Metformin
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Drug Status
Government Approvals
US(FDA), UK(BNF)
WHO Essential Medicine
YES
Known Teratogen
No
Pharmaceutical Class
Biguanide
Controlled Drug Substance
No
Metformin
Summary
Metformin is primarily used to manage type 2 diabetes. It can also be used to treat polycystic ovary syndrome (PCOS), which is a hormonal disorder that can cause insulin resistance.
Metformin works by reducing the amount of sugar produced by the liver and improving your body's sensitivity to insulin, which is a hormone that regulates blood sugar levels. It also slows down the absorption of sugar from your intestines, helping to control blood sugar levels after meals.
The usual starting dose of Metformin for adults is 500 mg once or twice daily with meals. The dose can be gradually increased, typically up to a maximum of 2000-2500 mg per day, depending on your blood glucose levels and tolerance.
The most common side effects of Metformin include gastrointestinal issues such as nausea, diarrhea, abdominal discomfort, and bloating. More serious adverse effects, though rare, include lactic acidosis, vitamin B12 deficiency, and kidney problems.
Metformin should not be used by individuals with severe kidney impairment, as it increases the risk of lactic acidosis, a serious condition. Caution is also required for people with heart failure or other cardiovascular issues. Metformin should be temporarily discontinued before or after contrast imaging procedures to prevent kidney complications. Excessive alcohol consumption while taking Metformin also increases the risk of lactic acidosis.
Indications and Purpose
How does Metformin work?
Metformin works by helping your body use insulin more effectively. It belongs to a class of drugs called biguanides. Metformin reduces the amount of sugar your liver releases into your blood and improves your body's response to insulin, which is a hormone that helps control blood sugar. Think of it like adjusting the thermostat in your home to maintain a comfortable temperature. Metformin helps keep your blood sugar levels stable, which is important for managing type 2 diabetes and reducing the risk of complications.
Is Metformin effective?
Yes, Metformin is effective for managing type 2 diabetes. It helps lower blood sugar levels by improving your body's response to insulin, which is a hormone that helps control blood sugar. Clinical studies show Metformin significantly improves blood sugar control, lowers HbA1c levels, and may help with weight management. It's often the first choice for treating type 2 diabetes and can be used alone or with other medications. Regular check-ups with your doctor are important to monitor its effectiveness and adjust your treatment as needed.
What is Metformin?
Metformin is a medication used to treat type 2 diabetes. It belongs to a class of drugs called biguanides, which help control blood sugar levels. Metformin works by reducing the amount of sugar your liver releases into your blood and improving your body's response to insulin, which is a hormone that helps control blood sugar. It's often used as a first-line treatment for type 2 diabetes and can be used alone or with other medications. Metformin may also have benefits for weight management and reducing the risk of diabetes-related complications.
Directions for Use
For how long do I take Metformin?
Metformin is usually a long-term medication for managing type 2 diabetes. You'll typically take Metformin every day as a lifelong treatment unless your doctor suggests otherwise. Stopping this medication without medical advice could cause your condition to worsen. How long you'll need this medication depends on your body's response, any side effects you experience, and changes in your overall health. Always talk with your doctor before changing or stopping your Metformin treatment. They will help you make any medication changes safely to protect your health.
How do I dispose of Metformin?
To dispose of Metformin, bring unused tablets to a drug take-back program or collection site at a pharmacy or hospital. They will dispose of this medicine properly so it doesn't harm people or the environment. If you can't find a take-back program, you can throw most medicines in the trash at home. But first, take them out of their original containers, mix them with something undesirable like used coffee grounds, seal the mixture in a plastic bag, and throw it away.
How do I take Metformin?
Take Metformin as prescribed by your doctor. It's usually taken once or twice daily with meals to reduce stomach upset. Swallow the tablet whole; don't crush or chew it. If you miss a dose, take it as soon as you remember unless it's close to your next dose. In that case, skip the missed dose. Don't take two doses at once. Avoid excessive alcohol, as it can increase the risk of side effects. Always follow your doctor's specific instructions regarding diet and fluid intake while on Metformin.
How long does it take for Metformin to start working?
Metformin starts working in your body shortly after you take it, but you may not notice all the benefits right away. For type 2 diabetes, you might see some improvement in blood sugar levels within a few days, but more significant changes typically take a few weeks. The full therapeutic effect may take up to three months. How quickly the medication works can depend on your overall health, diet, and exercise habits. Take it exactly as prescribed for the best results and attend regular check-ups with your doctor to monitor your progress.
How should I store Metformin?
Store Metformin at room temperature, away from moisture and light. Keep it in a tightly closed container to protect it from damage. Don't store your medicine in humid places like bathrooms, where moisture in the air could affect how well the medication works. If your pills came in packaging that isn't child-resistant, transfer them to a container that children can't easily open. Always store Metformin out of children's reach to prevent accidental swallowing. Remember to check the expiration date regularly and properly dispose of any unused or expired medication.
What is the usual dose of Metformin?
The usual starting dose of Metformin for adults is 500 mg taken once or twice daily with meals. Your doctor may gradually increase your dose to improve blood sugar control, with a maximum recommended dose of 2,000 to 2,500 mg per day, depending on the formulation. Dose adjustments may be needed for elderly patients or those with kidney problems. Always follow your doctor's specific dosing instructions for your personal health needs.
Warnings and Precautions
Can I take Metformin with other prescription drugs?
Metformin can interact with certain medications, increasing the risk of side effects or reducing its effectiveness. For example, combining Metformin with other diabetes medications can increase the risk of low blood sugar. Some medications, like diuretics or corticosteroids, can affect blood sugar control. Always inform your doctor about all the medications you take, including over-the-counter drugs and supplements. They can help manage potential interactions and adjust your treatment plan as needed to ensure safe and effective diabetes management.
Can Metformin be taken safely while breastfeeding?
Metformin is generally considered safe to use while breastfeeding. It passes into breast milk in small amounts, but studies show it doesn't harm the breastfed infant. Metformin doesn't affect milk supply. However, always consult your doctor before taking Metformin while breastfeeding. They can provide personalized advice based on your specific health situation and ensure the best outcome for you and your baby. Your doctor will help you make informed decisions about your treatment while nursing.
Can Metformin be taken safely while pregnant?
Metformin is generally considered safe during pregnancy, especially for women with gestational diabetes, which is high blood sugar during pregnancy. It helps control blood sugar levels and reduces the risk of complications for both mother and baby. However, always consult your doctor before taking Metformin during pregnancy. They can help create a pregnancy-specific treatment plan that protects both you and your baby. Your doctor will weigh the benefits and risks to ensure the best outcome for your health.
Does Metformin have adverse effects?
Adverse effects are unwanted reactions to a medication. Common adverse effects of Metformin include gastrointestinal issues like nausea, diarrhea, and stomach upset, affecting up to 25% of users. These are usually mild and improve over time. A rare but serious adverse effect is lactic acidosis, which requires immediate medical attention. If you experience symptoms like muscle pain, difficulty breathing, or unusual tiredness, contact your doctor. Always inform your healthcare provider about any new or worsening symptoms while taking Metformin.
Does Metformin have any safety warnings?
Yes, Metformin has important safety warnings. It can cause lactic acidosis, which is a rare but serious condition where lactic acid builds up in the blood. Symptoms include weakness, tiredness, and trouble breathing. This risk is higher in people with kidney problems, liver disease, or heavy alcohol use. Metformin can also cause low blood sugar, especially when combined with other diabetes medications. Always follow your doctor's instructions and report any unusual symptoms immediately. Regular monitoring of kidney function is recommended while taking Metformin.
Is it safe to drink alcohol while taking Metformin?
It's best to limit alcohol while taking Metformin. Drinking alcohol can increase the risk of lactic acidosis, which is a dangerous buildup of acid in your blood. This serious condition requires emergency medical treatment. Alcohol can also cause low blood sugar, especially if you skip meals. If you do choose to drink occasionally, limit how much alcohol you consume and watch for warning signs like nausea, vomiting, or trouble breathing. Talk with your doctor about alcohol use while taking Metformin to get personalized advice.
Is it safe to exercise while taking Metformin?
Yes, it's safe to exercise while taking Metformin. Exercise can help improve blood sugar control and overall health. However, Metformin can cause low blood sugar, especially if you take insulin or other diabetes medications. Low blood sugar might make you feel weak during workouts. To exercise safely, drink plenty of water before, during, and after physical activity. Watch for signs of dizziness, unusual fatigue, or low blood sugar. If you notice these symptoms, slow down or stop exercising and rest. Check with your doctor if you have concerns.
Is it safe to stop Metformin?
Stopping Metformin suddenly can cause your blood sugar levels to rise, which may worsen your diabetes symptoms. Metformin is usually used long-term for managing type 2 diabetes. If you need to stop taking it, talk with your doctor first. They might suggest gradually reducing your dose or switching to a different medication to keep your condition under control. Your doctor will help you make any medication changes safely to protect your health.
Is Metformin addictive?
Metformin is not addictive or habit-forming. This medication doesn't cause dependency or withdrawal symptoms when you stop taking it. Metformin works by helping your body use insulin more effectively, which doesn't affect brain chemistry in ways that could lead to addiction. You won't experience cravings for this medication or feel compelled to take more than prescribed. If you have concerns about medication dependence, you can feel confident that Metformin doesn't carry this risk while managing your health condition.
Is Metformin safe for the elderly?
Metformin is generally safe for the elderly, but they are more vulnerable to its side effects, like lactic acidosis, which is a dangerous buildup of acid in the blood. Kidney function often declines with age, increasing the risk of this condition. Elderly patients may also experience more gastrointestinal side effects. Regular monitoring of kidney function and adjusting the dose as needed can help manage these risks. Always consult your doctor about the safety of Metformin for elderly patients.
What are the most common side effects of Metformin?
Side effects are unwanted reactions that can happen when taking a medication. Common side effects of Metformin include stomach upset, nausea, diarrhea, and a metallic taste in the mouth. These effects are usually mild and occur in about 10-25% of people, often improving as your body adjusts to the medication. If you notice new symptoms after starting Metformin, they might be temporary or unrelated to the medication. Talk with your doctor before stopping any medication.
Who should avoid taking Metformin?
Metformin should not be used in people with severe kidney problems, as it can increase the risk of lactic acidosis, which is a dangerous buildup of acid in the blood. It's also contraindicated in people with severe liver disease or a history of lactic acidosis. Caution is needed in those with heart failure or who consume excessive alcohol. Always consult your doctor about these concerns. They will assess your health condition and determine if Metformin is safe for you.
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