Metformin (N, N-dimethylbiguanide) belongs to the biguanide class of antidiabetic drugs (containing two linked guanidine rings). This drug has a major clinical advantage that it does not induce hypoglycemia or weight gain with remarkable cardiovascular safety. Metformin is also used for the treatment of polycystic ovary disease, diabetic nephropathy, and gestational diabetes. Metformin acts via both AMP-activated protein kinase (AMPK)-dependent and AMPK-independent mechanisms; by inhibiting mitochondrial respiration and inhibiting mitochondrial glycerophosphate dehydrogenase, and a mechanism involving the lysosome. Metformin acts directly or indirectly on the liver in order to reduce glucose production, and acts on the gut to increase glucose utilization. At the molecular level, metformin acts to inhibit the mitochondrial respiratory chain in the liver, which results in activation of AMPK, enhances insulin sensitivity (via effects on fat metabolism) and lowers cAMP, and reduces the expression of gluconeogenic enzymes. Metformin shows AMPK-independent effects on the liver that results in inhibition of fructose-1,6-bisphosphatase by AMP.
Diabetes Type 2
Dose must be taken according to the doctor’s advice only; doses given below are suggested as supportive literature for better understanding in some areas of requirements. Adults dose: At first, take 500mg twice a day with the morning and evening meals, or 850mg once daily with the morning meal. The doctor may adjust the dose if needed until the patient's blood sugar is controlled. Doctors may recommend 500 or 850mg two to three times a day with meals according to the patient's condition. Child dose: Children of age 10 to 16 years: At first, 500mg twice daily taken with the morning and evening meals. Doctors may adjust dose according to the patient's condition.
Metformin overdose can cause hypotension. Consult your doctor in case of overdose.
In case you missed any dose, take the next dose as soon as you remember, but don't double your next dose to compensate for the missed one.
How To Use
All patients are advised to continue their recommended diet with an adequate distribution of carbohydrate intake during the day.
When Not Use
Metformin should not be used in case of hypersensitivity to the drug, metabolic acidosis, chronic heart, failure, myocardial infarction, diabetic ketoacidosis, severe renal disease, abnormal creatinine clearance resulting from shock, septicemia and lactation.
Assess renal function prior to initiation of this drug. If metformin-associated lactic acidosis is suspected, general supportive measures should be taken in a hospital setting, along with immediate discontinuation of this medicine.
Nausea Vomiting Stomach ache Loss of appetite Constipation Weight loss Hypoglycemia
If you are diabetic, go for the following tests: Glucose Tolerance Test, Blood sugar test, Blood Glucose Fasting Test