Metformin at Kanser

Metformin at Kanser
Iris Thiele C. Isip Tan

Marahil tulad ko, kayo ay labis na nag-aalala ngayon sa nababalita tungkol sa kanser at Metformin. Bilang endocrinologist, ang dami ko pong pasyente na umiinom ng Metformin kaya concerned din ako.

HUWAG PONG MAGTIGIL NG METFORMIN NANG HINDI NAGPAPAALAM SA INYONG DOKTOR. Iniimbestigahan pa lamang ng US FDA ang posibilidad ng kontaminasyon ng NDMA (N-Nitrosodimethylamine) sa mga tableta ng Metformin. Wala pang Metformin na tinatanggal sa US o sa Pilipinas dahil dito. Hintayin natin ang abiso ng FDA.

Dr. Janet Woodcock, Director ng Center for Drug Evaluation and Research ng US FDA noong December 5, 2019.

Ito po ang ilang importanteng punto sa sinabi ni Dr. Woodcock:

1. Karaniwang natatagpuan ang NDMA sa tubig at mga pagkain tulad ng mga inihaw na pagkain, mga produktong may gatas at mga gulay. Lahat ng tao ay nae-expose sa NDMA. May “acceptable limit” ang NDMA at kahit uminom ang isang tao ng gamot na may NDMA na nasa or mas mababa sa acceptable limit araw araw sa loob ng 70 taon, hindi naman tataas ang peligrong magka-kanser siya.

“NDMA is a common contaminant found in water and foods including cured and grilled meats, dairy products and vegetables. Everyone is exposed to some level of NDMA. The FDA and the international scientific community do not expect it to cause harm when ingested at low levels. The acceptable daily intake limit for NDMA in the U.S. is 96 nanograms. Genotoxic substances such as NDMA may increase the risk of cancer if people are exposed to them above acceptable levels and over long periods of time, but a person taking a drug that contains NDMA at-or-below the acceptable daily intake limit every day for 70 years is not expected to have an increased risk of cancer.”

2. Matatandaan na may na-recall na ilang gamot nitong mga nakaraang taon dahil din sa pagkakaroon ng NDMA. Iniimbestigahan kung bakit nagkaroon ng NDMA ang mga gamot na ito. Problema sa manufacturing ng gamot o kung paano iniimbak o pinapakete ang ilan sa mga naging dahilan ng pagkakaroon ng NDMA sa mga gamot, ayon sa US FDA.

“The U.S. Food and Drug Administration has been investigating the presence of genotoxic impurities, called nitrosamines, in some types of drugs. Over the past year and a half, several drug products including angiotensin II receptor blockers (ARBs) and ranitidine, commonly known as Zantac, have been found to contain small amounts of nitrosamines such as N-Nitrosodimethylamine (NDMA).”

“During this time, there has been an ongoing investigation into the presence of nitrosamines in other drug products. The FDA will continue to investigate the source of these impurities, but it is important to note that there are multiple reasons why NDMA can be present in drugs. Previously, we found the source of NDMA can be related to the drug’s manufacturing process or its chemical structure or even the conditions in which they are stored or packaged.”

3. Tulad po ng nasabi ko na, huwag pong itigil ang Metformin nang basta basta, dahil baka tumaas ang inyong asukal sa dugo. Sabi pa nga ng US FDA, patuloy pa ring ireseta ng mga doktor ang Metformin kung kinakailangan, habang ongoing ang imbestigasyon. Kahit maraming gamot para sa diabetes, wala kasing ibang gamot na kapareho ang Metformin.

“Metformin is a prescription drug used to control high blood sugar in patients with type 2 diabetes. Patients should continue taking metformin to keep their diabetes under control. It could be dangerous for patients with this serious condition to stop taking their metformin without first talking to their health care professional. The FDA recommends prescribers continue to use metformin when clinically appropriate, as the FDA investigation is still ongoing, and there are no alternative medications that treat this condition in the same way.”

Metformin at Kanser
Iris Thiele C. Isip Tan

Part of the March 2020 Endocrine Hotspots Edition

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Brought to you by the Philippine Society of Endocrinology Diabetes and Metabolism (PSEDM)

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