Metformin Stinks, Literally
Authors: Allen L. Pelletier, Ann M. Butler, Ralph A. Gillies, J. Russell May
Journal: Annals of Internal Medicine (2010)

Letters16 February 2010Metformin Stinks, LiterallyAllen L. Pelletier, MD, Ann M. Butler, RPh, MD, Ralph A. Gillies, PhD, and J. Russell May, PharmDAllen L. Pelletier, MDFrom Medical College of Georgia, Augusta, GA 30912-3500; and The University of Georgia College of Pharmacy, Athens, GA 30602-2351.Search for more papers by this author, Ann M. Butler, RPh, MDFrom Medical College of Georgia, Augusta, GA 30912-3500; and The University of Georgia College of Pharmacy, Athens, GA 30602-2351.Search for more papers by this author, Ralph A. Gillies, PhDFrom Medical College of Georgia, Augusta, GA 30912-3500; and The University of Georgia College of Pharmacy, Athens, GA 30602-2351.Search for more papers by this author, and J. Russell May, PharmDFrom Medical College of Georgia, Augusta, GA 30912-3500; and The University of Georgia College of Pharmacy, Athens, GA 30602-2351.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-152-4-201002160-00023 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Background: Metformin causes adverse gastrointestinal effects, including diarrhea, nausea and vomiting, flatulence, distention, and abdominal pain, and these effects often necessitate discontinuing the drug (1). Occasionally, taste distortion has been reported, but this event seems to be infrequent (1). Adverse gastrointestinal effects seem to be less common with extended-release metformin (2).Objective: To describe a characteristic of metformin that has not been reported previously in the medical literature.Case Reports: Case 1 was an adult man with diabetes and severe visual impairment. He had taken brand-name metformin (Glucophage, Bristol-Myers Squibb, New York, New York) for several years without reporting adverse ...References1. Glucophage prescribing information. New York: Bristol-Myers Squibb; 2009. Accessed at packageinserts.bms.com/pi/pi_glucophage.pdf on 8 January 2010. Google Scholar2. Blonde L, Dailey GE, Jabbour SA, Reasner CA, Mills DJ. Gastrointestinal tolerability of extended-release metformin tablets compared to immediate-release metformin tablets: results of a retrospective cohort study. Curr Med Res Opin. 2004;20:565-72. [PMID: 15119994] CrossrefMedlineGoogle Scholar3. Edwards IR, Aronson JK. Adverse drug reactions: definitions, diagnosis, and management. Lancet. 2000;356:1255-9. [PMID: 11072960] CrossrefMedlineGoogle Scholar4. Brittain HG, eds. Analytical Profiles of Drug Substances and Excipients, Volume 25. New York: Academic Pr; 1998. Google Scholar5. Diabetes Forums. Metformin + mystery odor. Accessed at www.diabetesforums.com/forum/lo-fi/t-34313.html on 8 January 2010. Google Scholar6. GYXE. What does your metformin smell like? Accessed at gyxe.com/diabetes/60-588-what-does-your-metformin-smell-like-read.shtml on 8 January 2010. Google Scholar7. PrescriptionDrugInfo.com. Metformin smell. Accessed at www.prescriptiondrug-info.com/forums/view_drug_forum.asp?Title=metformin+smell&Page=65213 on 8 January 2010. Google Scholar8. OBGYN.net. Re: Gluc question and dumb question too … Accessed at forums.obgyn.net/pcos/PCOS.0209/0297.html on 8 January 2010. Google Scholar Author, Article, and Disclosure InformationAuthors: Allen L. Pelletier, MD; Ann M. Butler, RPh, MD; Ralph A. Gillies, PhD; J. Russell May, PharmDAffiliations: From Medical College of Georgia, Augusta, GA 30912-3500; and The University of Georgia College of Pharmacy, Athens, GA 30602-2351.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byFood-Drug Interaction in Older AdultsTrial of restarting and tolerating metformin ( TreatMet )Drug–Nutrient Interactions: A Broad View with Implications for PracticeMetformin Extended Release Treatment of Adolescent Obesity: A 48-Week Randomized, Double-Blind, Placebo-Controlled Trial With 48-Week Follow-upInappropriate Sexual Behaviors Associated with Donepezil; Metformin-Induced Vitamin B 12 Deficiency; Metformin Stinks, Literally; Varenicline-Triggered Pheochromocytoma Crisis; Ranolazine-Related Dyspnea on Exertion; Severe Opioid Withdrawal Due to Misuse of a New Combined Narcotic Agonist/Antagonist Product; A Nearly Overlooked Case of Ziprasidone-Induced Lingual Dystonia 16 February 2010Volume 152, Issue 4Page: 267-268KeywordsAdverse reactionsDrugsInternetNauseaPharmacistsSmellSweatTasteVisual impairmentsVomiting ePublished: 16 February 2010 Issue Published: 16 February 2010 Copyright & PermissionsCopyright © 2010 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...