Metformin: Know About Medicine to Treat Type 2 Diabetes

Last updated on September 28th, 2022

Diabetes management is crucial to keep your blood sugar levels in control. High blood sugar levels can lead to serious health issues including liver and kidney issues and cardiac arrest. Diabetes management mainly includes lifestyle change, diet control, and workout. Along with these, medication is also very important to control your diabetes. The ‘US Food and Drug Administration has approved Metformin as an approved drug to treat diabetes.

What is Metformin?

Metformin or metformin hydrochloride is a prescribed oral drug. It is the generic name of Glucophage. It helps in controlling blood sugar levels in adults with type-2 diabetes mellitus. You can take it with other medications or insulin to keep your blood sugar levels in the normal range. This medicine is not for people with diabetes type-1.

Also Read: How to Lower Blood Glucose Levels?

How do Metformin works?

It helps in lowering your blood glucose levels. It performs multiple functions in your body to prevent spikes in blood glucose levels and also reduces the amount of glucose (sugar) made by your liver. This medicine decreases the amount of glucose that your body absorbs and increases the effect of insulin on your body.

Forms of Metformin

Metformin oral tablets are available in two forms. One is the immediate-release metformin and the other is extended-release metformin. Both forms of medicine contain the same active ingredients. However, there are different ways to take both medicine.

• Metformin Immediate Release: This form of metformin is available in 500 mg tablet. You need to take this medicine twice a day with food. Also you can find 850 mg immediate-release metformin hydrochloride tablets. You need to take it once a day. The maximum dose of immediate-release medicine is 2000 mg per day. It can be in divided dosage. Immediate-release metformin is suitable for both adults and children.
• Metformin Extended Release: It is the extended version of medicine to treat diabetes. The maximum dose of extended-release medicine is 2000 mg. However, a person with diabetes needs to take it once a day. It is ideally only for adults with type-2 diabetes. A person with diabetes type-2 should strictly take this medicine under the advice of a doctor because it has some side effects. However, its effect lasts longer than regular medicine.

Also Read: Is jaggery good for diabetes?

Interaction of Metformin with other medicines

One dark side of Metformin hcl drug is that it can easily interact with some medicines. The drug interaction can change its working and affect the effectiveness. This also increases the risks of serious side effects. Therefore, it is recommended to share with your doctor the details of all the medicines that you take. Some of the drugs that easily interact with Medicine are:

• Antibiotics: There are some antibiotics like rifampin that prevent medicine to perform its functions.
• Blood Pressure drugs: Taking diuretics can increase your blood sugar levels. Therefore taking these drugs with medicine will not give you effective results.
• Diabetes drugs: Insulin or some insulin-releasing medicines when taken with medicine reduces your blood sugar levels. It can cause hypoglycemia.
• Thyroid drugs: There are few thyroid drugs like desiccated thyroid, levothyroxine, liothyronine, and liotrix which make medicine less effective.
• Topiramate: This drug treats seizure and nerve pain. Taking topiramate with medicine increases the risk of lactic acidosis. Do not use these medicines together.
• Cholesterol drugs: The cholesterol controlling drug, Niacin increases your blood sugar levels. Metformin and cholesterol drugs do not work together.
• Glaucoma drugs: Taking glaucoma treating drugs with medicine increases the risk of lactic acidosis.
• Hormone drugs: Metformin with certain other drugs are less effective in reducing your blood sugar levels. Avoid this medicine with hormone drugs like estrogen and corticosteroids. Medicine also promotes ovulation. It causes changes in the menstrual cycle and hence increases the chance of getting pregnant.

Metformin during pregnancy and lactation

Women can take metformin during pregnancy with diabetes. Pregnant women need to take consultation with a gynecologist before taking medicine. Generally, pregnant women take insulin to control their increased blood sugar levels. It can easily enter breast milk. It can cause side effects to the breastfeeding child. Thus, metformin should be avoided during lactation or breastfeeding.

Metformin dosage

It is important to take medicine exactly in the dose as the doctor prescribes you. Do not chew or crush medicine tablets. You need to swallow it as a whole. The dose of metformin prescribed to the patients depends upon several factors. These include:

• the form of metformin you take
• severity of your diabetes
• your age
• your medical conditions

Initially, your doctor may start with a low dose. Over time the doctor adjusts your dosage according to your blood sugar levels. However, you need to ensure to take the dosage that your doctor prescribes. The doctor prescribes you the dosage that suits your health condition.

Dosage for Type-2 Diabetes

Dosage for type-2 diabetes for adults is:

• Immediate-release tablets are available in 500 mg and 850 mg. The doctor suggests taking these medicines twice per day and once per day respectively. Patients need to take the immediate-release metformin tablets with meals. Your doctor can increase your dose up to a total of 2,000 mg per day in divided doses.
• Extended-release tablets are available in 500 mg. You need to take it once a day with your evening meal. A doctor can increase your dosage of metformin hydrochloride 500 mg every week on the basis of your blood glucose levels. The maximum dose of extended-release tablet is 2,000 mg per day. You can take the extended-release tablet once a day. Still, if your doctor realizes the need to increase the dosage, your doctor will divide the dose into two.

People older than 80 years of age should not take metformin especially if they have kidney problems. Older people also have a higher risk of lactic acidosis.

Also Read: Metformin 1000 mg Tablet Uses, Side Effects, Dosage & Interactions

Overdose of metformin

Overdose of metformin may lead to some side effects including hypoglycemia and lactic acidosis. In case you miss your metformin dose, you need to take the medicine as soon as you can. Do not try to add up your missed dose with the next dose. It can cause low blood sugar. If you miss the dose, take the next dose at the correct time.

Side effects of Metformin

There can be mild or serious side effects of metformin. If you experience any below mentioned are the mild side effects nevertheless, you need to immediately stop metformin and inform your doctor.

• Nausea
• Vomiting
• Stomach upset
• Diarrhea
• Weakness
• Metallic taste in the mouth

The serious side effects of metformin Lactic Acidosis and Hypoglycemia. These are rare but can be fatal for the person with diabetes, who is taking metformin.

Also Read: Foods to Avoid While Taking Metformin

Lactic Acidosis: A serious side effect of metformin

Lactic acidosis is a medical condition caused by the build-up of lactic acid in your body. It is a kind of metabolic acidosis that results due to an overproduction or underutilization of lactic acid. It mainly happens when there is no enough oxygen in your muscles to break down glucose and glycogen. The build-up of lactic acid causes an imbalance in the pH level of your body.

Patients who are at the risk of Lactic Acidosis:

Lactic Acidosis is more likely to occur in patients who have kidney or liver issues and serious infections. Those who have experienced recent congestive heart failure, heart attack, and stroke are also at the risk of developing lactic acidosis. Heavy alcohol use, a severe loss of body fluids (dehydration), or X-ray or scanning procedures that require an injectable iodinated contrast drug also increases the chances of Lactic Acidosis.

Symptoms of lactic acidosis

The common symptoms of lactic acidosis are as follows:

• Breathing troubles
• Severe Drowsiness
• Slow or irregular heartbeat
• Unusual muscle pain
• Cold arms and legs
• Unexplained stomach and intestinal issues
• Feeling weak or tired

Prevention of Lactic Acidosis

If you notice any of the above-mentioned symptoms, stop taking metformin and call your doctor. There are certain metformin interactions that can result in lactic acidosis. Thus, you need to inform your doctor about all the other prescription medicines, vitamins, herbal and over-the-counter medicines that you are taking along with metformin.

Also Read: Can you Reverse Type 2 Diabetes?

Hypoglycemia: A common but serious side effect

Metformin usually does not cause low blood sugar levels. If you still experience low blood sugar levels, you need to talk to your doctor. It can be due to the interaction of metformin with some other prescribed medicine. The doctor will either change your other medicines for diabetes or lower their dose.

Symptoms of Hypoglycemia

Some of the visible symptoms of hypoglycemia are:

• Tingling of hands and feet
• Sudden sweating
• Faster heartbeat
• Blurred vision
• Dizziness
• Hunger

You are also supposed to monitor your blood glucose levels for few days when you start taking metformin. It will help you and your doctor to know if medicine is working effectively on your body or not.

Also Read: best sugar testing machine in india

Treatment of Hypoglycemia

When you don’t know if metformin can lower your blood sugar levels or not, it is good to carry some glucose tablets. It will immediately raise your blood glucose. You can also have sugar, candy, honey, or fruit juice on experiencing the symptoms of low blood sugar levels. It will help you to avoid the consequences of hypoglycemia. After that, you can immediately inform your doctor about the reaction. The doctor will change the dosage of metformin or prescribe you the alternate medicine.

Also read:- Hypoglycemia diet plan

Storage of metformin

It is best stored at a temperature between 68°F and 77°F. The temperature between 59°F and 86°F is also suitable for its storage. Keep this drug away from light and high temperatures. Also, keep it away from moist and damped areas. This can spoil the drug. You can also check the label of the pack of this drug to know the storage details.

Also read:- Diabetes treatment in homeopathy

FAQ’s:

References:

1. https://www.drugs.com/metformin.html#dosage
   
2. https://www.medicalnewstoday.com/articles/metformin-oral-tablet#take-as-directed
3. https://www.diabetes.co.uk/insulin/diabetes-and-metformin-FAQs.html