Metformin

What is Metformin (Glucophage)?

Metformin is a first-line medicine used for the treatment of type 2 diabetes. It was discovered in the 1920s, and has since been marketed under various trade names, most recently as Glucophage. It is particularly effective in diabetics who are overweight.

What is it used for?

Metformin is an oral antidiabetic medication used to help you control your blood sugar levels. It is prescribed for people with type 2 diabetes, and is occasionally used together with insulin or other diabetes medications.

How does it work?

Metformin is in the biguanide class of oral antidiabetic medications. It works by helping your body respond better to the insulin it makes naturally by:

• decreasing the amount of sugar your liver produces
• decreasing the amount of sugar your intestines absorb

People with type 2 diabetes are not able to produce enough insulin, or are unable to respond normally to the insulin their bodies make. When this happens, sugar builds up in the blood, which can lead to serious medical conditions including blindness, amputations, and kidney damage. Diabetes is also closely associated with heart problems. The primary goal of Metformin treatment is to help you lower your blood sugar to a normal level.

How to take this medication

While you take Metformin, or any other your diabetic drugs, continue to exercise and follow the diet advised for your diabetes treatment by your doctor. Your doctor will tell you how much medicine to take and when to take it. Always follow the directions provided by your doctor for using this medicine. Taking this medicine with food will decrease the chance of developing symptoms such as nausea and vomiting. Do not start or stop any medicine without consulting your doctor first.

Active Ingredients

Metformin hydrochloride (HCL)

The active ingredient in this medication is Metformin hydrochloride (HCl). HCl is the chemical salt of the drug which is commonly used in the production process of many drugs to make them stable, as well as water and acid soluble.

Metformin dosage

The initial recommended dose is typically 500 mg, taken orally, twice a day, or 850 mg once a day. Only increase doses as your doctor recommends. Weekly increases in 500 mg increments or 850 mg every two weeks are generally well tolerated. A typical maintenance dose is 2000 mg daily in divided doses. The maximum recommended dose is 2550 mg daily.

Missed Doses

If you should happen to forget to take your tablet, take your next dose at the usual time. Do not take a double dose to make up for the missed dose. If you are not sure what to do after you miss a dose, contact your doctor for advice.

Overdose

In general, an overdose may lead to increased symptoms as described under the “Side effects” and “Warnings and Precautions” section. If you think you have taken too many tablets, or suspect you have taken a larger dose than recommended immediately see your doctor, contact the poison control or go to the nearest hospital emergency department. Do this even if you experience no signs of discomfort or poisoning.

Benefits

Metformin is an extremely valuable drug and is on the World Health Organization’s List of Essential Medicines, as one of the most effective and safe medicines needed in a health care system. It is generally well tolerated with a small risk of causing low blood sugar levels, and is relatively cost-effective. Besides being an approved medication for the treatment of diabetes, it has also been shown to be beneficial for weight loss in certain cases, to have some cardiovascular protection properties, as well as being able to help reduce the effects of metabolic syndrome.

Warnings and Precautions

Do not take these tablets if you:

• have metabolic acidosis (including diabetic ketoacidosis, history of ketoacidosis or lactic acidosis)
• have a liver or kidney condition
• drink a lot of alcohol
• are going to have x-ray procedure with injection of dyes
• have high levels of stress, have severe infections, are experiencing some trauma prior to surgery or during the recovery phase
• suffer from severe dehydration
• are hypersensitive or allergic to metformin or any other ingredient in the formulation or component of the container
• are currently breastfeeding
• are currently pregnant or are planning on becoming pregnant
• suffer from cardiovascular collapse, which is an abrupt failure of blood circulation
• have or cardiorespiratory insufficiency, which is a difficulty with breathing caused by a weakened heart

The drug may rarely cause a serious, life-threatening condition called lactic acidosis.

Signs and symptoms of lactic acidosis may include:

• Suddenly developing irregular or a slow heartbeat
• Feeling uncomfortable, very weak or tired
• Unexpected or unusual stomach discomfort
• Trouble breathing
• Feeling dizzy or lightheaded
• Feeling cold
• Unusual muscle pain

If any of the above side effects occur, make sure to consult your doctor immediately. Remember to tell your doctor if you are currently pregnant or are planning on becoming pregnant.

Metformin should not be taken during pregnancy. Talk with your doctor about your treatment choices if you are pregnant. You must not take it if you are nursing a child, either. Insulin is generally the preferred treatment for gestational diabetes.

Gestational diabetes occurs when a woman without a previous history of diabetes develops high blood sugar levels during pregnancy. A diagnosis of gestational diabetes does not necessarily mean that you had diabetes before you conceived, or that you will have diabetes after pregnancy.

Tell your doctor if you have any other medical condition, including vitamin B12 deficiency, anemia, excessive alcohol use or allergies.