The main side effect of this medication is sleep and rest, which plays a very important role in the healing process. Usually, within an hour or so after taking a dose, the oil is telling you to lay down and relax. Don’t try to fight the oils sleepy effects, just lay down and get comfortable, then allow the oil to give you the rest and relaxation you require to heal properly. The effects of the oil may cause your mind to wander a bit and often patients will be somewhat unsteady on their feet when they begin to use this medication. But as the patient builds up their tolerance, these effects will diminish quickly. Usually within 3 to 4 weeks, the daytime tiredness associated with this treatment after the patient takes their dosage just fades away, but the patient continues to sleep very well at night.
Administration advice :
-Take orally with meals
-Gastrointestinal tolerability may be improved by a slow increase in dosage; doses above 2000 mg per day may be better tolerated given 3 times a day with meals
-Extended-release product: Take with evening meal; swallow whole; do not crush, cut, dissolve, or chew
-If patients have not responded to therapy after 3 to 4 months, consider intensifying treatment as outlined in accepted diabetes management algorithms and diabetes standards of care.
-Not for use in patients with type 1 diabetes or diabetic ketoacidosis.
-Temporarily stop treatment prior to radiologic studies utilizing iodinated contrast materials and for surgical procedures when restricted food or fluid intake is expected; may resume once adequate renal function is confirmed.
Renal: Assess renal function baseline, repeat at least annually and more often as clinically indicated.
Hematologic: Measure hematologic parameters annually; periodically asses Vitamin B-12 levels, especially in patients peripheral neuropathy or anemia.
-Monitor glycemic control
Patient advice :
-Tablet shells may appear in feces, and this should not cause alarm.
-Inform patients about the risk of lactic acidosis, conditions that might predispose them to its occurrence, and symptoms to watch for and report.
-Patients should understand the signs and symptoms, risks, and treatment of low blood sugar, especially if using this drug in combination with insulin or other drugs that may lower blood sugar.
-Advise patient that this drug may need to be temporarily stopped if undergoing radiologic studies with intravascular iodinated contrast materials or surgical procedures that will limit food or fluid intake.
-Advise patients on the risks of excessive alcohol intake.
-Tell patients that while gastrointestinal symptoms might be common when initiating treatment, gastrointestinal problems after initiation should be reported.