What is Medformin?
Metformin is the active ingredient that is mainly used to treat type 2 diabetes and also to treat polycystic ovarian syndrome. The drug inhibits the formation of new glucose in the liver and leads to improved glucose utilization in the periphery. Metformin is only available with a prescription and is not an over-the-counter medication.
The advantage of Metformin is that when used as a single diabetes medication, it causes almost no hypoglycemia and does not increase weight because it has a mild appetite suppressant effect.
Metformin is also used with other diabetes medications when the substance alone does not sufficiently lower blood sugar levels.
What Medformin is used for?
The drug is used to treat type 2 diabetes and polycystic ovarian syndrome.
Mechanism of action of Metformin
Metformin can only be used in patients with type 2 diabetes whose pancreas is still producing insulin. It slows the formation of new sugar in the liver, releases the blood sugar-lowering hormone GLP1 in the intestine, and improves glucose utilization. It also improves the action of insulin. This allows muscle cells in particular to absorb more glucose from the blood.
How long does Metformin work?
Metformin starts to work 2.5 hours after oral administration. It works for about 3 to 5 hours after a single dose.
Half-life of Metformin
The half-life of Metformin is approximately 17.6 hours. It will take approximately 4 days for Metformin to be completely eliminated from the body.
Metformin: Dosage
Metformin therapy alone or combined with other anti-diabetic drugs: The standard starting dose is 500 mg or 850 mg of Metformin twice or three times daily.
After about 10-15 days, the dose is usually adjusted depending on blood sugar levels. Slowly increasing the dose has a positive effect on the gastrointestinal tolerance of Metformin. The highest recommended dose per day is 3 g of Metformin Hydrochloride, which should be divided into 3 doses.
When switching from another oral antidiabetic drug to Metformin, the previous drug should first be discontinued and then Metformin should be started at a dose of 500 mg or 850 mg two or three times daily.
Metformin and insulin can be combined to achieve better blood sugar control. Metformin hydrochloride is given in the usual starting dose of 500 mg or 850 mg two to three times a day, and the insulin dose is changed according to blood glucose readings.
Elderly patients
Because older patients often have impaired renal function, the dose of Metformin should be adjusted according to renal function. Renal function in elderly patients should be measured regularly.
Renal dysfunction
The GFR should be assessed before starting therapy with Metformin-containing drugs and then at least once a year. In elderly patients and in patients at increased risk of further deterioration of renal function, renal function should be monitored more frequently, e.g., every 3-6 months.
The maximum daily dose is 3 g for a GFR of 60-89 ml/min, 2 g for a GFR of 45-59 ml/min, and 1 g Metformin hydrochloride for a GFR of 30-44 ml/min. Maximum daily doses are divided into 2-3 doses per day. Metformin is contraindicated in GFR less than 30 ml/min.
Children and young adults
When treating with Metformin alone and also for combination with insulin: The drug is used to treat children over 10 years old. The standard starting dose is 500 mg or 850 mg of Metformin once daily.
The maximum recommended daily dose is 2 g of Metformin Hydrochloride divided into 2 or 3 doses.
What is the minimum dose of Metformin you can take?
The usual recommended starting or minimum dose is 500 mg or 850 mg of Metformin hydrochloride.
However, the exact starting dose for each patient should be prescribed solely by a physician, as many factors can affect the effectiveness of the drug and its effects.
How many points does Metformin reduce blood sugar levels?
On average, most patients' HbA1c levels decrease by as much as 1.5% when taking this medication.
When to take Metformin?
As a rule, the drug is taken with a meal 2-3 times a day.
What are the benefits of taking Metformin at bedtime?
Taking Metformin before bedtime can improve diabetes control by reducing morning hyperglycemia.
Side effects
The most common unwanted effects at the beginning of treatment are:
- Nausea
- Vomiting
- Diarrhea
- Abdominal pain
- Loss of appetite
To avoid these symptoms, it is recommended to divide the daily dose of Metformin into several doses and gradually increase the dose, following the doctor's recommendations.
Does Metformin cause drowsiness?
Taking Metformin may cause vitamin B12 deficiency. This can cause fatigue and drowsiness. Lactic acidosis also sometimes occurs. Drowsiness and fatigue can be manifestations of it.
Can Metformin cause fatigue?
Sometimes patients who take Metformin can develop condition lactic acidosis.
This condition can cause symptoms such as dizziness, severe drowsiness, fatigue, and muscle pain.
Metformin: Hypoglycemia
Taking the active ingredient Metformina 850, it is possible to reduce elevated blood sugar levels quite reliably. At the same time, the drug rarely causes hypoglycemia, as it does not directly affect the amount of insulin in the body. However, a possible side effect is lactoacidosis, which can cause low blood sugar.
Hypoglycemia can occur in combination with other blood sugar-lowering drugs, such as sulfonylurea derivatives, glinides or insulin. Blood sugar levels should be checked more frequently, especially at the beginning of such combined treatment and at the end of it.
It is also recommended that the diet be closely monitored and that doses of medication not be exceeded.
Metformin: interactions
If you are taking other medications, note:
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Cimetidine (used for heartburn) allows Metformin to last longer. You may need to reduce your dose of Metformin.
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Oral and inhaled glucocorticoids (for inflammation, immune reactions, asthma, COPD) and beta-2 agonists (for asthma, COPD) may decrease the effect of Metformin; then the risk of hyperglycemia increases. At the beginning and after the end of treatment with these drugs, as well as when increasing the dose of the drug, blood sugar levels should be monitored more frequently and, if necessary, sugar-lowering therapy should be adjusted.
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Iodine-containing contrast agents are necessary for some radiological examinations. They can impair kidney function and thereby impair excretion of Metformin. This increases the risk of serious side effects (lactic acidosis).
Treatment with Metformin should be interrupted before administering the contrast agent and should not be resumed until 48 hours later. Treatment should be continued only if examination has confirmed no further deterioration of renal function. Otherwise, diabetes should be treated with insulin for a short time.
Contraindications of Metformin
In the following conditions Metformina 850mg should not be taken or should be stopped immediately, as otherwise there is a risk of blood acidification (lactoacidosis):
- Sensitivity to the components of the drug
- Altered metabolism, resulting in too much sugar in the blood (hyperglycemia)
- Surgery or period after surgical manipulations
- Circulatory disorders
- Serious lung diseases (asthma, chronic obstructive pulmonary disease)
- Heart insufficiency
- Dehydration
- Starvation, exhaustion
- Liver dysfunction
- Serious renal dysfunction
- Alcohol abuse
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