Metformin, is a medication commonly prescribed to manage Type 2 Diabetes.
When taken correctly, Metformin can effectively control your diabetes.
So, you will need to know... • How and when should you take your Metformin
• How long does it take for the medication to working?
• How long will you need to take your medication? • Are there any side effects?
Today, we will be answering the most frequent questions about your medication.
My name is Dr Hart-Pinto. At JHP medical we make weekly information videos. If you
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What is Metformin?
Metformin is a medication commonly prescribed for the management of type 2 diabetes.
Before we can understand how this medication works for you, we need to understand
what type 2 diabetes is. Type 2 diabetes is a condition of high blood sugars. Here,
your body doesn’t effectively respond to insulin, the natural hormone produced by
your body to reduce blood sugar levels. Common symptoms include increased thirst,
passing urine more frequently and feeling tired all the time. If left uncontrolled diabetes can
lead to significant problems with your heart, blood vessels, eyes, kidneys and nervous system.
Metformin lowers your blood sugars, firstly by reducing the amount of sugars released
into your blood stream, and increasing the effectiveness of the hormone hormone insulin.
Metformin is can be used in adults and children above the age of 10 years. It is available in both
liquid and oral forms, and may be prescribed under the any of the following commercial branded names:
• Glucophage • Bolamyn
• Diagemet • Glucient
• Metabet • Riomet
Is there anyone who should not take Metformin ?
It is best to speak with your doctor if you have any of the following conditions:
• You have had a previous allergic reaction. • Suffer from a heart condition such
as heart failure. • Have kidney disease
Increased caution is required in older patients.
Additionally, your doctor may ask you to temporarily stop
your metformin if: • You are currently
suffering from a severe infection • Plan to have a scan requiring a special dye
• Before a surgical procedure where you will be put to sleep.
Is Metformin safe in Pregnancy and Breastfeeding ?
Metformin is generally considered to be safe to use during pregnancy.
So much so that it is recommended for a form of temporary diabetes of pregnancy
some women develop called “gestational diabetes”.
In breastfeeding a small amount of Metformin is present in your breast milk.
This is not thought to be harmful to baby in such small amounts.
Is it safe to take Metformin with my current medications?
Metformin, can interact with several medication, and your doctor may need to make appropriate
adjustments to your existing medications to ensure they remain effective for you.
The medications to look out for are:
• Other diabetic medications • Steroids and Hormone treatments,
including the oral contraceptive pills o Contraceptive pills can affect your
blood sugars, so if you take this medication your doctor may need to adjust your existing
diabetic medications • Heart medications
and those used to control your blood pressure • Water tablets, those which make you pass urine,
and control how much fluid your body holds onto, such as furosemide.
What is the correct dose of Metformin ?
Metformin comes in a wide variety of strengths. A common starting dosage is 500mg taken once daily,
with your breakfast. Your healthcare professional with a just your dosing to help you reach a
healthy target for your blood sugars. This is usually guided by a blood test known as HbA1c. The
maximum licensed dose of metformin for diabetes is 2000mg per day, usually taken in divided doses.
Metformin is also available in both immediate release and slow release preparations.
How long does Metformin take to work?
It can take 1-2 weeks before your blood sugar control improves. Usually after approximately
3 months your doctor will repeat your blood tests,
to see how well Metformin is working for you, and consider the need for any dose adjustments.
How to take Metformin
It’s advisable to take your Metformin with a meal, with a large glass of water. Using this
method can help limit the side effects patients may experience when taking this medication.
The timing of your doses will obviously be dependant on your dosing regime,
and your prescribing doctor or pharmacist can advise you on your individual circumstances.
Are there any foods I should avoid?
As part of your ongoing diabetes care, you should limit your intake of sugary foods.
Particularly, cakes, biscuits, fizzy drinks and fruit juices.
Doing this will ensure that you get closer to your diabetic target,
and reduces your risk of long term complications associated with poor diabetic control.
Can I Drink Alcohol with this medication?
It is safe to take Alcohol with Metformin. However, in excess alcohol in combination
with metformin can lead to your blood sugars becoming too low. Therefore,
please drink sensibly when taking this medication.
I have missed my dose. What should I do?
If you forget to take your metformin, don’t worry,
take it as soon as you remember. However, if it is almost time for your next dose
skip the missed dose. Remember to take your next dose at the regular time.
Do not take a double dose to make up for a missed one.
I have accidentally taken too much medication.
If you have taken too much of this medication you should speak with an emergency doctor.
If you take too much this can cause a build up of acid,
lactic acid, in your blood which in severe cases may be life threatening.
Overdose of Metformin can cause symptoms of: • Stomach pains, decreased appetite and diarrhoea
• Feeling very cold • Tiredness, sleepiness or weakness
• Change in your breathing pattern • Muscle cramping
How long will I need to take my medication?
It is likely that you will remain on metformin for the long term, with most patients with type
2 diabetes requiring medications for life. Stopping metformin without an alternative
medication in place, is likely to result in a poorer control of your blood sugars
and put you at increased risk of long term diabetic issues.
Are there any side effects?
Unfortunately, side effects when commencing Metformin are common. Some individuals
will in the first few weeks experience: Nausea, vomiting, stomach ache, and diarrhoea
Reduced appetite Unusually metallic taste in the mouth.
For the vast majority these side effects will settle after 1 week.
One technique to limit these side effects is to ensure thatr you take your medication
alongside a meal. If these symptoms persist, or are particularly troublesome, your doctor
can switch you to a slow release version of metformin which is usually better tolerated.
Less common, but concerning side effects can occur. If they do,
please seek immediate medical assessment. Allergic reactions such as
Development of a skin rash or itching Swelling of face lips and mouth
Difficulty breathing Development of lactic acidosis:
Sensation of feeling generally unwell assiciated with severe tiredness, sleepiness,
altered breathing to slow heartbeat, Yellowing of your eyes or skin,
suggesting inflammation of your liver damage Symptoms of low B12
Metformin can limit the amount of B12 your body absorbs
Symptoms include: Tiredness,
lethargy, pins and needles Muscle weakness
Soreness to your mouth and tongue, development of mouth ulcers
Does Metformin cause Hypos?
Hypos, short for hypoglycaemia, are low blood sugars, these can be a risk to your
life if they occur. Fortunately, metformin on its own does not ordinarily cause hypos.
However, many inidividuals will be taking other diabetic medications such as insulin injections,
or gliclazide, which can cause low blood sugars.
Therefore, all patients should to educate themselves on the early
warning signs of low blood sugars which include:
Poor concentration, confusion and sweating
Shaking or trembling Feeling hungry
If you experience these symptoms eat a fast acting carbohydrate,
to bump your blood sugar, such as a fruit juice.
To maintain your blood sugars for longer consume something more starchy, like a sandwich.
I hope this video has supplied the answers you were looking for.
Of course, this video does not provide individual
medical advice and is intended for informational purposes only.
Do not consider this as a substitute for professional medical advice,
diagnosis, or treatment. Please do not ignore professional
medical advice in seeking treatment because of something you have heard here.
If you believe you may have a medical emergency, immediately call your doctor or ambulance service.