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<DIV>The advantage of the normal metformin or gliclazide with BD or TDS
dosing is that missing one dose out of the day but taking the other one/two
means that at least some of the drug gets on board! Case by case assesment
rather than blanket policy??</DIV>
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<DIV>Erik van den Berg<BR>Outreach Pharmacist<BR>Cairns Base Hospital</DIV>
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<DIV>PH 4050-6287<BR>FAX 4050-6585</DIV>
<DIV><BR>>>> MichaelW.Nixon@nt.gov.au 04/19/07 9:54 am
>>><BR><BR><FONT face=sans-serif size=2>I am finding such a lot of
non-compliance amongst the Aboriginal diabetic population and I'm slowly
changing all my patients over to SR metformin (up to 2gms) in the hope that
there may be more compliance by a once daily dose in the morning - to be had
with their weetbix or porridge! - So far seems to be working. Just watch the
Kidneys! - Mike.</FONT> <BR><BR><FONT face=sans-serif size=2>Dr Michael W
Nixon<BR>DMO Reg. Rm 126, Block 4, RDH<BR>(Chair MSHR, Ethics
Research Committee)<BR>Box 40596<BR>CASUARINA NT 0811<BR>Ph 892 28358 Mob 0427
618 915<BR></FONT><BR><BR><BR></DIV>
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<TD width="40%"><FONT face=sans-serif size=1><B>"Alex Hope"
<wombat@octa4.net.au></B> </FONT><BR><FONT face=sans-serif
size=1>Sent by: carpa-bounces@ozdocit.org</FONT>
<P><FONT face=sans-serif size=1>18/04/2007 09:36 PM</FONT>
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<DIV align=center><FONT face=sans-serif size=1>Please respond
to<BR>Central Australian Rural Practitioners Association
<carpa@ozdocit.org></FONT></DIV></TR></TBODY></TABLE><BR></P>
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<DIV align=right><FONT face=sans-serif size=1>To</FONT></DIV>
<TD vAlign=top><FONT face=sans-serif size=1>carpa@ozdocit.org</FONT>
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<DIV align=right><FONT face=sans-serif size=1>cc</FONT></DIV>
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<DIV align=right><FONT face=sans-serif size=1>Subject</FONT></DIV>
<TD vAlign=top><FONT face=sans-serif size=1>[CARPA] Fwd: Re:
swapping to Metformin XR</FONT></TR></TBODY></TABLE><BR>
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<TD></TR></TBODY></TABLE><BR></TR></TBODY></TABLE><BR><BR><BR><FONT
size=2><TT>Would be good to have input from a few more people on this
topic.<BR>I haven't tried it with any of my patients yet.<BR>Alex<BR>(scroll
down for email exchange)<BR>Dr Alex Hope<BR><BR>Community GP,<BR>Ltyentye Apurte
Community Government Council Health Centre,<BR>CMB Santa Teresa,<BR>via Alice
Springs,<BR>NT 0872.<BR><BR>Ph 08 8956 0911<BR>Fax 08 8956 0910<BR>Mobile
0408 085 143<BR><BR><BR><BR>PLUG FOR THE CARPA LIST SERVER<BR><BR>The CARPA list
server aims to foster networking and discussion between health professionals
working throughout Australia, particularly in isolated situations and/or
Aboriginal health.<BR>To see the collection of prior postings to the list, visit
the CARPA Archives here:<BR><BR>http://ozdocit.org/pipermail/carpa/<BR><BR>To
sign up for the CARPA discussion emails go
here:<BR><BR>http://ozdocit.org/cgi-bin/mailman/listinfo/carpa<BR><BR>For more
information about CARPA in general go
here:<BR><BR>www.carpa.org.au<BR><BR><BR>***********Here Followeth a
Forwarded Message***********<BR><BR>On 18/04/2007 at 8:18 PM
Ciara.OSullivan@nt.gov.au <Ciara.OSullivan@nt.gov.au> wrote:<BR><BR>>Hi
there<BR>> <BR>>The recommended maximum dose of metformin XR is 2 g daily,
which is pretty<BR>>much in line with the total dose of standard metformin we
are mostly using<BR>>now.<BR>> <BR>>Ideally metformin XR is taken nocte
... but this is not very practical and<BR>>I think we just have to compromise
over this detail.<BR>> <BR>>Cheers - Ciara<BR>><BR>>-----Christine
Connors/THS/NTG wrote: -----<BR>><BR>>To: Ciara
O'Sullivan/THS/NTG@NTGeMAG<BR>>From: Christine Connors/THS/NTG<BR>>Date:
04/16/2007 10:01AM<BR>>cc: Alan Evans/THS/NTG@NTGeMAG, Heinz
Deiter/THS/NTG@NTGeMAG, John<BR>>Hester/THS/NTG@NTGeMAG, Louise
Elliott/THS/NTG@NTGeMAG, Nick<BR>>Tyllis/THS/NTG@NTGeMAG,
russell.thompson@wynhealth.org.au, Stephen<BR>>Brady/THS/NTG@NTGeMAG, Stephen
Foster/THS/NTG@NTGeMAG, wombat@octa4.net.au<BR>>Subject: Re: swapping to
Metformin XR<BR>><BR>>so what is other people's experience<BR>>will
patients take the 4 tabs to make 2gm daily or do they prefer the<BR>>usual
1gm bd?<BR>><BR>>Ciara: apart from the obvious issue of big tablets, is
there any issues<BR>>taking metformin XR as 3gm single daily
dose?<BR>><BR>><BR>>Dr. Christine Connors<BR>>Program Director
PCD<BR>>NT Department of Health & Community Services<BR>>Phone: (08)
8922 8218<BR>>Fax: (08) 8922 7714<BR>>Mobile: 0401 116 121<BR>>email:
christine.connors@nt.gov.au<BR>><BR>><BR>><BR>><BR>><BR>><BR>><BR>>
Ciara O'Sullivan/THS/NTG<BR>><BR>><BR>>Ciara O'Sullivan/THS/NTG
<BR>><BR>>14/04/2007 07:31 PM<BR>>To<BR>><BR>>Alan
Evans/THS/NTG@NTGeMAG, Stephen Foster/THS/NTG@NTGeMAG,
John<BR>>Hester/THS/NTG@NTGeMAG, Louise Elliott/THS/NTG@NTGeMAG,
Nick<BR>>Tyllis/THS/NTG@NTGeMAG, Heinz
Deiter/THS/NTG@NTGeMAG,<BR>>russell.thompson@wynhealth.org.au<BR>><BR>>cc<BR>><BR>>Christine
Connors/THS/NTG@NTGeMAG, wombat@octa4.net.au,
Stephen<BR>>Brady/THS/NTG@NTGeMAG<BR>><BR>>Subject<BR>><BR>>Re:
swapping to Metformin XR<BR>><BR>><BR>><BR>>Hi team<BR>>
<BR>>Metformin XR is now available in most remote clinics.<BR>> <BR>>I
would like to emphasise that metformin XR and standard metformin 500
mg<BR>>tablets are equivalent and when swapping from a usual treatment dose
of<BR>>standard metformin of 1 g bd, you need to prescribe metformin XR 4
tablets<BR>>daily. No down-titration is needed with subsequent
up-titration.<BR>> <BR>>YES!!! The metformin XR tablets are pretty big and
are actually the same<BR>>size (but bulkier) than metformin 1 g tablets. You
need to show the<BR>>patients what they are getting as some patients are
horrified and refuse<BR>>to swap. <BR>> <BR>>I think using metformin XR
in usual treatment doses of 2 g per day is very<BR>>useful for patients on
few other tablets. However use of metformin XR<BR>>poses some real problems
for us as clinicians; on the one hand we want to<BR>>provide convenient once
daily medications (improves compliance) but on the<BR>>other hand,
prescribing 4 whoppers in addition to a handful of other<BR>>morning
medications is very off putting for many patients
(reduces<BR>>compliance).<BR>> <BR>>This is the doctors' s dilemma.
However, the solution is not to prescribe<BR>>half the previous standard dose
of meformin (ie swapping from metfrormin 1<BR>>g bd to metformin XR 1 g od)
which potentially deprives the patient of<BR>>useful treatment, and this is
what I am seeing on a lot of the scripts at<BR>>the moment!<BR>>
<BR>>Cheers - CIara<BR><BR>*********** END FORWARDED MESSAGE
***********<BR>_______________________________________________<BR>CARPA
mailing
list<BR>CARPA@ozdocit.org<BR>http://ozdocit.org/cgi-bin/mailman/listinfo/carpa<BR></TT></FONT><BR><FONT SIZE=3><BR>
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