular monitoring of blood glucose levels and kidney function is important, especially in older adults or those with existing kidney problems.
- Avoid excessive alcohol consumption, as this can increase the risk of lactic acidosis, a rare but serious complication of metformin use.
- Store Riomet in a cool, dry place and shake the bottle well before each use. Measure the dose carefully using the provided measuring cup or oral syringe.
- If you miss a dose, take it as soon as you remember, unless it is close to your next dose. Do not take two doses at once to make up for a missed one.
Side Effects of Riomet
Common Side Effects
- Diarrhea
- Nausea or vomiting
- Stomach upset or abdominal discomfort
- Loss of appetite
- Metallic taste in the mouth
Uncommon/Severe Side Effects
- Lactic acidosis (a rare but serious buildup of lactic acid in the body), which can present with symptoms such as unusual tiredness, trouble breathing, stomach pain, or feeling cold.
- Low vitamin B12 levels with long-term use, which can lead to symptoms of anemia or neuropathy.
Risks and Warnings of Riomet
- Lactic Acidosis: Although rare, metformin can cause lactic acidosis, a serious condition that can be fatal. Risk factors include kidney impairment, liver disease, alcohol use, and conditions that reduce oxygen levels in the blood (e.g., heart failure, severe infection). Symptoms include fatigue, muscle pain, trouble breathing, and slow or irregular heartbeat. If these symptoms occur, seek emergency medical attention.
- Renal Function: Kidney function should be assessed before starting Riomet and periodically thereafter. Patients with reduced kidney function (eGFR less than 30 mL/min) should not take Riomet.
- Surgical or Radiological Procedures: Discontinue Riomet temporarily in patients undergoing surgery or contrast dye procedures due to the increased risk of lactic acidosis.
Interactions with Riomet
Common Drug Interactions
- Alcohol: Drinking alcohol while taking Riomet can increase the risk of lactic acidosis.
- Contrast agents: Use of iodinated contrast agents during imaging procedures can increase the risk of lactic acidosis and renal failure. Riomet should be discontinued before the procedure and resumed after kidney function is reassessed.
- Medications that impair kidney function: Drugs such as nonsteroidal anti-inflammatory drugs (NSAIDs), certain diuretics, or blood pressure medications may increase the risk of kidney problems, and careful monitoring is needed.
Alternatives to Riomet
- Glucophage (metformin tablets): The tablet form of metformin, widely used for type 2 diabetes management.
- Januvia (sitagliptin): A DPP-4 inhibitor that helps lower blood sugar in adults with type 2 diabetes.
- Victoza (liraglutide): A GLP-1 receptor agonist that helps control blood sugar and is available as an injection.
- Insulin therapy: For patients who cannot achieve adequate blood sugar control with oral medications, insulin may be used as an alternative.
