Re: Metformin,Prascend Question

Sherry Morse

Martha's already provided you with the info on Metformin but I'd add that since elevated ACTH can drive insulin numbers up you may find that her insulin is better once her ACTH is under control.  Unfortunately the only way to confirm that would be to stop the metformin and then test again after a week or so to see if her numbers are trending up or not.  I would not recommend doing that until she's on the correct dose of Prascend to control her ACTH.

As far as when to retest ACTH - 3 weeks after getting to the target dose, which is most likely going to be at least 2g for Saraphina, although it may well be more.  Since we're heading into the seasonal rise's period of main effect the sooner you can get her to the target dose the better; but you may find at this point you're 'chasing the rise' with her dosing.

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