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- What brand names are available for metformin?
- Is metformin available as a generic drug?
- Do I need a prescription for metformin?
- What are the uses for metformin?
- What are the side effects of metformin?
- What is the dosage for metformin?
- Which drugs or supplements interact with metformin?
- Is metformin safe to take if I'm pregnant or breastfeeding?
- What else should I know about metformin?
What are the uses for metformin?
- Metformin is used for treating type 2 diabetes in adults and children. It may be used alone or in combination with other diabetic medications.
- Metformin also has been used to prevent the development of diabetes in people at risk for diabetes, treatment of polycystic ovaries, and weight gain due to medications used for treating psychoses.
What are the side effects of metformin?
The most common side effects with metformin are
These symptoms occur in one out of every three patients. These side effects may be severe enough to cause therapy to be discontinued in one out of every 20 patients. These side effects are related to the dose of the medication and may decrease if the dose is reduced.
Metformin may also cause:
- respiratory tract infections,
- low levels of vitamin B-12,
- low blood glucose,
- heartburn, and
A serious but rare side effect of metformin is lactic acidosis. Lactic acidosis occurs in one out of every 30,000 patients and is fatal in 50% of cases. The symptoms of lactic acidosis are
- trouble breathing,
- abnormal heartbeats,
- unusual muscle pain,
- stomach discomfort,
- light-headedness, and
- feeling cold.
Patients at risk for lactic acidosis include those with reduced function of the
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What is the dosage for metformin?
- For treating type 2 diabetes in adults, metformin (immediate release) usually is begun at a dose of 500 mg twice a day or 850 mg once daily. The dose is gradually increased by 500 mg weekly or 850 mg every two weeks as tolerated and based on the response of the levels of glucose in the blood. The maximum daily dose is 2550 mg given in three divided doses.
- If extended tablets are used, the starting dose is 500 mg or 1000 mg daily with the evening meal. The dose can be increased by 500 mg weekly up to a maximum dose of 2000 mg except for Fortamet (2500 mg of Fortamet, once daily or in two divided doses). Glumetza tablets (500 -1000mg formulations are given once daily (either 1000 to 2000mg). Fortamet and Glumetza are modified release formulations of metformin. Metformin should be taken with meals.
- For pediatric patients 10-16 years of age, the starting dose is 500 mg twice a day. The dose can be increased by 500 mg weekly up to a maximum dose of 2000 mg in divided doses.
- Children older than 17 years of age may receive 500 mg of extended release tablets daily up to a maximum dose of 2000 mg daily. Extended release tablets are not approved for children younger than 17 years of age.
- Metformin-containing drugs may be safely used in patients with mild to moderate renal impairment. Renal function should be assessed before starting treatment and at least yearly.
- Metformin should not be used by patients with an estimated glomerular filtration rate (eGFR) below 30 mL/minute/1.73 m2 and starting metformin in patients with an eGFR between 30-45 mL/minute/1.73 m2 is not recommended.
- Metformin should be stopped at the time of or before administering iodinated contrast in patients with an eGFR between 30 and 60 mL/minute/1.73 m2; in patients with a history of liver disease, alcoholism, or heart failure; or in patients who will be administered intra-arterial iodinated contrast. Kidney function should be evaluated 48 hours after receiving contrast and metformin may be restarted if kidney function is stable.
Which drugs or supplements interact with metformin?
- Cimetidine (Tagamet), by decreasing the elimination of metformin from the body, can increase the amount of metformin in the blood by 40%. This may increase the frequency of side effects from metformin.
- Ioversol (Optiray) and other iodinated contrast media may reduce kidney function, which reduces elimination of metformin, leading to increased concentrations of metformin in the blood. Metformin should be stopped 48 hours before and after use of contrast media.
- Thiazide diuretics, steroids, estrogens, and oral contraceptives may increase blood glucose and reduce the effect of metformin. When these drugs are stopped, patients should be closely observed for signs of low blood glucose.
- Alcohol consumption increases the effect of metformin on lactate production, increasing the risk of lactic acidosis.
Is metformin safe to take if I'm pregnant or breastfeeding?
What else should I know about metformin?
What preparations of metformin are available?
- Tablets: 500, 850, and 1000 mg
- Tablets (extended release): 500, 750, and 1000 mg.
- Solution: 100 mg/ ml
How should I keep metformin stored?
Metformin should be stored at room temperature between 20 C to 25 C (68 F to 77 F).
Metformin (Glucophage, Glucophage XR, Glumetza, Fortamet, Riomet) is a medication prescribed to treat type 2 diabetes and the prevention of type 2 diabetes in patients who are at risk for type 2 diabetes. Side effects of metformin include:
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