Metformin

Metformin is used to treat patients with type 2 diabetes mellitus (also called 'non-insulin dependent diabetes') where diet and exercise alone have not been enough to control blood glucose levels.

Taking Metformin over a long period of time also helps to lower the risk of complications associated with diabetes. It is also most often prescribed to diabetic patients who are overweight.

If you have diabetes, your pancreas does not make enough insulin or your body is not able to use the insulin it produces effectively. This leads to a high level of glucose in your blood, which Metformin helps to lower to as normal a level as possible.

Metformin is a very commonly prescribed medication for diabetes treatment. It is also marketed under brand names such as Glucophage®, Glucophage® SR, Metsol®, Bolamyn® SR, Fortamet®, Riomet®, Glumetza® to name a few.

Metformin contains the active ingredient Metformin Hydrochloride, which helps control blood sugar levels and responds to insulin produced by the body. It can be used on its own or combined with other similar antidiabetic medication or insulin.

Our cells need glucose to function. In our bodies, a hormone called insulin helps our cells take glucose out of the bloodstream and use it as fuel. In type 2 diabetes, the body either doesn’t produce enough insulin to function properly, or no longer reacts to insulin in the way it should. This means that glucose stays in the blood and cannot be used as energy.

Metformin helps control high blood sugar levels by decreasing the amount of sugar the body makes and absorbs, while also making your cells more responsive to insulin.

This treatment helps control blood sugar by:

• lowering glucose production in the liver
• decreasing glucose absorption from food we eat
• increasing the body’s sensitivity to insulin, meaning less glucose is in the bloodstream as the body is able to use it

You should only ever take Metformin as prescribed and follow the instructions on the patient leaflet closely. It is recommended you take each prescribed tablet during or after meals and swallow it without chewing. Regular blood tests should be conducted by your doctor to ensure blood sugar levels are maintained.

Metformin is taken two or three times per day as a 500mg or 850mg tablet. The maximum dose is 3,000mg a day, split into three individual doses. If you feel that your prescribed dosage is too strong or too weak, you can arrange an appointment with your doctor to adjust it after 10 to 15 days.

There is also a modified-release version available. These exist in the dosages of 500mg, 750mg and 100mg. The maximum dose for modified-release tablets is 2,000mg a day. Your doctor will prescribe this if the immediate release tablets are deemed unsuitable. From a user perspective, the main difference is that the dose should be taken once daily, usually with a meal in the evening.

Metformin is used to treat type 2 diabetes. It is also sometimes used as a preventative measure for people who are at risk of developing diabetes (pre-diabetes).

Metformin can also be used in combination with insulin to treat severe symptoms of diabetes type 2. It is not prescribed for the treatment of type 1 diabetes.

If you are allergic to any of the ingredients in the medication, you should not take it.

You should talk to your doctor before taking Metformin if you:

• have uncontrolled diabetes (hyperglycaemia or ketoacidosis)
• are experiencing extreme dehydration from diarrhoea or vomiting
• suffer from heart, kidney or liver problems
• have a severe infection
• drink a lot of alcohol
• are breastfeeding

Ask your doctor for advice if you need to have a major surgery, or require a CT scan or x-ray that uses an injected dye, as you will need to stop taking Metformin temporarily.

You should also monitor yourself for the possibility of lactic acidosis, a rare but potentially serious complication. Symptoms include vomiting, muscle cramps, difficulty breathing and severe tiredness. Read the patient information leaflet for more information on how to spot the signs, and seek immediate medical attention if you suspect you may have lactic acidosis.

Is Metformin safe to use during pregnancy?

Clinical studies have found no issues of concern relating to the use of Metformin during pregnancy. You should tell your doctor if you are pregnant, as you may also need insulin during pregnancy.

Can I drink alcohol while using Metformin?

If you have diabetes, excessive alcohol intake can lower your blood sugar, even for some time after you’ve stopped drinking. Drinking also makes it difficult for your body to get rid of lactic acid as quickly, which increases your risk of lactic acidosis. Beer, as well as some very sweet alcoholic drinks, may increase your blood sugar levels. You should ask your doctor if it is safe for you to drink while taking Metformin to avoid any adverse effects.

As with any medication, there may be some side effects when taking Metformin.

Common side effects:

• decreased appetite
• abdominal pain
• nausea
• vomiting
• diarrhoea (usually transient)
• altered taste
• gastrointestinal disorder

Note: Gastrointestinal issues are initially common, (but do pass for most patients) especially with the very high doses.

You should not use Metformin if you suffer from acute metabolic acidosis (including lactic acidosis and diabetic ketoacidosis).

If you experience any persistent or serious side effects, consult your doctor as soon as possible.

You can buy Metformin online from euroClinix after completing a simple consultation. One of our doctors will review your responses and issue a prescription if they determine it’s suitable for you. Then, our pharmacy will dispense your medication and deliver it to you with free next-day delivery.