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Rx only PATIENT INFORMATION ABOUT (metformin hydrochloride tablets) 500 mg, 850 mg, and 1000 mg WARNING: A small number people who have taken Glucophage have developed a serious condition called lactic acidosis. Property functioning kidneys are needed to help prevent lactic acidosis. Most people with kidney problems should not take Glucophage. (See Question Nos. 10-14) 01.

Why do need to take GLUCOPHAGE? Your doctor has prescribed GLUCOPHAGE (GLUE-coe-iahj) to treat your type 2 diabetes. This is also known as non-insulin-dependent diabetes mellitus. 02. What is type 2 diabetes? People with diabetes are not able to make enough insulin respond normally to uie insulin their body does make. When this happens, sugar (glucose) builds up in the bipod.

This can lead to serious medical problems including kidney damage, amputations and blindness. Diabetes is also closely linked to heart disease. The main goal of treating diabetes is to lower your blood sugar to a normal level. 03. Why is it important to control type 2 diabetes? Studies have shown that good control of blood sugar can prevent or delay complications such as blindness.

04. How Is type 2 diabetes usually controlled? High blood sugar can be lowered by diet and exercise, by a number of oral medications and by insulin injections. Before taking GLUCOPHAGE you should first try to control your diabetes by exercise and weight loss. Even if you are taking GLUCOPHAGE, you should still exercise and follow trie diet recommended for your diabetes. 05.

Does GLUCOPHAGE work differently from other glucose-control medications? Yes it does. Until GLUCOPHAGE (metformin hydrocnloride tablets) was introduced, all tJie available oral glucose-control medications were from the same chemical group railed sulfonylureas. These drugs tower blood sugar primarily by causing more of the body's own insulin to be released. GLUCOPHAGE lowers the amount of sugar in your blood by helping your body respond better to its own insulin. GLUCOPHAGE does not cause your body to produce more insulin.

Therefore, GLUCOPHAGE rarely causes hypoglycemia (low blood sugar) and it doesn't usually cause weight gain. 06. What happens if my blood sugar is still too high? When blood sugar cannot be lowered enough by either GLUCOPHAGE or a sulfony- lurea, the two medications may be effective taken together. However, if you are unable to maintain your blood sugar with diet, exercise and glucose-control medication taken orally, then your doctor may prescribe injectable insulin to control your diabetes. Q7.

Why would I tafce GLUCOPHAGE HI am already on insulin? Because adding GLUCOPHAGE to insulin can help you better control your blood sugar while reducing the insulin dose and possibly reducing your weight. 03. Can GLUCOPHAGE cause side effects? GLUCOPHAGE, like all blood-sugar towering medications, can cause side effects in some patients. Most of these side effects are minor and will go away after you've taken GLUCOPHAGE for a while. However, there are also serious, but rare side effects related to GLUCOPHAGE (see below).

05- What kind of side effects can GLUCOPHAGE cause? if side effects occur, they usually occur during the first few weeks of therapy. They are normally minor ones such as diarrhea, nausea and upset stomach. Taking your GLUCOPHAGE with meals can help reduce these side effects. Altfiough these side effects are likely to go away, call your doctor it you have severe discomfort or if these effects last for more than a few weeks. Some patients may need to have their dose towered or stop taking GLUCOPHAGE, either temporarily or permanently.

Although these problems occur in up to one-third of patients when they first start taking GLUCOPHAGE, you should tell your doctor if the problems come back or start later on during the therapy. three out of one hundred people report having a temporary unpleasant or metallic taste when they start taking GLUCOPHAGE 010. Are there any serious side effects that GLUCOPHAGE can cause? GLUCOPHAGE rarely causes serious side effects. The most serious side effect that GUJCOPHAGE can cause is called lactic acidosis. 011.

What is lactic acidosis and can it happen (o me? etidoas is caused by a buildup of lactic acid in the blood. Lactic acidosis with GLUCOPHAGE is rare and has occurred mostly in people whose kjd- ays not working normally. Lactk; acidosis has been reported in about one in if ft pftents taking GLUCOPHAGE over the course of a year. Although rare, if lac- does occur, ft can be fata! in up to half the cases. It's also important for your liver to be working normally when you take GLUCOPHAGE.

Your liver helps remove lactic acid from your bloodstream. Your doctor will monitor your diabetes and may perform blood tests on you from time to time to make sure your kidneys and your liver are functioning normally. There is no evidence that GLUCOPHAGE causes harm to the kidneys or liver. Q12. Are there other risk factors for lactic acidosis? Your risk of developing lactic acidosis from taking GLUCOPHAGE (metformin hydrochloride tablets) is very low as long as your kidneys and liver are healthy.

However, some factors can increase your risk because they can affect kidney and liver function. You should discuss your risk with your physician. You should not take GLUCOPHAGE if: You have chronic kidney or liver problems You have congestive heart failure which is treated with medications, e.g., dioox- in (Lanoxin 1 or furosemide You drink alcohol excessively (all the time or short-term "binge" drinking) You are seriously dehydrated (have lost a large amount of body fluids) You are going to have certain x-ray procedures with injectable contrast agents You are going to have surgery You develop a serious condition such as a heart attack, severe infection, or a stroke You are 80 years of age and have MOT had your kidney function tested. Q13. What are the symptoms of lactic acidosis? Some of the symptoms include: feeling very weak, t'red or uncomfortable; unusual muscle pain, trouble breathing, unusual or unexpected stomach discomfort, feeling cold, feeling dizzy or lightheaded, or suddenly developing a slov; or irregular heartbeat.

tf you notice thesa symptoms, or if your medical condition has suddenly changed, stop taking GLUCOPHAGE and call your doctor right away. Lactic acidosis is a medical emergency that must be treated in a hospital. Q14. What does my doctor need to know to decrease my risk of lactic aetdo- sis? Tel I your octor if you have an IIIness that results in severe vomitino, diarrti ea fever, or if your intake of fluids is significantly reduced. These situations can lead to severe dehydration, and it may be necessary to stop taking GLUCOPHAGE temporarily.

You should let your doctor know if you are going to have any surgery or specialized x-ray procedures that require injection of contrast agents. GLUCOPHAGE therapy will need to be stopped temporarily in such instances. Q15. Can I take GLUCOPHAGE with other medications? Remind your doctor that you are taking GLUCOPHAGE when any new drug is prescribed or a change is made in how you take a drug already prescribed. GLUCOPHAGE may interfere with the way some drugs work and some drugs may interfere with the action of GLUCOPHAGE.

016. What if I become pregnant while taking GLUCOPHAGE? Tell your doctor if you plan to become pregnant or have become pregnant As with other oral glucose-control medications, you should not take GLUCOPHAGE during pregnancy. Usually your doctor will prescribe insulin while you are pregnant As with all medications, you and your doctor should discuss the use of GLUCOPHAGE if you are nursing a child. 0.17. Are there other risks associated with GLUCOPHAGE? There is some evidence that any oral diabetes drug may increase the risk of heart problems.

Experts are not sure what the real risk is for heart problems, if any, from taking oral diabetes medicine. 018. How do I take GLUCOPHAGE? Your doctor will tell you how many GLUCOPHAGE tablets to take and how often. This should also be printed on the label of your prescription. You will probably be started on a low dose of GLUCOPHAGE and your dosage will be increased gradually until your blood sugar is controlled.

Q19. Where can I get more information about GLUCOPHAGE? This leaflet is a summary of the most important information about GLUCOPHAGE. If you have any questions or problems, you should talk to your doctor or other healthcare about type 2 diabetes as well as GLUCOPHAGE and its side effects. There is also a leaflet (package insert) written for health professionals that your pharmacist can let you read. GLUCOPHAGE' is a registered trademark of UPHA s.a.

Licensed to Bristol-Myers Squibb Company. Revised January 1999 6060DIM-07 F5-B001R-1-99 Bristol-Myers Squibb Company Distributed by Bristol-Myers Squibb Company Princeton. NJ 08543 USA AR1 Rod and Liz: Just Pals; lizabeth Taylor and I are just good friends," insisted Rod Steiger, 74. There has been gossip about the two Oscar-winners spending time together, but Steiger told us he already has "a lady Benedict, who was on General, Hospital. Liz credited Steiger with helping her get back out in the world after a fall in February 1998.

Rod and Joan, his real Now that she's lad friend recovering from another broken vertebra, will he help Liz again? "Always," said Rod. "From 10 years of depression, I learned that support is so important. It validates the value ofliving and boosts the spirits." Help for Troubled Children don't give childhood mental illness as much respect as physical illness, so most children suffer silently, and their parents carry shame, 11 says Dr. Harold Koplewicz of the New York University Child Study Center. He looks at the plight of these 8 million troubled kids in a new book, Childhood Revealed, and an art show that begins a national tour next month.

"A common problem," says Kop- lewicz, "is: Where can parents go for helpp" He suggests an NYU Web site (www.aboutourkids.org) that gives parents the warning signs of mental illness, questions to ask the pediatrician and other tips; tracing the Roots of Slavery first time I went to a slave castle! I fort in Africa where Europeans held I I cried," says Henry Louis Gates Jr. Then I thought, 'Somebody in my family was tough enough to make it, because Fm Gates, a Harvard professor and descendant of a slave, tours the continent and traces his roots in Wonders of tne African Worfd, Oct. 25-27 on PBS. PAGE 8 OCTOBER 17,1999 PARADE MAGAZINElfj.