Diabetes is a disorder that makes all the organs and systems of the human organism suffer and wear off faster than it happens in healthy individuals. The drug that has the potency to help improve the quality of life and its duration is Metformin. It was discovered in 1922, yet it came to the medicinal market many years later, in 1957 in Europe and in 1995 in the United States.
Metformin is a generic preparation, which means it is available for purchase at a reasonable price and is affordable to people regardless of their level of income. In the United States, this preparation ranks four on the list of the most often prescribed medications. The positive effects Metformin induces on patients treated with it got this preparation on the WHO’s List of Essential Medicines.
The primary indication for Metformin therapy is type 2 diabetes. The medication helps to deal with the disease in two ways. First, it reduces the secretion of glucose by the liver. The second one is the increase in the sensitivity of the body tissues to insulin. This preparation is recommended to people whose type 2 diabetes is associates with excessive weight and obesity. Metformin intake doesn’t lead to gaining weight. On the contrary, it may be useful for losing weight as it reduces the absorption of glucose from the gastric tract.
Metformin can also be prescribed to women suffering from polycystic ovarian syndrome to treat infertility and increase the chances of live births. The drug appears to be effective even in those women who failed to get pregnant after the therapy with an ovulation-inducing drug called clomiphene.
Gestational diabetes is another health issue that can be managed due to therapy with Metformin. In the UK, this drug is considered the first-line treatment for women dealing with gestational diabetes.
Metformin is a generic medication produced in tablet form. The pills are available in four dosage strengths. The tablets with the lowest dose of the active ingredient contain 500 mg of metformin. Then come 750 mg and 850 mg dosages and 1000 mg dosage strength. The preparation comes in the immediate- and the extended-release pills.
The choice of the most appropriate dose of the medication should be done by a doctor. A specialist will take into account your blood sugar levels, tolerance to the drug, and the medications you will use concomitantly with Metformin.
Usually, to reduce the risks for unwanted reactions, the Metformin dosage is titrated up gradually. The initial recommended dose of the drug for patients with type 2 diabetes is either 500 mg twice a day or 850 mg once daily. The dose increase is done biweekly by 500 mg or every two weeks by 850 mg, depending on the patient’s response to the treatment and tolerance to the preparation.
For extended-release tablets, the recommended starting dose is 500 mg or 1000 mg once a day. The dose titration should be done by 500 mg every week until the maintenance dose of 2000 mg a day is achieved. The daily dose should be divided into two or three intakes. The maximum safe daily dose for patients with type 2 diabetes is 2550 mg.
To cope with the female infertility associated with anovulation due to polycystic ovarian syndrome, high doses of Metformin may be used. Usually, the daily dose of Metformin for such patients ranges from 500 mg to 3000 mg.
Metformin may be taken either as a single daily dose (when the dose doesn’t exceed 850 mg) or divided into two or three intakes (usually when the dose reaches 1000 mg). To avoid or at least minimize the risks for gastrointestinal side effects, the tablets should be administered with a meal.
It is better to take Metformin at the same time daily. There are two reasons for that: keeping stable levels of medication in the organism will help your health condition and you won’t miss taking the pills if it gets into the habit. Missing a dose of the preparation may lead to the worsening of your health condition and elevation of your blood sugar levels.
One of the hazards of Metformin therapy is the risk of developing lactic acidosis. To prevent this, drink a lot of water and keep control of your body’s hydration. For the same reason, you should minimize the amounts of alcohol you drink. Spirits cause dehydration, which is dangerous when on Metformin.
Individuals with light liver or kidney disease may take this medication. However, regular checkups at the doctors are required for such patients. Those aged 65 and older can be prescribed Metformin only if the potential benefits prevail on the possible risks. The medication can be used with caution in patients suffering from hypoxic health conditions.
It’s better to discontinue the drug intake before surgery or radiological studies with the application of the contrast agent containing iodine.
Be careful when driving a car or operating machinery during the treatment with Metformin. This drug can cause dizziness or blurred vision, which will make any activity demanding alertness dangerous.
All medicines, including Metformin, are aimed at helping people deal with certain health issues. However, for some patients, the possible risks of the treatment prevail on its potential benefits. In such situations, Metformin intake is contraindicated. The health problems that may get worse when on Metformin include:
moderate-to-severe renal impairment;
moderate or severe hepatic impairment;
hypersensitivity to metformin or any of the inactive ingredients of the tablets;
severe breathing disorders, including asthma and COPD;
metabolic acidosis (either acute or chronic).
The therapy with Metformin may change the way your body reacts to other medicines you may use. Therefore, you are to consult your healthcare provider who will help you determine whether any of the preparations (including herbal products) you currently use may get into interaction with Metformin. The major risks of Metformin interactions are associated with the following medications:
Glipizide. Their concomitant intake may provoke hypoglycemia. To prevent it, a dose adjustment is required.
Ibuprofen, mixed with Metformin, increases the risks for lactic acidosis.
Insulin potentiates the effects of Metformin, which may result in hypoglycemia.
Lasix may cause dehydration, which may trigger lactic acidosis in patients on Metformin.
Lisinopril elevates the risks for low blood sugar when taken with Metformin.
Phentermine therapy, when on metformin, can cause low blood sugar.
Levothyroxine reduces the efficiency of Metformin.
In case you cannot give up taking these medications when on Metformin, discuss the possible dose adjustment with your healthcare provider. Also, you may need your blood glucose to be monitored more often than usual if you combine Metformin with some of the listed medications.
Based on the results of some studies regarding the Metformin safety profile, this medication causes adverse effects in approximately 26% of patients taking it. Those appearing most often are listed below:
The unwanted reactions associated with the gastrointestinal tract are temporary and disappear soon after your body gets used to the effects induced by Metformin. It is better to inform your attending doctor about any unwanted reactions you experience during the therapy. You have to keep in mind that the gastrointestinal side effects manifestations appearing later in the treatment may signal lactic acidosis – the most dangerous of Metformin side effects.
Though Metformin itself is not likely to cause low blood sugar, if you are combining this medication with some other antidiabetic drug, you have to be attentive and notice the symptoms of hypoglycemia in time. They are racing heartbeat, increased sweating, dizziness, increased appetite. Contact your doctor right away or go to the nearest clinic for a consultation..