Those taking Metformin (Recap of Lost Posts, Topic Created by oldbeauty on Nov 02, 2018)
This recap includes posts that were lost during CSN's data outage from 10/29/18 to 1/30/18. While there have been a number of posts about taking metformin on this board, this discussion topic covered several subjects, notably the difference in the costs of metformin depending upon one's insurance coverage.
There are also several posts that discuss issues with the transition from employment-related or individual insurance to Medicare that members had experienced when they were close to becoming Medicare eligible.
oldbeauty
Nov 02, 2018 - 4:20 pm
Does anybody have anything to share about the side effects, if any, of Metformin Hcl? I am going on Medicare early next year and I am shopping for a Part D Prescription Drug Plan. Under my current Marketplace plan, I take the Extended Release formulation (which I believe required pre-approval, which was granted). I pay $20 for a 3-month mail order supply. I also take Lyrica, which has no generic and costs me $270 every three months. When I plugged my meds into the Medicare "find a plan" function, I found that my estimated annual costs for drugs (including premium and deductible) is close to $4,000 per year. I picked myself up off the floor and played around with the drug list. I removed the Lyrica, thinking that was the culprit, but the cost savings was only a few hundred dollars. Then I noticed that the Metformin extended release is a Tier 4 drug and I substituted the "regular" formulation, which is a Tier 1. I was stunned to see that my estimated annual costs decreased to about $2,200!!! The extended release formulation is supposed to minimize "intestinal distress" but it often causes morning diarrhea anyway. $2,000 is big money and I think I will ask my doctor to re-write the Rx for the "regular" Metformin. But I want to ask if anyone who is taking "regular" Metformin has any bad experience that would convince me to bear the added expense. I am taking 2,000 mg a day. Thanks for any personal experience stories. Best wishes, Oldbeauty
CheeseQueen57
Nov 02, 2018 - 4:44 pm
I've finally got my A1C up enough that my endo will probably give the meteor in I’ve been begging for for 2 years. Good news/bad news. Probably because of the weight gain from the Megace. I’ll also be looking for a part D plan because I got my Medicare from being on disability for two years. Ha! Outlived your predictions suckers. My PCP mentioned he was noticing people having more diahrea with the ER version. He blamed it on a different additive. I thought metformin was generic. Doesn’t Walmart sell it cheap?
oldbeauty
Nov 02, 2018 - 5:46 pm
CheeseQueen, I was on Provera and not Megace. It was not an appetite stimulant for me and my endocrinologist shook her head when I asked if I should switch when I returned to the US from overseas, saying there would be weight gain. Only problem is Provera tablets are only 10 mg in this country, and I took 400 mg daily. Megace is what they give to frail elderly and seriously ill folks to try to encourage them to take nourishment. Best wishes, Oldbeauty
CheeseQueen57
Nov 02, 2018 - 6:31 pm
A1C is 6.7. I had prediabetes before but weight loss solved it. Gained 15 pounds with Megace but seems to have stabilized and not really wanting to tempt fate and switch because Megace is working. Unfortunately total slug this past year because of stent pain (that may have been solved) and broken ankle. And I am not motivated to lose weight because I know I have to adhere to strict 1200 calories and be hungry all the time and I’m not willing to do it with my potential limited lifespan. So maybe willing to try metformin. I have constipation problems and have to take Megace every day so metformin may solve that. BTW I hate this spell check.
MAbound
Nov 02, 2018 - 5:10 pm
Have you checked prices on goodrx.com? Metformin is one of those drugs you can get for $4 at Walmart. It's a good site to check for all meds because sometimes paying cash is the cheapest option.
oldbeauty
Nov 02, 2018 - 5:40 pm
I will research that option. Best wishes, Oldbeauty
MAbound
Nov 02, 2018 - 5:18 pm
Taking metformin on an empty stomach can cause diarrhea. It can also occur when you first start taking it until you adjust to it.
EZLiving66
Nov 02, 2018 - 6:16 pm
I switched from extended release to regular. I take two tablets after my late breakfast and two before I go to bed. I have had IBS with diarrhea for 55 years and didn't notice any difference from the SR to the regular. I take 2000 mg a day and my last A1c was 5.5.
Love,
Eldri
oldbeauty
Nov 03, 2018 - 4:08 pm
What I recommend is you get an iron deficiency like I've developed, so that a combo of Metformin that causes diarrhea and Iron that causes constipation evens everything out nicely! Best wishes, Oldbeauty
cmb
Nov 02, 2018 - 6:38 pm
When I first started on Metformin for Type II diabetes I was taking a 500MG extended release tablet. I had no side effects at that dose. But when the dosage was increased to 1000MG extended release, I did start having occasional diarrhea, which continues to this day. I keep Imodium handy at all times. I've never taken the "regular" Metformin so I can't compare the two types.
Regarding insurance, I had my doctor switch me from a single 1000MG extended release tablet to two 500MG extended release tablets immediately after she increased the dosage. The cost of the single 1000MG tablets would have been a couple of hundred dollars versus a few dollars for the 500MG tablets on my insurance plan! I'm happy to take two pills at once for that cost savings. You may want to check if there is a similar pricing difference between dosage types.
oldbeauty
Nov 03, 2018 - 4:13 pm
I do have the 500mg tabs already. I am just shocked that a generic extended release version of a generic drug costs so much. And Lyrica, which helps my neuropathy pain, is not generic and it costs less. I am certainly spoiled by having my Rx insurance embedded in my health plan where all I have to worry about is a co-pay. I have no idea how much of the premium is allocated to the Rx plan. Hence I am having sticker shock when I investigate what my annual costs are going to be on Medicare versus my current health plan. I am going to check out the WalMart angle. Best wishes, Oldbeauty
cmb
Nov 03, 2018 - 5:13 pm
Although I still have 1 1/2 years to go before I'm eligible for Medicare, your post made me curious about the Metformin costs under the Medicare drug plan that my siblings use. Two of them also take Metformin and neither had commented on its cost. The 500mg Metformin ER tablets under that plan are considered a Tier 1 drug, with a maximum of 120 pills per 30 days.
I know that my one sister carefully checks the Medicare formulary for the upcoming year when it is published and has had to change plans a couple of times already. But it's still surprising that there is such a cost difference between plans for such a common drug.
oldbeauty
Nov 03, 2018 - 5:28 pm
I used the plan finder function on myMedicare.gov and it came back with only a few plans, to my surprise. I filtered for my drugs being on the formulary, that's all. Of 30 plans with at least a 3-star rating, 3 plans from Aetna were the cheapest. I'll go back and check but I'm pretty sure that the Metformin ER 500 mg was shown to be a Tier 4 drug, which I guess is the problem. "Regular" Metformin is a Tier 1. I'm going to check Aetna's web site independently to check this out. I tell you, my head is spinning doing all this research. I still have to shop for a Medigap plan. Even though the university medical center I use has an insurance co-hort that offers a Medicare Advantage Plan that contains Rx, I do not trust any private insurance company's possible freedom to alter important coverage terms at will. And once you forgo a Medigap plan when first eligible, you can't get in without medical underwriting which would block me from getting in. So, I'm going with regular Medicare, a Medigap Plan and Part D coverage. I am going to miss my Marketplace plan, which has been wonderful. I suspect my out of pocket expenses will increase under Medicare, but the protection it offers of guaranteed insurance is most welcome. Thanks for your stories. It is very helpful. Best wishes, Oldbeauty
CheeseQueen57
Nov 03, 2018 - 5:41 pm
I’m going through the same thing
I‘m currently going through the same thing since I became eligible for Medicare in September due to disability. A friend of mine does this for a living. She advised me against the Medicare Advantage plans. They’re not mobile and have too many restrictions. She advises the G plan. F is more rich but she says will be discontinued next year and although you can be grandfathered, she’s concerned the rates will continue to rise significantly. The RX plans are a nightmare. I have to really devote some time to researching them.
Oldbeauty
Nov 04, 2018 - 6:46 am
I hadn't thought about the effect of starting out in the higher base price F plan; that it's premiums in the future might advance at a higher rate than G. Since the only difference I could see between F and G is that F covers the deductible, which isn't that high, I think I will follow your friend's advice and choose G. Thanks for the heads up. Best wishes, Oldbeauty
BluebirdOne
Nov 04, 2018 - 8:21 pm
Oldbeauty: Medicare has been great so far!
I have more than $60k in bills so far, (about 1/2 have come in) and my out of pocket besides my $183 deductible might be literally $17.58. Medicare, my Priority Health MediGap and Humana Drug programs have covered the rest. This year I have had so many medical procedures, blood work, labs, surgeries, chemo, radiation, my spreadsheet is on fire when I open it. This is my 3rd year on Medicare and I love it. I never fight over a bill, and this whole financial situation gives me tremendous peace of mind. Of course, the Medigap is not cheap but it has picked up everything. I keep waiting for payment or treatment denial, but none so far. I am being treated at Mayo in Rochester. Good luck to you.
Denise
zsazsa1
Nov 02, 2018 - 7:30 pm
I've known many people who had little to no trouble with metformin 500 mg twice a day. And it's dirt cheap as a Walmart generic. I'd go with that.
6.7 is not that bad, and if you go on metformin, it will probably bring it down a little bit.
pinky104
Nov 03, 2018 - 2:20 am
I was on regular Metformin. I got frequent diarrhea, even taking it on a full stomach, plus I had really bad itching with it. I never did get around to asking my PCP for the extended release. Before that happened, I found out from my GYN/onc. that he'd used Metformin in clinical trials, and it had done nothing for the patients with my type of cancer, UPSC. I'd had enough of the diarrhea and horrible itching by then, so I stopped it ib a trial basis for two weeks. The diarrhea stopped. The itching got better but never totally went away. I would've liked to have been able to stay on it as I lost a few pounds on it and I might have been able to protect myself against other kinds of cancer, but the diarrhea was the big problem since I have a history of frequent UTI's and diarrhea often brings on those.
oldbeauty
Nov 03, 2018 - 4:24 pm
Pinky, yours is a very informative post. Yes, I know that the evidence about Metformin is equivocal at this time. But I figured if it didn't hurt me and might help me, I would take it. The cost is shocking but there appear to be ways of sourcing it cheaply. What you say about itching is intriguing. Although I've been taking the Metformin for almost a year, and the highest dose for a few months now, the diarrhea in the morning is a constant but not a deal-breaker. But in the last few weeks I've had two incidences of a rash breaking out for unclear reasons. One spot was the small of my back. I couldn't see it but hubby said the bumps were not inflamed, hardly visible but they itched like crazy. Steroid cream helped a bit. I think taking a Benadryl worked best, as it killed the itch mostly very quickly although the bumps remained for several days. They're gone now but it still is itchy. The other place was a bank of welts around my upper thigh. Now that, I am partly attributing to wearing thigh-high hose, which I'd never done before. Perhaps I am allergic to the sticky stuff they put around the band so the hose stay in place. But my thought is that it's the chemotherapy that changes so much in the body that is to blame. I don't really understand what Metformin does. I am not diabetic and although I have read about the disease, I don't really understand the whole endocrine/metabolic thing that makes the disease so serious. But your itchy experience intrigues me. Nothing I'm experiencing would make me stop the Metformin but the cost is an issue I would like to find a work-around for. Best wishes, Oldbeauty
pinky104
Nov 04, 2018 - 12:57 am
I had hives on my back near my spine while I was taking Metformin, but they appeared a week and a half after having an epidural steroid shot in my back, so I attributed them to that. I'd also had some itching without hives after the first steroid shot I'd had last year, a couple of weeks before. My back, scalp, and the inside of my ear itched terribly. I discontinued the steroid shots and hoped the itching would go away totally. It got better but didn't go away. My PA at my family doctor said that he thought the Metformin was causing the itching when it hadn't totally gone away several months later. I should also say that I saw my dermatologist several years ago for my annual check-up and mentioned itching along my spine then. He said it had something to do with age and a problem with the nerves that originate in the spine. He prescribed Mometasone cream, a steroid, for that. It helped, but I've also found that if I stand up straighter or sit and put pressure on my back, the itching goes away. I've had problems with it occasionally since then. I saw him again a month or two after all the itching started this year, and he said it could be atopic dermatitis, another name for eczema. I've never had eczema before, and I'm 70 years old now. I've tried a lot of stuff, including shampoos for eczema, benadryl cream, Mometasone cream, betamethazone cream, scalpicin, lotrimin cream, bacitracin ointment, Benadryl pills and ointment, Zyrtec, and now I'm trying topical lidocaine, which probably works better than the rest, but the itching still comes back. I really think the Metformin got it going in the first place, but nothing seems to stop it. I'm also NOT a diabetic, so I'm glad I could stop taking the Metformin.
takingcontrol58
Nov 04, 2018 - 10:27 am
Low cost of Extended Release Metformin
Old Beauty, I am not on Medicare yet, but if you live near a Rite-Aid pharmacy, they have a discount drug plan. I get 750mg extended release metformin (take twice a day) - I get a 90 day supply for $14.99. This plan does not go through any insurance. It costs me a few dollars less than going through my own insurance, Aetna, who will only provide a one month supply at a time. It is much more convenient getting a 3-month supply.
My husband just joined medicare Part D and pays $6/month for 500mg extended release. The plan is he on is called Envision. I don't know if that plan is in your area.
I have been on the drug since February 2015- just celebrated 4 years of being totally cancer free from my metastatic cancer (liver, spleen, vaginal cuff, plus nodules in various locations). All my metastases formed two months after my hysterectomy and all disappeared within 7 months of being on metformin. I have not experienced any side effects from metformin. I also use many supplements that I have been taking the entire time. Perhaps some of those supplements have prevented me from experiencing any side effects.
Takingcontrol58
oldbeauty
Nov 05, 2018 - 5:44 am
Enough ladies have reported low-cost use of Metformin on Medicare that I will go back to the drawing board to figure this out. I'll call Aetna and have them go thru my Rx list with me to see what cost I can expect. Thanks to so many who chimed in on this question. Best wishes, Oldbeauty
Lulu7582
Nov 14, 2018 - 1:51 pm
Yes I have been on metformin the regular one 1000mgs twice a day and pay zero because Publix will give it to you free with a prescription. Check out Good RX and find out the cash price near you which might be cheaper than running it thru your insurance. As far as the G/I probs ...it has been fine. Hope that helps.
Tamlen
Dec 11, 2018 - 2:12 pm
I came across this in today's science reading and thought some of you might be interested:
"The widely used anti-diabetes drug metformin not only reduces blood sugar but also has an anti-cancer effect. However, the metformin dose commonly used in the treatment of diabetes is too low to inhibit cancer growth. The previous study of Prof. Hall's group at the University of Basel's Biozentrum revealed that the antihypertensive drug syrosingopine enhances metformin's anti-cancer efficacy...The combination of the two drugs blocks a critical step in energy production thus leading to an energy shortage, which finally drives cancer cells to 'suicide'."
- Lethal Combination: Drug Cocktail Turns Off the Juice to Cancer Cells
oldbeauty
Dec 11, 2018 - 3:02 pm
Thanks, Tamlen, for the link. I find it encouraging that there are scientists out there working on cancer treatments that go back and look at new ways of using old, safe drugs, like metformin. I am by no means hypertensive, so I would not be a candidate to beg for an Rx for syrosingopine. I'm following myself these days for what I consider to be unduly low blood pressure....Best wishes, Oldbeauty
MAbound
Dec 11, 2018 - 5:39 pm
It's hard enough getting a doctor to prescribe Metformin for cancer use, so I have my suspicions that getting this prescribed with it would be even harder. As far as I've been able to find out, syrosingopine is a derivitive of reserpine that has antipsychotic as well as antihypertensive uses. It's not much used clinically, however, because of it's adverse effects. It's not even listed in the PDR online. The PDR (Physicians Desk Reference) is every drs. bible.
http://www.reference.md/files/C084/mC084824.html
LisaPizza
Dec 11, 2018 - 7:24 pm
It wasn't a human or even animal trial, so it's theoretical at this point anyway. Still interesting.
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