Metformin is the common name for prescription drugs Glucophage, Glumetza and Fortamet, used to control blood sugar in people with type 2 diabetes.
Type 2 diabetes is a disease that occurs when the body does not produce or use insulin, which leads to increased blood sugar (glucose).
Metformin works by reducing the amount of sugar you get from food, and reduces the amount of glucose that your liver produces. It also improves the response of your body to insulin.
Metformin belongs to a class of drugs called biguanides. It is sometimes used together with diet, exercise and other medications to control blood glucose levels.
It is also used to prevent the development of diabetes in people at high risk of disease, the treatment of polycystic ovary syndrome (PCOS), and to increase the control weight resulting from the taking of certain medications.
The Food and Drug Administration (FDA) approved the drug in 1994.
Metformin and PCOS (Polycystic Ovary Syndrome)
Synthesis of polycystic ovaries (PCOS) is a common endocrine disorder that affects about one in 10 women of reproductive age.
Women with PCOS can have enlarged ovaries that contain fluid or follicles. These fluids can cause rare or prolonged menstrual periods, excessive hair growth, acne and weight gain.
The exact cause of PCOS is unknown, but the disorder is associated with insulin resistance and excessive insulin in the body.
If you have insulin resistance, your body can not effectively use insulin. As a result, your pancreas needs to secrete more insulin to make glucose available to cells and tissues, including those that make up the ovaries.
Researchers believe that excess insulin can affect the ovaries by increasing production of androgens, which can hamper the ability of ovaries to ovulate.
Because metformin can increase your body’s response to insulin, the drug has been used in the treatment of PCOS, especially in women with gestational diabetes.
There are conflicting data concerning the efficacy of Metformin in PCOS.
Studies have shown that Metformin can restore ovulation, reduce weight, reduce levels of circulating androgen, reduce the risk of miscarriage and reduce the risk of gestational diabetes in women with PCOS.
It has also been reported that metformin improves the outcome of pregnancy, as an addition to ovarian stimulation in women undergoing in vitro fertilization (IVF).
However, there are other studies suggesting that Metformin is not effective for improving the insulin response in women with PCOS.
Oral contraceptives are the first choice in most non-diabetic patients in PCOS. Oral contraceptives are preferable to metaphenin to protect the endometrium, hyperandrogenic symptoms and restore normal menstrual cycles.
If you have been diagnosed with PCOS, consult your doctor to find out if Metformin is a good option.
In rare cases, metformin can cause a life-threatening condition, known as lactic acidosis (accumulation of lactic acid in the body). Perhaps you are more prone to this if you:
- Have liver or kidney disease
- Have congestive heart failure
- Have a serious infection
- Drink a large amount of alcohol
You should tell your doctor if you are over 80 years old and if you have ever had a heart attack, stroke, diabetic ketoacidosis (extremely high blood sugar that requires emergency medical attention) or coma, or kidneys, heart disease or liver disease ,
You should also tell your doctor that you are taking Metformin before carrying out any operations, including dental procedures. Your doctor will tell you when to stop and resume the drug.
Some laboratory animals given high doses of Metformin developed non-cancerous abnormal tissue growth (polyps) on the uterus. It is not known whether this medicine increases the risk of polyps in humans. You can talk to your doctor about this risk.
Your doctor will most likely order special tests to check your body’s response to the drug.
This medicine controls diabetes, but does not cure it. You should continue taking Metformin even if you feel well.
Metformin should not be used to treat people with type 1 diabetes. The medication should not be given to a child under 10 years of age. The form of prolonged action of the drug should not be given to a child under the age of 17 years.
Metformin and weight loss
Some patients may experience weight loss when taking Metformin. The drug can cause loss of appetite and a sense of completeness that lead to such an effect.
Metformin and PCOS
Metformin is sometimes used to lower insulin levels and blood sugar levels in women with polycystic ovary syndrome or PCOS. PCOS causes irregular or non-menstrual periods, irregular ovulation and a high level of androgens (male hormones) in the body, sometimes leading to hirsutism (excessive growth of hair on the face or body on women)
Reducing blood sugar and insulin can help regulate menstrual cycles, begin ovulation and reduce the risk of miscarriage in women with PCOS.
Metformin and Fertility
Adjusting the blood sugar level with Metformin can help women who are struggling with infertility.
Pregnancy and Metformin
Metformin is an FDA drug for pregnant women in category B, which means that it will not be harmful to the unborn child. However, you should talk with your doctor before taking this medicine, if you are pregnant or plan to become pregnant.
It is unknown whether Metformin passes into breast milk and can harm an infant. You should also talk to your doctor before you start breastfeeding if you are taking Metformin.
Metformin Side Effects
Common side effects
You should tell your doctor if you have one of the following symptoms:
- Abdominal pain
- Unpleasant metallic taste in the mouth
- Change nails
- Pain in the muscles
Serious side effects
Immediately consult your doctor if you experience the following serious side effects:
- Extreme fatigue
- Nausea or vomiting
- Fast or slow heartbeat
- Rashes on the skin
- Pain in the muscles
- Feeling cold
- Abdominal pain
- Decreased appetite
- Rapid breathing or shortness of breath
- Thoracic pain
You should always tell your doctor about any prescription, non-prescription, illegal and recreational medications; medicinal products from plants; and food or dietary supplements that you take, especially:
- Acetazolamide (diamox)
- Amyloride (Midamor)
- Angiotensin converting enzyme (ACE) inhibitors, such as Benazepril (Lotensin), Captopen (Capoten), Enalapril (Vasotec), Fosinopril (monopril), Lisinopril (Prinivil, Zestril), Moexipril (Univasc), Perindopril (Aceon), quinapril (Accupril) , Ramipril (Altace) and Trandolapril (Mavik)
- Beta-blockers, such as Atenolol (Tenormin), Labetalol (Normodyne), Metoprolol (Lopressor, Toprol XL), Nadolol (Corgard) and Propranolol (Inderal)
- Calcium channel blockers, such as Amlodipine (Norvasc), Diltiazem (Cardizem, Dilacor, Tiazac, others), Felodipine (Plendil), Isradipine (DynaCirc), Nicardipine (cardene), Nifedipine (Adalat, Procardia), Nimodipine (Nimotop), Nisoldipine (Sular) and Verapamil (Calan, Isoptin, Verelan)
- Cimetidine (Tagamet)
- Digoxin (lanoxin)
- Furosemide (Lasix)
- Hormone replacement therapy
- Insulin or other drugs for diabetes
- Medications for asthma and colds
- Medicines for mental illnesses
- Medications for nausea
- Drugs for the treatment of diseases of the thyroid gland
- Morphine (MS Contin and others)
- Oral contraceptives (birth control pills)
- Steroids such as Dexamethasone (Decadron, Dexon, etc.), Methylprednisolone (Medrol) and Prednisone (Deltazone)
- Phenytoin (Dilantin, Phenytek)
- Prokainamide (Prokanbid, Proneshil)
- Ranitidine (Zantac)
- Topiramate (Topamax)
- Triamterene and hydrochlorothiazide (Dyazide, Maxzide and others)
- Trimethoprim (Primsol)
- Vancomycin (Vancocin)
- Zonisamide (Zonegran)
Metformin and alcohol
Alcohol consumption when taking Metformin may increase the risk of developing lactic acidosis or may lead to a decrease in blood sugar levels. You should talk with your doctor about how much alcohol is safe to consume before taking this medicine.
Metformin is supplied as a liquid, tablets and tablets with prolonged release for oral administration. You should try to take the medicine at about the same time every day with food.
Typical dose for adults from type 2 diabetes
Immediate release tablets: 500 milligrams (mg) twice daily or 850 mg once daily. This dose can gradually increase by 500 mg per week or 850 mg every two weeks. The maximum daily dose of Metformin is 2.550 mg divided into three smaller doses.
Extended-release tablets: 500 mg or 1000 mg daily with dinner. The dose can be increased by 500 mg per week to a maximum of 2000 mg. If you take Fortamet or Glumetza (Metformin modified release formulations), you may be given different dosing instructions.
You must swallow a tablet with an extended release. Do not split, crush or chew it.
A typical infantile dose of type 2 diabetes
Children aged 10 to 16 years: 500 mg twice daily. The dose can be increased by 500 mg per week to a maximum of 2000 mg in divided doses.
Children older than 17 years: 500 mg tablets with prolonged release daily to 2,000 mg per day.
Symptoms of overdose may include the following:
- Abdominal pain
- Rapid heartbeat
If you suspect an overdose, you should immediately contact a toxicology center or an emergency room. You can contact the Toxicology Center
Missed Metformin Dose
If you missed the dose of Metformin, take it as soon as you remember. However, if it is already time for the next dose, skip past and continue with regular medication. Do not take an extra dose to make up for the missed one.