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Is It Safe To Take Glycomet At Night When On Clozapine And Risdone?

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Posted on Mon, 20 Apr 2015
Question: My brother is on antipsychotics tab clozapine 100mg and tab risdone forte 1/2 tablet(risperidone 4mg+ trihexy phenidyl) for schizophrenia for long time at night in single dose.he is 39 yrs old.FBS is 289 with urine sugar in random night sample is 3plus+.we had shown to a doctor he advised to start from thurday night i. e from 26th march before dinner glycomet GP 1 twice daily.and advised for RFT, lipid profile , Hb 1àc.is the medication ok.dose ok. Is gliperamide and metformin can be given safely with the above antipsychotics medicine.when sugar test has to be repeated. Any other investigation required advised.When follow up required. BP was OK. HIS lifestyle and diet is erratic .advise best medication for him.So chances of hypoglycemia are not there.antipsychotics he is taking at night.please plan his antidiabetic medication best for him
and advice the follow up blood sugar level and other investigations for him.he is taking glycomet GP1 from 26th March before dinner from 2 days.best advice need.if the type of antipsychotics medicines that can be changed
doctor
Answered by Dr. Dr. Ashok Kumar Choudhary (43 minutes later)
Brief Answer:
Yes these are safe and risk of hypoglycemia is low

Detailed Answer:
Hello,
Thanks for using healthcaremagic.

I read your query and understand your concern.

Regarding medication I feel the prescription is according to current standard guidelines and there is no problem with glimepride, metformin and current antipsychotics.

These medications can be given safely with current antispchotics and risk of hypoglycemia is not present with metformin and low with glimepride.

Sugar need to be repeated after one week and should be repeated every week till controlled. After proper control blood sugar determination can be done with prolonged intervals.

I like to recommend following things for him which are likely to benefit in short term and long term.

Regular exercise- it is very essential to have exercise of 45 minutes a day and 200 minutes a week. You need to encourage him to do so and it is possible that sometime you have to accompany for walk/exercise.

Diet control- This is very essential for proper control of blood sugar. Stop all sugar diet and fast foods. Encourage him to take more fruits and green vegetables.

Talk to your doctor about Clozapine. This is the medication which causes weight gain and hypergylycemia. Discuss with him whether it is possible to decrease the dose of Clozapine. In my view if he is not a resistant case of psychosis/schizophrenia this can be done with slight effort.

I hope this helps you.
If you have any further query, I would be glad to help you.
If not, you may close the discussion and if possible you may rate the answer for me, so that I get a good feedback.
In future if you wish to contact me directly, you can use the below mentioned link:
http://doctor.healthcaremagic.com/doctors/dr-ashok-kumar/67386
Thanks and regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. Ashok Kumar Choudhary (16 minutes later)
How clozapine can be decreased. Or stopped.And gliperamide can be taken at morning before breakfast 2mg and metformin. 500mg twice a day
So at night taking gliperamide the low risk of hypoglycemia by gliperamide can be reduced at night.as he is taking 100mg clozapine at night and this done forte half tablet at night.so guide if gliperamide 2mg can be taken at morning before breakfast and metformin 500mg twice a day. And how dose of clozapine can be reduced in steps or stopped.and if risdone forte had be increased by how much.what shall be the dose risdone forte

Thanks doctor .and help in the further queries.thans to you.sir if you can help to guide further.at which hospital you are doing consultation .so he can be shown personally to you.

The answer was good.and satisfactory. You were helpful.
doctor
Answered by Dr. Dr. Ashok Kumar Choudhary (5 hours later)
Brief Answer:
These should be done in guidance of treating doctor

Detailed Answer:
Hello,
Thanks for reverting back to me.

Clozapine can be reduced if there is alternative drug for it to replace or the demand for clozapine is not there. Clozapine we generally use in resistant cases, where no other drug works, and in these cases it is very difficult to reduce the dose of Clozapine. It will be appropriate to talk to your doctor before taking any such step. Un monitored use of clozapine can be quite dangerous and use of it require proper monitoring by lab tests, initially weekly and than fortnightly. So be in touch with your treating doctor before making any change in medication.


If you want adequate response with medications, take it as advised and I like to inform you that your doctor prescribed them rightly. Do not make any change as per your choice. You are likely to do more harm than any benefit to your brother.

I practice at King XXXXXXX Medical University, XXXXXXX and my working hours are from 10 AM to 4 PM. You can visit any day except Sunday.

Thanks and regards
Note: For further guidance on mental health, Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Dr. Ashok Kumar Choudhary

Psychiatrist

Practicing since :2000

Answered : 3355 Questions

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Is It Safe To Take Glycomet At Night When On Clozapine And Risdone?

Brief Answer: Yes these are safe and risk of hypoglycemia is low Detailed Answer: Hello, Thanks for using healthcaremagic. I read your query and understand your concern. Regarding medication I feel the prescription is according to current standard guidelines and there is no problem with glimepride, metformin and current antipsychotics. These medications can be given safely with current antispchotics and risk of hypoglycemia is not present with metformin and low with glimepride. Sugar need to be repeated after one week and should be repeated every week till controlled. After proper control blood sugar determination can be done with prolonged intervals. I like to recommend following things for him which are likely to benefit in short term and long term. Regular exercise- it is very essential to have exercise of 45 minutes a day and 200 minutes a week. You need to encourage him to do so and it is possible that sometime you have to accompany for walk/exercise. Diet control- This is very essential for proper control of blood sugar. Stop all sugar diet and fast foods. Encourage him to take more fruits and green vegetables. Talk to your doctor about Clozapine. This is the medication which causes weight gain and hypergylycemia. Discuss with him whether it is possible to decrease the dose of Clozapine. In my view if he is not a resistant case of psychosis/schizophrenia this can be done with slight effort. I hope this helps you. If you have any further query, I would be glad to help you. If not, you may close the discussion and if possible you may rate the answer for me, so that I get a good feedback. In future if you wish to contact me directly, you can use the below mentioned link: http://doctor.healthcaremagic.com/doctors/dr-ashok-kumar/67386 Thanks and regards