What is Metformin?

Metformin is a commonly prescribed medication used to manage type 2 diabetes. It helps your body to use sugar in more efficient way.

How it Works?

Think of sugar (glucose) as energy source for your body's cells. In type 2 diabetes, insulin secreted by beta cells of pancreas won't properly. This leads to too much sugar staying in your blood. Metformin manages this problem by following ways:

• 1. Reduces sugar production by the liver: your liver naturally produces sugar from non-glucose molecules like fats and proteins (this process is called gluconeogenesis). Metformin helps to slow down this process, so less sugar is released into your blood.
• 2. Improves insulin sensitivity: It helps your body's cells respond better to the insulin available in body. This allows more sugar to enter your cells for energy.

Uses

Metformin is mainly used for:

• Type 2 Diabetes: As a first-line treatment, commonly prescribed when diet and exercise alone aren't enough to control blood sugar levels. It can be used alone or in combination with other antidiabetic drugs.
• Prediabetes: Sometimes, doctors prescribe it to prevent type 2 diabetes in people who are at high risk.
• Polycystic Ovary Syndrome (PCOS): Metformin can be used to help manage PCOS symptoms, such as reduced insulin sensitivity, obesity, and irregular periods, even if you don't have diabetes.

Dosage

Adults: Initial dose is 500 mg orally twice a day or 850 mg orally once a day. Dose can be increased with regular monitoring of blood glucose levels. Maximum daily dose is 2000 mg.

Side Effects

Many people experience some mild side effects, especially in initial few weeks of starting metformin. These usually improve over time. Common Side Effects:

• Diarrhea
• Bloating, gas
• Loss of appetite
• Metallic taste in your mouth

Less Common but More Serious Side Effects (seek medical attention if you experience these):

• Lactic Acidosis: This is a very rare but serious side effect where too much lactic acid accumulates in your blood. It's more likely if you have kidney problems or liver problems, drink a lot of alcohol. Symptoms can include tiredness, weakness, muscle ache, difficulty in breathing, diarrhea, fever, and an increase in heart rate.
• Vitamin B12 Deficiency: Long-term use of metformin, especially in higher doses, can sometimes lead to lower levels of vitamin B12. Your doctor may recommend checking your B12 levels or taking a supplement.

Safety Precautions

• Alcohol: It is unsafe to consume alcohol with metformin tablet
• Pregnancy: Metformin is safe to use in pregnancy.
• Breastfeeding: Metformin is safe to use in breastfeeding.
• Kidney: Metformin should be used with special caution in kidney disease. It can increase the risk of lactic acidosis/Dose reduction is needed. Please consult your doctor. It can increase the risk of lactic acidosis.
• Liver: Metformin is safe to use in liver disease.

Drug Interactions

Metformin can interact with other medications, which can either make metformin less effective, increase its side effects, or affect your blood sugar levels.

• Other Diabetes Medications (e.g., insulin, sulfonylureas): Combining metformin with these can increase the risk of low blood sugar (hypoglycemia).
• Alcohol: Drinking too much alcohol with metformin can significantly increase the risk of lactic acidosis. Limit your alcohol intake.
• Diuretics ("water pills," e.g., hydrochlorothiazide, furosemide): These can sometimes make metformin less effective.
• Corticosteroids (e.g., prednisone): These can increase blood sugar levels, making metformin less effective.
• Some Antipsychotic Medications (e.g., clozapine): Can increase blood sugar levels.
• Beta blockers (e.g., propranolol): Can affect blood sugar levels and mask symptoms of low blood sugar.

📦 Storage

• Store at room temperature (68-77°F or 20-25°C)
• Keep in original container, tightly closed

Quick Tips

1. Take with food: Always take metformin with meals to help reduce stomach upset. If you're on a once-daily dose, take it with your evening meal.
2. Start low, go slow: Your doctor will usually start you on a low dose and gradually increase it. This helps your body adjust and minimizes side effects.
3. Stay hydrated: Drink plenty of fluids, especially if you experience stomach upset, diarrhea to prevent dehydration.
4. Monitor your blood sugar levels: Regularly check your blood sugar levels as advised by your doctor to see how well metformin is working.
5. Maintain healthy lifestyle: Metformin works best when combined with a healthy diet and regular exercise. These are crucial for managing diabetes.