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Source: ONE News
The commonly used diabetes drug metformin stinks, literally, and
this may explain why many patients stop taking it, US doctors
reported.
The drug smells like fish or dirty socks to some people and this
could account for the well-known side effects of the drug, which
can make people nauseated, they said.
But the problem could be solved by coating the pills so they do not
smell or release the odour into the stomach, where it can be burped
up, they wrote in a letter to the Annals of Internal
Medicine.
"We wonder why this reaction to metformin has not been previously
reported," Dr Allen Pelletier of the Medical College of Georgia and
colleagues wrote in a letter to the journal.
"Patients may report that metformin nauseates them but do not
further elaborate or distinguish this as a visceral reaction to the
smell of the medication."
They described two cases in detail.
The first had taken brand-name metformin (Glucophage, made by
Bristol-Myers Squibb) for several years before being switched to an
immediate release, generic version of metformin, which he refused
to take.
"He reported that it smelled like 'dead fish' and nauseated him,"
they wrote.
An extended release generic version, coated to make it dissolve
more slowly, solved the problem.
A second man refused to ever take metformin again, even coated
formulations, they said.
"Our cases show that the distinctive odour of metformin
(independent of other, well-known gastrointestinal adverse effects
of the medication) causes patients to stop taking the drug," they
wrote.
Doctors may simply think patients are having the other side-effects
such as diarrhoea, nausea and vomiting, flatulence, distension and
abdominal pain, but the smell could make patients feel ill,
Pelletier and colleagues said.
"Although reaction to the odour of metformin has not been reported
in the medical literature, hundreds of postings to message boards
on the internet note the peculiar odour of the drug, which is also
well known to pharmacists," they added.
"Trial of a film-coated, extended-release formulation may be a
reasonable approach in such cases," they said.
Doctors often struggle to persuade patients to take their diabetes
drugs as directed and this could be one easy fix, they said.
