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Metformin

Brand names of metformin

  • Alti-Metformin
  • Apo-Metformin
  • Dom-Metformin
  • Gen-Metformin
  • Glucophage
  • Glycon
  • Novo-Metformin
  • Nu-Metformin
  • PMS-Metformin
  • Rhoxal-Metformin
  • Riva-Metformin

Metformin, an oral medication, is used for reducing the blood sugar level of type 2 diabetes patients. Pancreas produces a hormone called insulin which controls the blood sugar level. Insulin reduces the glucose made by the liver by increasing the glucose removal from blood by fat tissues. This leads to lower blood glucose levels. Diabetes caused as a result of lack of insulin leads to increased glucose production. The medication works by escalating the liver sensitivity, fat and other muscle tissues to the uptake. As a result of these actions, the blood sugar level is controlled.

Metformin is different from sulfonylurea class of drugs. These drugs also lower the glucose levels by increasing the insulin concentration in the blood and could lead to hypoglycemia (low blood glucose levels). Among the common examples of sulfonylurea class drugs are glipizide or glyburide. As per some studies it has been proved that metformin reduces the different complications of diabetes like blindness, kidney disease and heart disease. FDA approved metformin in December 1994.

Things you need to tell your physician before taking metformin

Prior to starting this medication, a patient must consult his doctor whether he is allergic to the medicine. Metformin has some constituents which may result in allergic reactions. The doctor must be informed prior if the patient has any of the following diseases: lung disease, kidney disease, blood problems like deficiency of vitamin B12, anemia, breathing problems like severe asthma, metabolic acidosis like diabetic ketoacidosis. The doctor should review the medical history of the patient and check whether the patient has any history of the diseases mentioned above.

Patients must tell their doctor about the metformin medication before undergoing any X-ray/scanning procedure or surgery using iodinated contrast material. Metformin medication should be stopped temporarily before undergoing any X-ray/scanning procedure or surgery. The doctor or the dentist must be informed prior about the drugs in use including the herbal products, prescription drugs and nonprescription drugs. Due to high or low level of blood sugar, vision may get blurred and the patient may feel dizziness and drowsiness. Patients are advised to avoid any task which needs alertness such as driving a vehicle or working on a machine. High fever, diarrhea, sweating or too much vomiting may lead to loss of body water and could lead to lactic acidosis. In such a scenario, metformin medication must be stopped immediately and doctor must be informed in case of a prolonged vomiting or diarrhea. A patient must take enough fluids so as to avoid dehydration or loss of water. In case if the body is too much stressed (because of infection, injury, fever etc.) it may get difficult to control the blood sugar. The doctor must be informed immediately as the higher stress level demands change in medication and treatment plan. Older people are susceptible to side effects like lactic acidosis or low blood sugar. During pregnancy, metformin should be taken only if it is required. Doctor must be consulted as he may prescribe insulin instead of metformin during the pregnancy period. Instructions given by doctor must be strictly followed. Metformin can lead to menstrual cycle changes thus increasing the chances of becoming pregnant. To avoid pregnancy proper birth control steps must be taken as per the consultation of a doctor. Doctor should be consulted before breast feeding as metformin also passes into breast milk.

Usage

Metformin is used for reducing the blood sugar level in patients suffering from noninsulin-dependent diabetes (type 2). In this case, it is impossible to control the sugar level by controlling diet or by exercise. Metformin can be used along with the use of insulin or sulfonylurea medicaments.

How to use metformin

Metformin comes in both tablet and liquid form. Extended release i.e. a long acting tablet is also available which is to be taken by mouth. The liquid form of the medicine is consumed along with the meals once or twice a day. The extended-release tablets are taken after finishing the evening meals while the regular tablets are taken after finishing the meals, generally two to three times a day. It is advisable to take the medicine at the same time each day such that it becomes a habit. The pharmaceutical company prints all the necessary information on the labels, patients should read the information on the label and may even ask the doctor for further explanation in case of any confusion. The consumption of this medicine should be as per the prescription of a doctor. Over dosage or under dosage may prove to be critical for the patients.

The extended-release tablets of metformin must be swallowed completely; these should not be crushed or chewed.

The doctors start the use of metformin with a low dose and may increase the dosage slowly. Blood sugar level must be monitored carefully so that the doctor can comment on the working of metformin.

Metformin does not cure diabetes rather it controls diabetes. In case a patient feels improvement, he should not stop the dose and must continue till the doctor asks him to stop.

How metformin works

Glucose production in the liver is reduced as a result of metformin, thus slows down the breakdown of fatty acids necessary for production of glucose. The glucose present in the liver, muscle cells and other tissues of the body gets removed as a result of metformin.

Side effects

Serious:
In rare cases, metformin can lead to lactic acidosis, an unusual and potentially life-threatening build-up of lactic acid in the blood. Symptoms include:
  • abdominal distress
  • muscle pain
  • rapid, shallow breathing
  • unusual sleepiness
  • unusual weakness
Metformin also sporadically causes abnormally low blood glucose levels (hypoglycemia) and symptoms can include:
Common:
  • abdominal bloating
  • diarrhea
  • diminished appetite
  • gas
  • nausea
  • vomiting
Less common:
  • metallic, unpleasant taste in mouth

Possible interactions

Herbal medicines or minerals:
Due to the use of chromium, the body may undergo a change in the manner it uses sugar. It has been found that some health foods have adequate vanadium content which plays the role of insulin. But it is found to be toxic and requires more analysis before prescribing vanadium. DHEA is found to change the insulin resistance. Ginseng, ginger, garlic, nettle, licorice, yohimbe and hawthorn are found to change the blood sugar. As a result it may require alteration in hypoglycemic medicine dosage. Doctor should be immediately consulted before taking any of these herbal medicines. Diabetic patients should avoid taking blonde psyllium seed or husk and Echinacea purpurea. Similar to metformin, St. John's wort may also lead to sensitivity towards sun rays. Thus this combination must be avoided by any means.
Alcohol:
Alcohol drinking can prove to worsen the effects of metformin on lactate. You should avoid excessive amounts of alcohol.
Marijuana smoking:
Marijuana smoking is very harmful and may lead to increased dizziness.
Exposure to sun:
Medicines with similar composition to metformin have been found to increase the sensitivity towards sun.
Occurrence of unrelated illness:
Due to some other diseases, consumption of insulin may be required to attain the required blood sugar level.
Heavy exercise or exertion:
Heavy exercise is found to consume the body sugar faster. Use of metformin will cause lowering of the blood sugar. Symptoms of low blood sugar must be watched carefully.

Storage instructions

The drug should be placed safely away from the children in a tight container at room temperature. The storage place should be maintained at room temperature. Places such as bathroom must be avoided for storage. Outdate medication should not be used and must be disposed right away. Disposal methods should be followed as per the guidance of pharmacist.

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