new onset diarrhea with long term metformin

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This is not a request for medical advice, but an observation, and a suggestion. I took Metformin Extended Release for many years without significant side effects and reasonable glucose control.

Over recent months, I developed severe, unpredictable diarrhea. I tried changing the times I took the meds, to no avail. I stopped taking Metformin and the diarrhea ceased completely, but my glucose levels were higher. Subsequently, I asked the pharmacist for a two week supply of the brand name product: Glucophage XR. Like magic, my blood glucose improved and my GI symptoms have not returned. (I hope my physician can be persuaded to order the brand name product in the future.)

My pharmacy had changed generic metformin manufacturers, and my suspicion is that the recent generic formulation I was using was causing the GI problems.

Here is my observation: Although the metformin literature states that initial GI side effects will resolve, it seems to be a possibility that people who have been on metformin for a long time can have new and severe GI symptoms. This is not a minor side effect; it affected my ability to work and carry out my daily activities.

Here is my request: Listen to patients and believe them when they say they are having problems with metformin. Be an advocate. My doctor didn't listen to me, but my pharmacist did. I'm wondering if my experience might be common. Several people I have spoken to say they have severe diarrhea with metformin, but are willing to live with it because they believe it "shows the medication is working". I'm also wondering if there is a varying pattern of GI side effects with different metformin manufacturers.

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Specializes in Family Nurse Practitioner.

Yes it is possible to develop an allergy or intolerance to medication even after years of use. Thank you for your warning about brand vs generic metformin. Please make sure to consult with your physician/primary care provider in the future before stopping or making any changes to your medication schedule.

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Why was your doctor refractory to your plight?

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He is very much a follower of guidelines-- from the professional organizations, from the insurance company, and I think, from his employer. Although I consider him competent, he is difficult to communicate with because of a very heavy accent, and some cultural differences. He did mention I could discontinue the generic meds, but didn't follow through on his initial comment. I now have a prescription for the brand name product and am doing well. (The pharmacist called his office and got the change made.)

You may ask why I stay with this physician. I live in a rural area with a lot of provider turnover. This physician has been here probably for 10 years and shows no sign of leaving. Continuity is worth a lot.

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This is not a request for medical advice, but an observation, and a suggestion. I took Metformin Extended Release for many years without significant side effects and reasonable glucose control.

Over recent months, I developed severe, unpredictable diarrhea. I tried changing the times I took the meds, to no avail. I stopped taking Metformin and the diarrhea ceased completely, but my glucose levels were higher. Subsequently, I asked the pharmacist for a two week supply of the brand name product: Glucophage XR. Like magic, my blood glucose improved and my GI symptoms have not returned. (I hope my physician can be persuaded to order the brand name product in the future.)

My pharmacy had changed generic metformin manufacturers, and my suspicion is that the recent generic formulation I was using was causing the GI problems.

Here is my observation: Although the metformin literature states that initial GI side effects will resolve, it seems to be a possibility that people who have been on metformin for a long time can have new and severe GI symptoms. This is not a minor side effect; it affected my ability to work and carry out my daily activities.

Here is my request: Listen to patients and believe them when they say they are having problems with metformin. Be an advocate. My doctor didn't listen to me, but my pharmacist did. I'm wondering if my experience might be common. Several people I have spoken to say they have severe diarrhea with metformin, but are willing to live with it because they believe it "shows the medication is working". I'm also wondering if there is a varying pattern of GI side effects with different metformin manufacturers.

While the active ingredient in brand name prescriptions are the same, the bioavailability, I don't care what they say, is not.

Even a pharmacist will confess it...if you corner them on it.

That can happen with Metformin or any other medication. I have the ability with my insurance to request brand-name and pay the higher price.

I always do.

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Specializes in Psych, Addictions, SOL (Student of Life).

Interesting as I just started taking low dose metformin and can't stop farting. No matter how discrete I try to be they just come ripping out. If this doesn't change I'll have to find another med. A few years back when Wellbutrin went generic we saw a big rise in suicidality in our stable depression patients. When we put them back on thename brand they improved.

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Interesting as I just started taking low dose metformin and can't stop farting. No matter how discrete I try to be they just come ripping out. If this doesn't change I'll have to find another med. A few years back when Wellbutrin went generic we saw a big rise in suicidality in our stable depression patients. When we put them back on thename brand they improved.

The office I worked in we gave a MOTHERLOAD of Metformin. We always wrote for the extended release..there is a huge difference between regular Metformin and the XR. We started everyone off on 500 mg and had them take the tablet with the evening meal. If we were wanting them to be on 1500 mg Q day, we would tell them to take the 500 mg for 10 days, then add the second 500 mg, for 10 days, etc.

We had some patients that were given larger doses to take at once and it was a major problem. LOL...one lady had the best excuse ever to stop taking it...she said, "When I sharted at work, I was done." When we changed her to XL and had her slowly increase, she did great.

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Metformin had always given me some GI issues. Usually gas, but I had to be weened onto it because of the side effects. Now I only get the intense side effects if I eat something super fatty or higher in sugar. The worse is gas cramps for me. I've woken up in the middle of the night doubled over and unable to get back to sleep without pooping and farting for at least 30 minutes. My pharmacy offered to switch me to the XR formula but truthfully it doesn't happen that often and keeps me honest about my diet.

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