Brief Answer:
Right medications & safe.

Detailed Answer:

Hi,
I have gone through your question and understand your concerns.

Post nasal drip of sinus infection can induce vomiting and heart burn (GERD). You are on right medications to cover both respiratory problem and gastric reflux.

As such, there is no drug interaction between these drugs (metformin, lexapro 20, augmentin and omeprazole), can be taken.

Meanwhile, follow these instructions to reduce acidity - Avoid spicy diet, smoking, alcohol consumption, keep 3 hours interval between dinner and sleep, and take 6 small meals instead of large 3. Keep head elevated with extra pillow during sleeping to prevent regurgitation.

Can you upload the report of liver enzymes? I would like to know values of liver enzymes.
Elevated liver enzymes could be due to overweight which can cause fatty liver.


Hope this answers your question, if you have additional questions or follow up questions then please do not hesitate in writing to us. I will be happy to answer your questions.


Wishing you a good health.

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Brief Answer:
Slightly elevated, REGULAR EXERCISE

Detailed Answer:

Hello again,


Thanks for considering my answer and for your follow up.


Normal range in adults: (ALT 7 - 56 IU/L), (ALP 30 - 120 IU/L).

In your case, slightly elevated levels could be due to lexpro, metformin and certain extent of your diet.

As such, metformin is used in short term for PCOD.

Kindly discuss with your treating doctor, related to these medications.

Mean time needs to cut down alcohol, meaty diet, pain killers and sugar. Do regular walk for 30 minutes. Try to reduce your weight.


Hope, I have answered your query. Take care.

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Brief Answer:
exercise and endocrinologist/gynecologist consultation required.

Detailed Answer:

Hello again,


Thanks for considering my answer and for your follow up.

Answers for your queries

1. Phentermine and topiramate extended-release (long-acting) capsules are used to help adults who are obese or who are overweight and have weight-related medical problems to lose weight and to keep from gaining back that weight.

2. Phentermine + escitalopram (lexpro): Combination of these medications can cause serious side effects like central nervous system related like anxiety, nervousness, hallucination...etc.
Topamax (Topiramate) also can interact with Lexapro and can cause moderate side effects like drowsiness, dizziness...etc. If you are taking currently discuss about this with your doctor about this. These medications should be taken under guidance of doctor.

3. The combination of metformín and Topamax can be used in weight loss (no interaction).

4. Omeprazole- proton pump inhibitor, safe, can be taken 2-4 weeks in case of GERD, where as in erosive gastritis, it should be for 6- 8 weeks.


Related to your PCOD (Polycystic ovarian syndrome) and drug dosage (metformin), endocrinologist or gynecologist opinion is needed. Do not change the dosage or discontinue medication with out your doctor advice. Metformin also helpful to reduce your weight. Dosage and duration of treatment will be decided by your doctor accordingly your weight, menstrual cycles, PCOS status and hormonal levels.

Hope, I have answered your query.

Take care.

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