“Metformin is a 70-year-old drug- Old is Gold” 

Brand names: Glycomet, Glucophage XR, CarbophageSR, Riomet, Gluformin, Diabne, Diabex, Diaformin, Glifor.

Metformin is the most widely used medication for diabetes taken through the mouth. It is available as a generic medication. It is the first line treatment for Type 2 diabetes. There is a reason for its popularity: it is safe, effective, and inexpensive for many people. 

How does Metformin act?

  • It reduces the release of stored glucose (glucose is stored as glycogen in liver) from liver.
  • It increases the uptake of glucose by cells i.e, it helps insulin to do its duty (increases insulin sensitivity).
  • It decreases the absorption of glucose in the intestine. 

All these results in low blood glucose levels. 

When you should avoid taking Metformin?

  • When your serum creatinine level is more than 1.5mg/dl in males and more than 1.4mg/dl in females. Creatinine is a measure of your kidney function.
  • When you already have lactic acidosis.

What is lactic acidosis? 

Normal pH of our blood is 7.4. It is maintained by normal metabolism. Metabolism is the process by which glucose, fat and proteins are broken down with the help of oxygen in cells to release energy. If there is some defects in metabolism, which can arise due to reduced oxygen supply, the process of breakdown will not occur completely. This results in an accumulation of certain acidic products. This lowers the blood pH to less than 7.4, i.e, your blood becomes more acidic. This is a rather simple way of explaining lactic acidosis. Lactic acidosis is diagnosed with blood gas analysis. Avoid Metformin if you have lactic acidosis, which usually presents as muscle pains and weakness. Metformin itself can cause lactic acidosis in some people. So, watch out for these symptoms:

  • Alcohol abuse with binge drinking.
  • If you are suffering from liver diseases.
  • When you are undergoing some procedures in which a dye will be injected in your blood for taking pictures (Contrast radiography).

More about Metformin

  • Metformin is found to reduce cardiovascular events like heart attacks and strokes when taken for diabetes.
  • Metformin improves the filling capacity of your heart and increases good cholesterol (HDL-C).
  • Metformin reduces free radical damage to organs, improves the elasticity of blood vessels. It prevents the formation of clots in blood vessels.
  • Metformin is also used in the treatment of polycystic ovary syndrome, a common cause of female infertility.
  • Metformin is known to delay or prevent the onset of diabetes in people who are prediabetic.
  • Metformin causes weight loss as it is known to reduce appetite.
  • Metformin is known to cause a metallic taste and hence can cause nausea in some people. It is known to cause diarrhea and loose stools (most common). Tell your healthcare provider about any side effects you are experiencing, so she/he can work with you to adjust the dose or change medications.

You can take Metformin as a pill. Maximum daily dose is up to five pills of 500 mg each. It is also available as a liquid. If ER/SR/XR is written in your medicine, it is an extended release preparation, i.e, the drug is released slowly. This means that the medicine will act for a longer duration of time.

Metformin does not improve your body’s ability to make insulin, so it is unlikely to cause episodes of low blood glucose. 

Ask your health provider about vitamin B12 deficiency if you have been taking Metformin for along time. S/he may measure your Vitamin B12 levels, and if they are found low, recommend taking a Vitamin B12 supplements. 

A single generic preparation of Metformin tablet costs about Rs. 2 to 3. 

Blood tests recommended when taking Metformin

  • Serum creatinine
  • Vitamin B12 assay
  • Fasting blood glucose levels
  • Serum lactate levels

    Disclaimer: This article is written by the Practitioner for informational purposes only. Users must not view the content as medical advice in any way. Users are also required to ’NOT SELF MEDICATE’ and always consult a practicing specialist before taking any medicines or undergoing any treatment. Practo and the Practitioner will not be responsible for any act or omission by the User arising from the User’s interpretation of the content.