Remember that the information presented here is not intended to replace the care of your own doctor. Before making any changes in the management of your own illness, you should consult your physician or other qualified medical professionals.
Question
My doctor prescribed
metformin [brand name: Glucophage],
and told me to ask the pharmacist if there were contraindications. She is very busy, my doctor, and my medicines are many.
I am taking Depakote, Klonopin, Lasix, potassium, Cartia XT, digoxin, warfarin, and metformin. Now the druggist did not really look it up but said he'd call back later if there was a problem.
But reading online, it seemed that Lasix and digoxin were contraindications to metformin.
Could you help me with this; it feels like someone is trying to pickle my liver. I don't know and each time I go to the doctor,
I get more medications.
Answer
Contraindications
are very different from
Interactions.
A contraindication means there's data that the drug should not be used, as the chances that something bad will
happen are high. An example: Metformin is contraindicated in people with
renal disease or renal dysfunction,
congestive heart failure requiring pharmacologic treatment,
known hypersensitivity to metformin hydrochloride, and
acute or chronic metabolic acidosis.
Drug interactions are not necessarily a cause for not prescribing a medication. For example, you
were already on digoxin and Lasix, which have a potential interaction with each other, and which is not a reason for concern if your doctor
is monitoring your potassium level routinely.
Interactions for many drugs, including metformin, are available (although unfortunately in very technical lingo) at
Drugs.com.
I notice that you are on digoxin, a drug commonly used for two reasons: for congestive heart failure, or for arrhythmias (heart rhythm problems)
So you may have a contraindication to the use of metformin (congestive heart failure requiring pharmacologic treatment) if you are on digoxin for CHF.
Go back to your physician and ask for clarification of why you're on digoxin — and if you are on it for CHF, there are many alternative medications that could be used for diabetes:
see
Medicines for people with diabetes.
Finally, I must add that it's the doctor's responsibility to know the medications that she/he prescribes. If there were problems,
it's no excuse to be "busy".
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