In this article we will explain the metformin uses, brands, precautions, side effects and other precautions. We will also look at what other information you need to know before taking this medicine, recommended metformin dosage, what to do if missed a metformin dose and what metformin brands are available.
Metformin – Overview, Dosage, Side Effects, Overdose, Brands
Metformin Side Effects – Overdose, Lactic Acidosis, Hypoglycemia, Hyperglycemia, Metformin Precautions
Before Taking Metformin
Before taking medicine, you need to explain your doctor all the relevant information that may be helpful for doctor to identify any possible side effects. Because The Doctor may need to look for an alternate if found any condition in which this medicine is not recommended. Hence You should clearly tell your doctor:
- If you are allergic to Metformin, any of the ingredients of it liquid or tablets or any other medications. Because this medicine may contain inactive ingredients which can cause allergic reactions or some other problems.
- If you have severe kidney disease
- If you have liver disease or a history of heart disease
- Tell your doctor your medical history in detail, especially if you have kidney disease, liver disease, severe breathing problems (such as severe asthma, obstructive lung disease), blood related disorders such as anemia and vitamin B12 deficiency etc.
- If you are in a state of diabetic ketoacidosis. Your doctor may suggest you to take Insulin instead of metformin.
- Tell your doctor if you have severe stress; because if you are in stress, it may be harder to control your blood sugar level. In that case your doctor may need to adjust your dose.
- Tell if you are pregnant or planning to become pregnant while using this diabetes controlling medicine. Though the metformin effects on fetus is still a subject of research but if you are pregnant, your doctor may suggest you to go for insulin instead of taking the medicine.
- Tell your doctor if you are breast-feeding your child because the medicine passes into milk from mother. It should not be taken if you breast-feed your child. See if you can see an alternate feed option for your baby, possibly.
It is not recommended to children younger than 10 years old - The Extended-release formulations (Glucophage XR, Glumetza, Fortamet) are strictly not recommended a person less than 18 years old.
- If you have recently taken Chlorpropamide.
- If you are going to have some type of scans which need injecting a dye into your veins such as some X-rays or CT scans, you need to stop taking metformin dosage temporarily
- Tell your doctor if you need to have a surgery.
- Tell the doctor the diet and exercise routine you follow. Because this may be a crucial factor in defining your metformin dosage.
- Ask your doctor if you can take It in Prediabetes condition.
Precautions
- If you ever see below symptoms, this is a medical emergency as these symptoms are associated with lactic acidosis. Call the medical emergency immediately.
- Numb or cold feeling in your arms and legs
- Having trouble while breathing
- Feeling very week, tired and having a whirling sensation
- Stomach pain, nausea with vomiting
- Uncontrolled or slow heart rate.
- Over consumption of alcohol while taking metformin can cause the fatal complication lactic acidosis. So stop or limit your alcohol intake while using the medicine.
- Don’t worry if you see something in your stool that looks like a tablet while taking extended-release tablets, that’s just the empty tablet shell.
- Dehydration increases the risk of lactic acidosis so make sure to drink enough liquid and keep your body hydrated while taking this medicine. Sometimes too much sweating, diarrhea, high fever or vomiting may also increase the risk of dehydration. Make sure to drink enough fluid to makeup the water lose and prevent dehydration.
- Older people are at higher risk of lactic acidosis and other metformin side effects, so pay special attention taking care of older people while taking medication.
What is Metformin?
Metformin is the American Diabetes Association (ADA) prescribed oral medicine to control blood sugar level in type 2 diabetes patients. It is used to improve blood sugar level, to reduce insulin resistance and raising the quality of life in type 2 diabetes patients. It is not an option for controlling blood sugar level in type 1 diabetes patients but can only be used for type 2 diabetes patients.
Remember, Diabetes is a chronic disease and metformin is not for diabetes cure but it controls level of blood sugar in patient with type 2 diabetes.
How to Use Metformin
Metformin should be used under the prescription of your doctor only. It is an oral medicine taken through mouth and sometimes your doctor can also prescribe any other medicine to take in combination of metformin such as Vitamin B12.
It comes in three forms i.e. liquid, tablet, and extended-release (long-acting). All three forms are taken orally by mouth. All three forms are taken with meal only. The tablet is usually taken 2-3 times with meal, liquid is taken 1-2 times daily with meal while the extended-release tablet is usually taken only once along with evening meal. Do not split of chew the extended-release metformin tablets but swallow them whole.
Remember, medicine is only the part of your diabetes management program and while taking metformin you must have to follow the proper diet and exercise program and follow other precautions required. Do increase your fluid intake while taking medicine unless directed by your doctor.
If you are overweight or obese, make sure you lose your weight by 5% to 7%. Follow a weight loss exercise program and eat healthy, diabetes friendly foods which could help losing weight.
Your doctor may adjust your dosage based on your disease condition and other factors such as possible side effects, if you are taking any other medicine or being allergic to the medicine etc. Do not forget to tell your doctor if you are taking any other medicines for diabetes or any other illness so that doctor can determine if the Metformin will not have any bad interaction with that medicine.
Be Punctual on Metformin Dosage
Make sure that you take your medicine dose at a fix time daily and do not change time of taking medicine. You must follow your doctor’s instructions carefully. Metformin dose is usually taken with the meal unless your doctor prescribe otherwise. Do not miss the medicine and always take it on time to take most benefit of it.
While taking metformin, it is recommended that you buy a Glucometer at home and keep a regular check on your sugar level. The ideal times to note your sugar levels are fasting blood glucose level that should be checked while your stomach is empty since 8-9 hours and check postprandial. The postprandial test is done after 2 hours of taking your meal.
Don’t forget to check your blood sugar during times when you are in stress, ill, exercised vigorously, traveling or any other medical emergency. Always maintain test records in a notebook and take it with you while having an appointment with your doctor.
Hypoglycemia
Remember, Metformin reduces the blood sugar level and if it is taken more than required dosage or if taken within shorter intervals, it may take your blood sugar level too low than required.
This is a serious condition if the blood sugar level goes too low, and called Hypoglycemia. So be very alert and keep a regular check on your sugar level if you are taking Metformin. You can feel symptoms of Hypoglycemia including sweating, problem in breathing, taking long breath commonly with a sound, confusion, headache, hunger, irritability, dizziness, or feeling shaky. If the symptoms are not severe, this condition can be recovered taking something sugary such as candy, glucose, fruit juice, crackers or raisins etc.
If the sugar level goes too low, the patient may lose his consciousness; this is an emergency condition and an immediate injection of Glucagon is required. Don’t forget to see your doctor immediately if you got under Hypoglycemia even if you have given the Glucagon injection at home. If you are taking metformin dosage, always keep your injection kit along with Glucagon injection with you. Also make sure that your family members, friends or whoever is around is aware how to handle such emergency situation.
An overdose may cause fatal lactic acidosis and you need to call an medical emergency help immediately.
Avoid drinking alcohol while taking medicine as it lowers the blood sugar and may increase your risk of lactic acidosis.
Hyperglycemia
Contrary to Hypoglycemia, the Hyperglycemia is the condition when blood sugar level goes too highly. Symptoms of Hyperglycemia (high blood sugar) may include rapid breathing, increased thirst, increased urination, drowsiness, confusion and fruity breath odor. Call your doctor right away if you see such symptoms as your doctor may need to adjust your metformin dosage.
Hyperglycemia condition may arise as a result of several missed doses or taking after a long duration, make sure you follow proper instructions of your doctor and always take medicine on time.
Storage of Metformin
This medicine should be kept at room temperature, away from direct sun light, away from moisture or excess heat. It should be kept in it’s original container. Keep it out of reach of children. Please read the leaflet instructions or ask your pharmacist for more details on storage and disposal of metformin.
Metformin Brands
This could be available in two variants either with metformin systemic alone, or in combination of other ingredients. There are many brands manufacturer in US, a few of them are given below.
Medications Containing Metformin
Name: metformin systemic
Brands names: Glucophage, Glumetza, Fortamet, Glucophage XR
Used for Treatment of: Diabetes Type 2, Insulin Resistance Syndrome, Polycystic Ovary Syndrome, Female Infertility
Metformin with Other Ingredients
Name: dapagliflozin/metformin systemic
Brand names: Xigduo XR
Used for Treatment of: Diabetes, Type 2
Name: alogliptin/metformin systemic
Brand names: Kazano
Used for Treatment of: Diabetes, Type 2
Name: canagliflozin/metformin systemic
Brand names: Invokamet
Used for Treatment of: Diabetes, Type 2
Name: empagliflozin/metformin systemic
Brand names: Synjardy
Used for Treatment of: Diabetes, Type 2
Name: metformin/saxagliptin systemic
Brand names: Kombiglyze XR
Used for Treatment of: Diabetes, Type 2
Name: metformin/sitagliptin systemic
Brand names: Janumet, Janumet XR
Used for Treatment of: Diabetes, Type 2
Name: glipizide/metformin systemic
Brand names: Metaglip
Used for Treatment of: Diabetes, Type 2
Name: glyburide/metformin systemic
Brand names: Glucovance
Used for Treatment of: Diabetes, Type 2
Name: linagliptin/metformin systemic
Brand names: Jentadueto, Jentadueto XR
Used for Treatment of: Diabetes, Type 2
Name: metformin/repaglinide systemic
Brand names: PrandiMet
Used for Treatment of: Diabetes, Type 2
Name: metformin/rosiglitazone systemic
Brand names: Avandamet
Used for Treatment of: Diabetes, Type 2
Name: metformin/pioglitazone systemic
Brand names: ActoPlus Met, ActoPlus Met XR
Used for Treatment of:Diabetes, Type 2
Metformin Missed Dose
Take the missed dose of metformin as soon as you remember it unless it is almost the time for your next dose. It is taken with meal; so if the next dose and meal time is just near, then do not take the missed dose but continue from the next dose. Do not take double dose to make up the missed metformin dose as it may decrease the blood sugar extreme low level and may cause hypoglycemia or lactic acidosis which can be fatal.
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