Metformin : Uses, Side Effects, Dosage, Precautions and More

Metformin is a widely prescribed oral medication used primarily to treat type 2 diabetes. As one of the cornerstone treatments for this condition, it plays a critical role in helping millions of people manage their blood sugar levels. This blog post provides a comprehensive overview of Metformin, including its uses, side effects, dosage, precautions, and more.

Uses of Metformin Tablets

1. Managing Type 2 Diabetes:

• Metformin is primarily used to lower blood sugar levels in individuals with type 2 diabetes.
• It works by decreasing glucose production in the liver and improving insulin sensitivity, which helps the body utilize glucose more effectively.

2. Polycystic Ovary Syndrome (PCOS):

• Metformin is also prescribed for women with PCOS to help regulate menstrual cycles and improve ovulation.
• It helps in reducing insulin resistance, a common issue in PCOS, and may aid in weight loss and reducing androgen levels.

3. Weight Management:

• Though not its primary use, Metformin can aid in weight loss, particularly in people with type 2 diabetes and PCOS.
• By improving insulin sensitivity and reducing appetite, it can contribute to weight management efforts.

4. Prediabetes:

• Metformin may be prescribed to individuals with prediabetes to prevent the progression to type 2 diabetes.
• It helps in maintaining lower blood sugar levels and reducing the risk of developing diabetes-related complications.

Side Effects of Metformin Tablets

1. Common Side Effects:

• Gastrointestinal issues such as nausea, vomiting, diarrhea, and abdominal discomfort are common, especially when starting treatment.
• A metallic taste in the mouth may occur.

2. Serious Side Effects:

• Lactic Acidosis: A rare but serious side effect, lactic acidosis is a medical emergency that requires immediate attention. Symptoms include muscle pain, difficulty breathing, abdominal pain, and extreme tiredness.
• Vitamin B12 Deficiency: Long-term use of Metformin can lead to a decrease in vitamin B12 levels, potentially causing anemia and neuropathy.

3. Allergic Reactions:

• Although rare, allergic reactions such as rash, itching, and swelling can occur. Seek medical help if you experience these symptoms.

Dosage of Metformin Tablets

1. Standard Dosage:

• The initial dose for adults typically starts at 500 mg once or twice daily or 850 mg once daily.
• Based on blood sugar control and tolerability, the dose can be gradually increased to a maximum of 2000-2500 mg per day, divided into two or three doses.

2. Extended-Release (XR) Formulation:

• For extended-release tablets, the initial dose is usually 500 mg once daily with the evening meal.
• The dose may be increased by 500 mg weekly, up to a maximum of 2000 mg once daily.

3. Special Populations:

• Dosage adjustments are necessary for individuals with renal impairment or those who are elderly.
• In children aged 10 years and older, the usual starting dose is 500 mg twice daily.

Precautions When Taking Metformin Tablets

1. Kidney Function:

• Regular monitoring of kidney function is essential, as Metformin is contraindicated in individuals with severe renal impairment.
• Dosage adjustments are required based on the estimated glomerular filtration rate (eGFR).

2. Liver Function:

• Metformin should be used cautiously in individuals with liver disease due to the increased risk of lactic acidosis.

3. Surgical and Radiologic Procedures:

• Metformin should be temporarily discontinued before undergoing surgery or radiologic procedures involving iodinated contrast materials to reduce the risk of lactic acidosis.

4. Alcohol Consumption:

• Excessive alcohol intake increases the risk of lactic acidosis and should be avoided while taking Metformin.

5. Pregnancy and Breastfeeding:

• Metformin is generally considered safe for use during pregnancy, especially for managing gestational diabetes.
• It is also excreted in breast milk in small amounts; however, it’s usually safe during breastfeeding.

Drug Interactions

1. Medications That May Increase Blood Sugar Levels:

• Certain medications, such as corticosteroids, diuretics, and oral contraceptives, may reduce the effectiveness of Metformin.
• Dose adjustments may be necessary when taking these medications.

2. Medications That May Increase the Risk of Lactic Acidosis:

• Drugs like carbonic anhydrase inhibitors (e.g., acetazolamide) can increase the risk of lactic acidosis.
• Concurrent use of these medications should be closely monitored.

3. Other Interactions:

• Cimetidine, a medication used to treat heartburn and ulcers, can increase Metformin levels in the blood, leading to a higher risk of side effects.

Monitoring and Follow-Up

1. Blood Sugar Levels:

• Regular monitoring of blood glucose levels is crucial to ensure effective management of diabetes.

2. Hemoglobin A1c:

• This test provides an average blood sugar level over the past 2-3 months and should be checked every 3-6 months.

3. Kidney Function Tests:

• Regular assessment of kidney function (eGFR) is important to adjust the Metformin dosage appropriately.

4. Vitamin B12 Levels:

• Periodic monitoring of vitamin B12 levels is recommended, especially in long-term Metformin users, to prevent deficiency.

Conclusion

Metformin is a vital medication for managing type 2 diabetes and other conditions such as PCOS and prediabetes. While it offers numerous benefits, it is essential to be aware of its side effects, appropriate dosage, and necessary precautions. Regular monitoring and follow-up with healthcare providers ensure the safe and effective use of Metformin. Always consult your doctor before starting or making any changes to your medication regimen.

Also read: Amitriptyline Tablet: Uses, Side Effects, Dosage, Precautions and More