In this article we will see what is metformin, metformin uses, dosage, side effects, overdose, brands, precautions, metformin storage and how to improve blood sugar level in type 2 diabetes patients with Metformin.
Metformin pronounced as (met for’ min) is the only American Diabetes Association (ADA) prescribed oral medicine for diabetes patients to control blood sugar levels. Metformin is used in patients with type 2 diabetes to improve their blood sugar level. It is not an option for treatment of type 1 diabetes but can only be used to improve blood sugar level in patients with type 2 diabetes. There could be other possible uses but this article will describe it’s uses in context of blood sugar level management in type 2 diabetes patients.
Before Taking Metformin
Make sure that you share all the relevant information to your Doctor which can help the Doctor determining your dosage. It will also help to see if there wont be any metformin side effects and would it be safe for you. Because there could be some serious metformin side effects if you are allergic to it, and other ingredient in medicine or have some certain medical history. So the Doctor may look for an alternate treatment if the side effects are susceptible to happen based on your medical condition, age and other factors. Your Doctor will decide if this medicine is recommended for you or you would be suggested to go on insulin. You should share the details given below with your Doctor before you decide to go with dosage.
Tell if you have severe kidney disease, liver or heart diseases. Metformin side effects are more likely to occur in patients having kidney, liver or heart diseases; hence not recommended for such people.
If you have breathing problems (such as severe asthma, obstructive lung disease), blood related problems including vitamin B12 deficiency and anemia or any other chronic diseases.
It may come with some inactive-ingredients which can cause allergic reactions in some people. So make sure to tell your doctor if you are allergic to it or any of the ingredients of liquid or tablets. So tell even if you are allergic to medications other than it.
If you are in diabetic ketoacidosis condition, your doctor may suggest to take Insulin instead of metformin. Patients with diabetic ketoacidosis are prone to have it’s side effects.
Precautions in Pregnancy
Though the metformin effects on fetus are not well known but usually it is not recommended in pregnant woman. Tell your doctor if you are pregnant or planning to be before going for this medication.
This medicine is passed into milk from mother to baby and should not be taken if you are breast-feeding a child
To avoid side effects, always take it under the prescription of a Doctor. Because Metformin uses and overdose can cause serious and fatal side effects; your doctor would know and can control it sooner if you are taking it under his supervision.
It comes in three forms i.e. metfomin tablet, liquid and extended-release (long-acting). All three forms are taken orally by mouth along with your meal. Metformin dosage would be based on your Doctor’s prescription. Usually the tablet is taken 2-3 times a day, liquid is taken 1-2 times a day and the extended-release tablet is taken only once along with evening meal.
Do not split or chew the extended-release tablets but swallow them as a whole.
Remember, metformin doesn’t cure diabetes but it helps in improving your blood sugar level. But It is only the part of your diabetes management program and you need to follow the proper diet and exercise program while taking it.
If you have type 2 diabetes, most probably you would be overweight or obese. Because being overweight and physically inactive is the major cause of type 2 diabetes. So you must need to make sure that you lose your weight by 5% to 7% and keep your weight under control with a proper exercise and diet plan. Also increase the intake of foods which help in losing weight and limit the foods which may cause weight gain.
Do increase your fluid intake while taking Metformin as the lack of enough fluid may cause dehydration and dehydration may lead to fatal lactic acidosis which is one of the serious side effects and seek an immediate medical emergency.
Why Would I Take It
Diabetes brings a number of worst complications associated with it, if you do not keep your blood sugar level controlled. Apart from a proper diet and exercise program, you also need medication which can help to control your blood glucose level. Though the blood sugar level in type 1 diabetes cannot be controlled with medication and you will have to take insulin injections, that is not the case with type 2 diabetes.
For the patients with type 2 diabetes metformin is the only prescribed medicine by American Diabetes Association (ADA) to control blood glucose level. It is used in patients with type 2 diabetes to prevent the complications of diabetes. For example, it helps prevent kidney damage, blindness, heart attack, stroke, nerve problems, loss of limbs, sexual function problems by controlling high blood sugar.
Metformin also helps reducing the production of extra sugar in your liver and also reduces the sugar absorption in your stomach. It also helps in reducing the Insulin resistance and raising the quality of life of the patient with type 2 diabetes.
Metformin directly impacts on your blood sugar level and you should follow some precautions while taking this medicine described below.
Do not over drink alcohol while taking this medicine as it can lead to fatal side effect lactic acidosis. It’s better that you stop your alcohol intake while using metformin.
Lactic acidosis is a serious medical emergency condition which may happen in case of dehydration, overdose, over consumption of alchohol and some other factors. Call your doctor immediately if you see the symptoms of lactic acidosis including:
- Stomach pain, nausea with vomiting
- Having trouble while breathing
- Feeling very week, tired and having a whirling sensation
- Numb or cold feeling in your arms and legs
- Uncontrolled or Slow heart rate.
If you are taking the extended-release tablets you may see something in your stool that looks like a tablet. But don’t worry about it, that’s just the empty tablet shell.
High fever, too much of sweating, diarrhea and vomiting increase the risk of dehydration. So make sure to drink enough fluid to makeup the water lose and prevent dehydration. Because dehydration increases the risk of lactic acidosis.
However, older people need special attention as they are at higher risk of lactic acidosis and other metformin side effects.
We can classify symptoms of metformin side effects in two categories.
Metformin Side Effects with Common Symptoms
Common side effects of metformin could be metallic taste in mouth, upset stomach, weakness, less severe diarrhea, less severe gas and less severe headache. It can also include Vitamin B12 deficiency, stomach cramps, swelling of the abdomen, taste problems and feeling of throwing.
So, tell your doctor if any of these symptoms persists or get severe.
Metformin Side Effects with Severe and Fatal Symptoms
Severe stomach pain and severe gas, severe diarrhea, bloating or swelling, indigestion, constipation, heartburn, chest pain, allergic reaction and rashes, severe headache and muscle pain.
In some conditions metformin can develop a serious side effect called lactic acidosis. For example, this may be more likely if you have liver or kidney disease, congestive heart failure, a severe infection, dehydration or if you drink large quantity of alcohol. So talk with your doctor about your risk of having lactic acidosis.
Lactic acidosis is a life threatening side effect and need medical emergency help. So this medicine is not recommend for patients having liver disease, kidney diseases, dehydration, severe infection or had congestive heart failure. This is a medical emergency, see your doctor immediately if you see the symptoms of lactic acidosis such as having trouble while breathing, stomach pain, nausea with vomiting, numb or cold feeling in your arms and legs and uncontrolled or slow heart rate.
An overdose may lead your sugar level to become too low, this condition is called hypoglycemia. Symptoms of hypoglycemia include difficulties in breathing, taking long breath usually with a sound, sweating, confusion, headache, hunger, sweating, irritability, dizziness or feeling shaky.
Hypoglycemia, if not having severe symptoms may be recovered by taking something sugary. But if symptoms are severe, it is a medical emergency and an injection of Glucagon is required immediately.
If the level of blood sugar is increased too high as it may happen if you miss the metformin doses or due to some other reasons, you may go under Hyperglycemia. Symptoms of Hyperglycemia include increased thirst, increased urination, drowsiness, confusion, rapid breathing and fruity breath odor. See your doctor right away if you feel such symptoms.
See a detailed information about side effects
Keep it away from light, at room temperature and away from moisture or excess heat. Always keep it in it’s original container and out of reach of children. In addition, please read the leaflet instructions or ask your pharmacist for more details on metformin storage and disposal.
It may be available in two variants either with metformin systemic or in combination of other ingredients. Few of the metformin brands available in US are given below.
Medications Containing Metformin
Name: metformin systemic
Brands: 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
More brands are listed in my other exclusive article metformin how to use.
Your doctor will suggest your metformin dosages based on your disease condition, medical history or any other criteria based on your diagnosis.
Missed Metformin Dose
Take the missed dose as soon as you remember it unless it is almost the time for next dose. Do not take double dose to make up the missed dose as it may cause the blood sugar level to become too low and may cause hypoglycemia or lactic acidosis, two the serious side effects.
Metformin overdose can cause the blood sugar level become too low and lead to Hypoglycemia or lactic acidosis or any other medical emergency conditions. These conditions could be fatal and seek prompt medical help