Riomet

What is Riomet

Riomet is used to regulate blood glucose (sugar) levels. Riomet works in three ways: first, it reduces the amount of glucose produced by your liver; second, it reduces the amount of glucose absorbed from food through your stomach; and third, it makes the insulin that your body produces work better to reduce the amount of glucose already in your blood.

Riomet is used to treat non-insulin-dependent diabetes mellitus (NIDDM or Type II diabetes). Riomet may be used alone or together with insulin or other diabetes medicines.

Riomet may also be used for purposes other than those listed in this medication guide.

General medical information about Riomet

A small number of people who have taken Riomet have developed a serious condition called lactic acidosis that has been fatal in up to 50% of cases. Lactic acidosis has occurred most often in people whose kidneys were not working properly. Liver problems may also increase the risk of developing lactic acidosis. Stop taking Riomet and call your doctor immediately if you experience a feeling of general discomfort or sickness; weakness; sore or aching muscles; trouble breathing, unusual drowsiness, dizziness or lightheadedness; unusual or unexplained stomach upset (after the initial stomach upset that may occur at the start of therapy with Riomet); or the sudden development of a slow or irregular heartbeat. These may be signs of lactic acidosis.

Avoid excessive alcohol intake while taking Riomet. Together, alcohol and Riomet may increase the risk of lactic acidosis and hypoglycemia.

Riomet does not usually cause hypoglycemia (low blood sugar). Nevertheless, hypoglycemia may occur in the treatment of diabetes, as a result of skipped meals, excessive exercise, or alcohol consumption. Know the signs and symptoms of low blood sugar, which include hunger, headache, drowsiness, weakness, dizziness, a fast heartbeat, sweating, tremor, and nausea. Carry candy or glucose tablets to treat episodes of low blood sugar.

What you should find out before taking Riomet

Do not take Riomet without first talking to your doctor if you
- have kidney disease;
- have liver disease;
- have congestive heart failure;
- have acute or chronic metabolic acidosis, including diabetic ketoacidosis;
- have had a heart attack or a stroke;
- have a serious infection, illness, or injury;
- need to have surgery;
- need to have x-rays or other procedures using injectable contrast agents;
- are dehydrated (have lost water from your body) due to diarrhea, vomiting, fever, heat stroke, decreased fluid intake, or any other cause;
- drink alcohol; or
- are 80 years of age or older and have not had your kidney function tested.

You may not be able to take Riomet, or you may require a dosage adjustment or special monitoring during treatment if you have any of the conditions listed above.

Riomet is in the FDA pregnancy category B. This means that it is unlikely to harm an unborn baby. Usually, your doctor will want to prescribe insulin to control diabetes during pregnancy. Do not take Riomet without first talking to your doctor if you are pregnant.

Riomet passes into breast milk and may affect a nursing baby. Do not take Riomet without first talking to your doctor if you are breast-feeding a baby.

If you are over the age of 65 years, there may be an slight increase in the risk of developing lactic acidosis due to a natural decline in kidney function with advancing age. A lower dose or special monitoring may be necessary during your treatment.

How should take Riomet

Take Riomet exactly as directed by your doctor. If you do not understand these directions, ask your pharmacist, nurse, or doctor to explain the instructions to you.

Take the tablets with a full glass of water.

Do not crush, chew, or break the Glucophage XR tablets. Swallow them whole. They are specially formulated to release the medication slowly in the body.

To ensure that you get a correct dose, measure the Riomet solution with a dose-measuring spoon, dropper, or cup, not a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist where you can get one.

Take Riomet with a meal to reduce nausea, diarrhea, and upset stomach that may occur with Riomet therapy. These symptoms may be more likely to occur during the first few weeks of therapy.

Occasionally, inactive ingredients in the Riomet extended-release (Glucophage XR) tablets may pass through your body undissolved and appear in the stool as a soft mass. This is not harmful, and the medication has been absorbed by your body.

It is important to take Riomet regularly to get the most benefit.

A decrease in vitamin B12 may also occur during Riomet therapy. Your doctor may want to monitor your blood levels of vitamin B12 and you may need to take B12 supplements. A vitamin B12 deficiency may rarely cause anemia.

Your healthcare provider may recommend regular monitoring of blood sugar levels with blood or urine tests.

Your doctor may want you to have blood tests or other medical evaluations during treatment with Riomet to monitor progress and side effects.

Store Riomet tablets and oral solution at room temperature away from moisture and heat.

If you miss a dose:

Take the missed dose as soon as you remember. However, if it is almost time for the next dose, skip the missed dose and only take the next regularly scheduled dose. Do not take a double dose.

What happens if you overdose:

Seek emergency medical attention if an overdose is suspected.

An overdose of Riomet is likely to cause lactic acidosis. Symptoms of lactic acidosis include a feeling of general discomfort or sickness; weakness; sore or aching muscles; trouble breathing; unusual drowsiness, dizziness or lightheadedness; unusual or unexplained stomach upset (after the initial stomach upset that may occur at the start of therapy with Riomet); and the sudden development of a slow or irregular heartbeat.

Avoid while taking Riomet

Avoid excessive alcohol intake while taking Riomet. Together, alcohol and Riomet may increase the risk of lactic acidosis and hypoglycemia.

Follow diet, medication, and exercise routines closely. Changing any of these things can affect blood sugar levels.

Tell your doctor or other health care provider that you are taking this medication if you need to have surgery or x-ray procedures that require injection of contrast agents. Treatment with Riomet may need to be stopped for a short period of time.

Tell your doctor that you are taking Riomet if you become ill, if you have a heart attack; if you have a stroke; if you develop congestive heart failure; if you experience diarrhea, vomiting, fever, or dehydration from any cause; or if you decrease the amount of food or liquid in your normal diet. You may need to stop your treatment with Riomet for a short amount of time until you are feeling better.

Possible side effects of Riomet

Stop taking Riomet and seek emergency medical attention if you experience an allergic reaction (difficulty breathing; closing of the throat; swelling of the lips, tongue, or face; or hives).

Other, less serious side effects may be more likely to occur. Continue to take Riomet and talk to your doctor if you experience
- nausea, vomiting, abdominal pain, or diarrhea at the start of therapy;
- abdominal bloating or increased gas production; or
- decreased appetite or changes in taste (metallic taste in your mouth).

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect Riomet

Before taking this medication, tell your doctor if you are taking any of the following medications:
- a diuretic (water pill) such as furosemide (Lasix), bumetanide (Bumex), ethacrynic acid (Edecrin), torsemide (Demadex), amiloride (Midamor), triamterene (Dyazide, Maxzide, Dyrenium), spironolactone (Aldactone), hydrochlorothiazide (HydroDiuril), chlorothiazide (Diuril), chlorthalidone (Hygroton), indapamide (Lozol), metolazone (Zaroxolyn, Mykrox), and others;
- a phenothiazine such as chlorpromazine (Thorazine), prochlorperazine (Compazine), promethazine (Phenergan), and others
- an estrogen (Premarin, Prempro, Ogen, and others) or birth control pill (Ovral, Lo-Ovral, Ortho-Novum, Triphasil, Levlen, Tri-Levlen, Alesse, and others)
- a calcium channel blocker such as nifedipine (Adalat, Procardia), verapamil (Calan, Verelan, Isoptin), diltiazem (Cardizem, Dilacor XR), felodipine (Plendil), bepridil (Vascor), amlodipine (Norvasc), and others;
- a steroid medication such as prednisone (Deltasone), methylprednisolone (Medrol), dexamethasone (Decadron), and others;
- a thyroid medication (Synthroid, Levoxyl, Levothroid, and others),
- digoxin (Lanoxin, Lanoxicaps);
- procainamide (Pronestyl);
- quinidine (Cardioquin, others);
- cimetidine (Tagamet, Tagamet HB) or ranitidine (Zantac, Zantac 75);
- morphine (Astramorph, MS Contin, Roxanol, and others);
- trimethoprim (Proloprim, Trimpex, Septra, Bactrim);
- phenytoin (Dilantin);
- isoniazid (Nydrazid); or
- nicotinic acid or niacin (Nicobid, Nicolar, others).

You may not be able to take Riomet, or you may require a dosage adjustment or special monitoring if you are taking any of the medicines listed above.

Drugs other than those listed here may also interact with Riomet or affect your condition. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines, including vitamins, minerals, and herbal products.