Metformin

Metformin is a medicine used to treat type 2 diabetes and has been licensed by the EMA since the 1960s. It is also known under several brand names including Glucophage and can be found in combination treatments like Janumet.

It is intended for diabetics who cannot control their blood sugar levels with diet and exercise alone. You can also be prescribed Metformin for PCOS, or for gestational diabetes in pregnant women or women who have just given birth.

Metformin is available in two forms:

• Modified-release (MR) - releases the medicine gradually which reduces digestive side effects
• Immediate-release (IR) - works quickly and requires multiple doses per day

At euroClinix, only immediate-release Metformin is available.

Type 2 diabetes can be worsened by an unhealthy lifestyle. So, it’s also important that you make lifestyle changes to improve your blood sugar levels while taking Metformin.

Metformin is the most common first-line type 2 diabetes treatment. It works by targeting the liver, gut, and insulin receptors to control blood sugar levels.

How Metformin works in the body

A simple explanation of how this medication helps manage blood sugar

Liver

In the liver, it reduces glucose production, preventing excess sugar from entering the blood

Gut

In the gut, it increases glucose absorption in the small intestine, alters gut bacteria, and increases the production of hormones responsible for regulating blood sugar.

Insulin receptors

It improves insulin sensitivity by binding to receptors, helping your body absorb sugar efficiently and lowering blood sugar levels.

This explanation focuses on how Metformin works. Speak with your healthcare provider about whether this medication is right for you.

Metformin has unique benefits when it comes to diabetes management.

Benefits of Metformin

Effective blood sugar control

Studies show it’s effective at controlling blood sugar levels within 1 week, with significant improvements within 3 months*.

Lowers the risk of diabetes

It can help reduce the risk of developing type 2 diabetes in those with prediabetes.

Protects against health risks

Can lower the risk of strokes, cancer as well as cognitive decline and dementia by improving circulation and insulin sensitivity.

Fast-acting

immediate-release Metformin works quickly after neals to regulate blood sugar.

Weight management

Some research has shown Metformin may aid weight loss.

*Based on a 6-month treatment duration.

Metformin therefore has long-term health benefits beyond blood sugar control.

Metformin has been proven to effectively treat high blood sugar levels.

Studies have also shown that Metformin significantly reduces the risk of developing type 2 diabetes.

One particular study was conducted on Metformin and its ability to prevent type 2 diabetes. Patients on Metformin saw a 58% reduction in the risk of developing type 2 diabetes. This was compared to a 31% reduced risk in those who took the placebo.

In addition, results from the United Kingdom Prospective Diabetes Study (UKPDS) showed that Metformin significantly reduces the risk of diabetes-related deaths by 42%.

Metformin is suitable for most people. However, you should always ask your doctor if you have another medical condition or take any other medication.

Who can use Metformin?

Metformin is suitable for people diagnosed with type 2 diabetes. It can also be prescribed to those who are at risk of developing type 2 diabetes to prevent or delay the condition.

You may also be prescribed this medicine for:

• Gestational diabetes - a type of diabetes that develops during pregnancy.
• Polycystic ovary syndrome (PCOS) - to help improve fertility, insulin resistance, and irregular menstrual cycles.
• Type 1 diabetes - when taken with insulin, it can be prescribed as a diabetes treatment to those with a BMI of 25 or more (or 23 or more for South Asian individuals). However, this is prescribed off-label, meaning it is not officially licensed to treat type 1 diabetes, but can still be prescribed if necessary.

Who cannot use it?

You cannot use Metformin if you:

• are allergic to Metformin or any of the listed ingredients
• currently have diabetic ketoacidosis (a complication of diabetes)
• currently have lactic acidosis (a complication of diabetes)
• have kidney or liver problems

Cautions

You should also ask your doctor if you have any of the following conditions, as you may be at a greater risk of side effects:

• you are at a risk of lactic acidosis
• you have chronic stable heart failure
• you are over 65

You should also tell your doctor if you need to have an examination like an X-ray or scan or a major surgery while on Metformin.

Your doctor may also prescribe Metformin temporarily to prevent kidney damage.

What dose do I take?

Metformin is available in two different forms: immediate-release tablets and modified-release tablets. Each are available in different doses.

Your dosage will depend on the form of Metformin you take.

These are the average recommended dosages, however, individual dosage schedules can vary based on personal health factors.

How do I take it?

You should take each dose with a meal. This will help to limit any side effects.

You should swallow each tablet whole with a glass of water. Do not chew, split or crush tablets.

What should I do if I miss a dose?

If you miss a dose, skip the missed dose and take your next dose at the regularly scheduled time. Do not take a double dose to make up for the missed dose.

How long do I take it for?

You will typically have to take Metformin for the rest of your life if you are taking it for type 2 diabetes.

Stopping it without being advised to by your doctor could make your blood sugar levels go up and your diabetes could get worse.

Metformin usually starts lowering blood sugar within a week, but full effects can take about 12 weeks.

However, how quickly it works will differ from person to person. Factors such as age, diet and the severity of insulin resistance can affect the efficacy of Metformin.

A clinical trial with a total 750 participants found that blood sugar levels decreased on Metformin within the first week of treatment.

The researchers also measured A1C levels of the participants, which is the measure for average blood sugar over the previous 90 days. They found that A1C levels were significantly reduced after 12 weeks.

If your doctor does not notice any improvements in your blood sugar levels, they may need to recommend alternative treatment options.

Signs Metformin is working:

• You’re not so hungry all the time
• You have more energy
• Your clothes feel looser
• Blood sugar levels improve

Type 2 diabetes and prediabetes are linked to and can be worsened by an unhealthy lifestyle. While Metformin may improve or prevent diabetes, making lifestyle changes will help to reduce blood sugar levels alongside treatment.

Small, consistent lifestyle changes—like eating balanced meals, staying active, and losing weight —can help your diabetes go into remission.

Dr. Caroline Fontana Lead Prescribing Doctor

Managing type 2 diabetes

Simple steps for better health

Healthy diet

Choose wholegrains, vegetables, and lean proteins. Avoid foods high in sugar, fat, sodium, and foods and drinks containing karela (bitter gourd).

Regular exercise

Aim for 30 minutes of activity 5 days a week. Even walking can benefit your cardiovascular health greatly. Up the intensity when you feel comfortable.

Weight loss

Losing just 5-10% of body weight can significantly improve blood sugar levels. Focus on sustainable changes rather than strict diets for long-term success.

Managing stress

Practice deep breathing for 5 minutes a day to lower stress and manage blood sugar. Schedule time for activities you enjoy as well.

Better sleep

Aim for 7-9 hours of sleep every night to help regulate blood sugar. Create a bedtime routine with dim lights and no screens to help you stick to this.

Quitting smoking

Quitting smoking makes diabetes medications work better. Ask your doctor about nicotine replacement options or consider medications that help you quit smoking.

Talk with your healthcare provider about which changes are right for you.

Common side effects

Another common side effect to look out for is vitamin B12 deficiency. This is because Metformin affects vitamin B12 absorption in the small intestine. Symptoms may include:

• rapid breathing or shortness of breath
• headaches
• indigestion
• loss of appetite
• heart palpitations
• vision problems
• feeling weak or tired
• diarrhoea
• strawberry tongue (a sore or red tongue)
• mouth ulcers
• problems with memory, understanding and judgement

Your doctor will monitor your vitamin B12 levels regularly, especially if you are on higher doses of Metformin or are on it for a long time.

Rare side effects

Rare side effects occur in less than 1-10 in every 1,000 people. Rare side effects include:

• lactic acidosis (a condition caused by a buildup of lactic acid in your blood, you’re usually more at risk if you have liver or kidney problems)
• hepatitis (inflammation of the liver)
• skin reactions
• liver problems
• hypoglycemia (dangerously low blood sugar levels)

Most side effects usually go away within a few days to a few weeks. If they do not subside, talk to your doctor.

To view a full list of side effects, check out the patient information leaflet.

Digestive side effects like diarrhoea, nausea and vomiting are the most common side effects of Metformin. They can be managed with some simple lifestyle changes.

Digestive side effects from diabetes treatment can often be managed by adjusting meal timing, fibre intake, and hydration—small changes that support both gut health as listed in the tips below.

Silvia Fonda Nutritionist

Tips for managing side effects on Metformin

	Eat smaller portions and eat more slowly to help with nausea.
	Eat soft and easily digestible foods to help with diarrhoea, like bananas and plain rice.
	Stay hydrated.
	Choose low-fibre foods like white bread, white pasta, rice and plain biscuits for diarrhoea.
	Eat foods that contain water like soup, cucumber or melon to stay hydrated.
	Go outdoors and get some fresh air to help with nausea.

Metformin may interact with other medicines you take. You should talk to your doctor if you take any other medications before using Metformin.

Metformin can increase your risk of hypoglycaemia (low blood sugar levels) when taken with the following diabetes and weight loss medicines:

• insulin
• sulphonylureas (e.g. gliclazide)
• gliflozins (e.g. dapagliflozin)
• gliptins (e.g. sitagliptin)
• acarbose
• repaglinide
• pioglitazone
• GLP-1 receptor agonists (e.g. semaglutide, liraglutide, and tirzepatide)

Your doctor may require you to have additional monitoring and you should make sure to check your blood sugar levels often to avoid hypoglycaemia.

Some medicines may increase the exposure to or concentration of Metformin. This includes:

• HIV medicines
• diuretics and ACE inhibitors (blood pressure medications)
• NSAIDs (anti-inflammatory drugs)
• corticosteroids
• certain cancer drugs
• cimetidine (for stomach ulcers)
• guanfacine (for ADHD)
• isavuconazole (an antifungal)
• mexiletine (used for heart rhythm problems)
• pitolisant (used for narcolepsy)
• ranolazine (used to treat angina)
• trimethoprim (an antibiotic often used to treat urinary tract infections)

For a full list of interactions, please refer to the list on the BNF.

Follow these instructions during treatment to ensure safety and efficacy.

Safety Tips

Pregnancy Consult your doctor

Consult your doctor before use, as they may need to monitor your blood glucose levels during treatment.

Breastfeeding Safe

Women can take Metformin for pre-existing diabetes whilst breastfeeding.

Alcohol Caution

Avoid drinking excessive amounts of alcohol as this can increase the risk of lactic acidosis, a serious side effect of Metformin. Alcohol is high in calories and sugar, which can affect your blood sugar management.

Driving Caution

Metformin on its own shouldn’t affect your ability to drive. However, if you take it with other diabetes medicines, you may be more at risk of hypoglycaemia, which could affect your ability to drive.

Storage

Metformin has no specific storage instructions. However, you should keep it out of sight and reach of children and away from sunlight and moisture.

You should also not use it past the expiry date. You can see the expiry date on the medicine carton after EXP. The date refers to the last day of the month.

Disposal

You should take any unused or expired Metformin to a pharmacy to dispose of it. Do not dispose of it in the general waste or by flushing it down the toilet. This harms the environment.

No, Metformin is a prescription-only medication. You need a valid prescription from a healthcare professional to purchase it. This ensures the medication is safe and suitable for your needs.

You can receive an online prescription from euroClinix.

Ordering Metformin online from euroClinix is convenient.

Follow these simple steps:

1. Complete a quick online consultation to check your eligibility.
2. UK-registered doctors review your responses to ensure the medication is right for you.
3. Upon approval, an e-prescription will be issued.
4. Enjoy free delivery from our licensed pharmacy with tracking details.

Your privacy is our top priority. euroClinix uses secure, encrypted transactions and complies with UK’s medical standards to keep your information confidential.

Start your online consultation today to enjoy professional care from the comfort of your home.

euroClinix is trusted by thousands of users in the UK for its safe and convenient service. Here’s why:

• Experienced doctors manage your consultations and prescriptions.
• Online consultations, quick approvals, and discreet doorstep delivery add to the convenience.
• A supportive team is on hand to answer treatment-related questions or concerns.
• Patients can manage their prescriptions hassle-free through our secure platform.

Join thousands who trust euroClinix for their healthcare needs and take control of your health today.

The price of Metformin at euroClinix includes everything you need:

• Free online consultation with our experienced doctors
• Free prescription, if approved
• Free delivery straight to your door

Our pricing is transparent, with no hidden fees. Order today and benefit from our complete, all-inclusive service.