Metformin- Indications, Uses, Precautions, and Side Effects of Metformin

Everything You Need To Know When You Take Metformin

Why Is Metformin Prescribed?

Metformin is usually the first medication prescribed after a new diagnosis of type 2 diabetes. Metformin helps lower your blood sugar through several different pathways. Metformin improves how your body utilizes insulin, decreases the amount of sugar your body absorbs from food, and also decreases the amount of sugar created by your liver.

Metformin is not used in the treatment of type 1 diabetes.

How Should I Use Metformin

Metformin is usually started once per day with either your morning or evening meal for 1-2 weeks. A second dose is generally added so that you take 1 pill with your morning meal and a 2nd dose with your evening meal. Alternatively, there is a long acting form of metformin that can be taken just once per day. There are also a number of different medications that combine metformin with other drugs.

Name Brands and Combination Metformin Products

Metformin brand names include:

  • Fortamet®
  • Glucophage®
  • Glumetza®
  • Riomet®

Metformin combination products include:

  • Actoplus Met® (Metformin + Pioglitazone)
  • Avandamet® (Metformin + Rosiglitazone)
  • Janumet® (Metformin + Sitagliptin)
  • Metaglip® (Glipizide + Metformin)

Are There Any Special Precautions With Metformin

  • Do not split, chew, or crush if you are taking a long acting or extended release form of metformin.
  • Metformin does not cure diabetes. To get benefit you must continue to take your metformin.
  • Metformin needs to be stopped before surgery or receiving contrast dye (e.g. getting a CT scan)

What Are The Side Effects of Metformin

While metformin is generally well tolerated, there is a risk for potential side effects with any medication. The most common side effects when beginning metformin are related to your gastrointestinal system. Diarrhea, bloating and abdominal discomfort are fairly common. To combat this, your doctor may start you on a low dose once per day and slowly increase the dose and frequency to twice a day dosing of metformin. Your body may adjust to the metformin after 1-2 weeks with an associated decrease in these gastrointestinal side effects. Additionally, a rare, but serious side effect of metformin is lactic acidosis. Build up of lactic acid in your system can lead to sever fatigue, muscle cramping, and shortness of breath.

If you experience any of the following side effects after starting metformin and they do not go away, worsen, or concern you discuss them with your doctor:

  • Constipation
  • Cough
  • Headache
  • Heartburn
  • Runny nose
  • Sneezing

While uncommon, metformin could cause hypoglycemia. If you develop any hypoglycemia symptoms, make sure you follow your doctor’s instructions about what to do.

Additionally, call your doctor if you have any of these symptoms of high blood sugar:

  • Dry mouth
  • Fast heart rate
  • Shortness of breath
  • Nausea
  • Vomiting
  • Fruity smelling breath
  • Altered mental status or decreased alertness

Other Metformin Uses Beside Diabetes

Your doctor may also use metformin for the following “off label” use?

  • Weight loss
  • Polycystic ovary syndrome
  • Gestational diabetes
  • HIV lipodystrophy syndrome.

Sources:

National Diabetes Information Clearinghouse. Accessed November 4, 2010. What I need to know about Diabetes Medicines

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