WARNING

Metformin is a commonly prescribed medication for managing type 2 diabetes, but like all medications, it can have side effects. Here are some risks associated with taking Metformin:

• Gastrointestinal Issues: Common side effects include nausea, vomiting, diarrhea, and abdominal discomfort. These are often manageable and may improve over time.
• Lactic Acidosis: Although rare, Metformin can lead to a serious condition called lactic acidosis, where lactic acid builds up in the blood. This is more likely to occur in people with kidney issues or severe infections.
• Vitamin B12 Deficiency: Long-term use of Metformin can interfere with vitamin B12 absorption, potentially leading to deficiency.
• Kidney Function: Metformin is processed through the kidneys, so it’s important to monitor kidney function regularly. Impaired kidney function can increase the risk of lactic acidosis.

Most people tolerate Metformin well, but it’s important to discuss any concerns with your healthcare provider and have regular check-ups.

Why is this medication prescribed?

Metformin is commonly prescribed for managing type 2 diabetes. It helps lower blood sugar levels by improving the body’s sensitivity to insulin and reducing the amount of sugar produced by the liver. It can also help with weight management and has potential cardiovascular benefits. In some cases, it’s used for conditions like polycystic ovary syndrome (PCOS) as well.

How should this medicine be used?

Metformin is typically taken orally in the form of tablets or liquid. Here are some general guidelines for its use:

• Dosage: The dosage is usually adjusted based on your blood sugar levels and individual response. It’s often started at a low dose to minimize side effects, then gradually increased.
• Administration:
  • Tablets: Usually taken 1-3 times a day with meals to help reduce gastrointestinal side effects.
  • Extended-release tablets: Typically taken once a day with the evening meal.
• Consistency: Take Metformin at the same time(s) each day to help remember and maintain steady blood sugar levels.
• Monitoring: Regular blood tests may be needed to monitor blood sugar levels and kidney function, as Metformin can affect kidney function in some people.
• Diet and Exercise: It’s important to follow a balanced diet and exercise plan as recommended by your healthcare provider to get the best results from Metformin.

Always follow your healthcare provider’s instructions and consult them if you have any questions or concerns about taking Metformin.

Other uses for this medicine

• Polycystic Ovary Syndrome (PCOS): Helps with insulin resistance and can improve symptoms like irregular periods and infertility.
• Prediabetes: Sometimes prescribed to prevent the progression from prediabetes to type 2 diabetes.
• Weight Management: Occasionally used off-label to help with weight loss in some conditions, although this is less common.

What special precautions should I follow?

Special Precautions for Metformin:

• Kidney Function: Metformin is primarily excreted through the kidneys, so it’s important to have regular kidney function tests. If you have kidney issues or are at risk, your doctor may adjust your dose or suggest an alternative medication.
• Lactic Acidosis: This is a rare but serious side effect where lactic acid builds up in the blood. Risk factors include severe kidney problems, liver disease, dehydration, or certain other conditions. Be alert for symptoms like unusual fatigue, muscle pain, or trouble breathing.
• Contrast Dyes: If you’re undergoing procedures that involve contrast dyes (e.g., CT scans), you might need to temporarily stop Metformin because the dye can affect kidney function and increase the risk of lactic acidosis.
• Alcohol Consumption: Excessive alcohol can increase the risk of lactic acidosis and interfere with blood sugar control, so it’s advisable to limit alcohol intake.
• Diet and Hydration: Maintain a balanced diet and stay hydrated to help reduce the risk of gastrointestinal side effects and manage blood sugar levels effectively.
• Pregnancy and Breastfeeding: Consult your healthcare provider if you are pregnant, plan to become pregnant, or are breastfeeding, as adjustments may be necessary.

Always follow your healthcare provider’s advice and inform them of any other medications or health conditions to ensure safe and effective use of Metformin.

What special dietary instructions should I follow?

• Balanced Diet: Follow a balanced diet rich in fruits, vegetables, whole grains, and lean proteins. This helps in managing blood sugar levels effectively.
• Regular Meals: Eat regular meals and snacks as prescribed by your healthcare provider to avoid blood sugar spikes and drops.
• Limit Sugary Foods: Reduce intake of sugary foods and beverages that can cause rapid increases in blood sugar levels.

What should I do if I forget a dose?

• Timing: If you remember within a few hours, take the missed dose as soon as you can. If it’s almost time for your next dose, skip the missed dose—do not double up to make up for a missed dose.
• Consistency: Try to take your medication at the same time each day to maintain a routine and reduce the chances of missing a dose.
• Consult Your Healthcare Provider: If you frequently forget doses or have any questions about missed doses, consult your healthcare provider for personalized advice.

What side effects can this medication cause?

Metformin can cause several side effects, but not everyone experiences them. Common side effects include:

• Gastrointestinal Issues: These are usually temporary and can often be minimized by taking Metformin with food and starting with a low dose.
  • Nausea
  • Vomiting
  • Diarrhea
  • Abdominal discomfort or bloating

   

• Taste Disturbance: Some people report a metallic taste in the mouth.
• Loss of Appetite: A decrease in appetite can occur in some individuals.
• Vitamin B12 Deficiency: Long-term use of Metformin may affect the absorption of vitamin B12, which could lead to deficiency over time. Regular monitoring of vitamin B12 levels may be advised.
• Lactic Acidosis (rare but serious): Symptoms include muscle pain, breathing difficulties, unusual fatigue, or stomach pain. This condition is a medical emergency and requires immediate attention.
• Skin Reactions: Rarely, Metformin can cause skin rashes or itching.

If you experience severe or persistent side effects, or if you have symptoms of lactic acidosis, contact your healthcare provider promptly. They can help manage side effects and adjust your treatment if necessary.

What should I know about storage and disposal of this medication?

Storage and Disposal of Metformin:

• Storage:
  • Temperature: Store Metformin at room temperature, typically between 68°F and 77°F (20°C and 25°C).
  • Protection: Keep it in a tight container, away from moisture and light.
  • Out of Reach: Store it out of reach of children and pets.
• Disposal:
  • Medication Take-Back Programs: The best way to dispose of Metformin is through a medication take-back program or a pharmacy take-back service.
  • FDA Guidelines: If a take-back program is not available, follow the FDA’s flush list for certain medications that should be flushed to avoid accidental ingestion. However, Metformin is typically not on this list.
  • Household Disposal: If disposal in household trash is the only option, mix Metformin with an undesirable substance (like used coffee grounds or cat litter), place it in a sealed bag or container, and discard it in your household trash.

In case of emergency/overdose

• Symptoms of Overdose: Symptoms of a Metformin overdose might include nausea, vomiting, stomach pain, and possibly more serious signs like lactic acidosis (muscle pain, difficulty breathing, severe weakness).
• Contact Emergency Services: If an overdose is suspected or you experience severe symptoms, seek immediate medical help or call your local emergency services.
• Poison Control: You can also contact your local poison control center for guidance on what to do next.

What other information should I know?

• Interactions: Be aware of potential interactions with other medications or supplements. Always inform your healthcare provider about all the medications and supplements you are taking.
• Monitoring: Regular follow-up appointments are important to monitor your blood sugar levels, kidney function, and vitamin B12 levels.
• Lifestyle: Maintain a balanced diet, exercise regularly, and follow your healthcare provider’s recommendations to manage your condition effectively.
• Medical History: Keep your healthcare provider informed about any changes in your health or new symptoms, as these might affect your treatment plan.
• Medication Adherence: Take Metformin exactly as prescribed, and don’t stop or adjust the dose without consulting your healthcare provider.