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How To Take Metformin | Metformin Side Effects and How to Reduce Them!

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What is Metformin? What is Metformin used for? What are the most common Metformin side effects? What are the warnings/interactions?

Welcome back my name is lucy i am a pharmacist  and a nurse. in this video we will be going   over the medication metformin, it uses, dosages,  side effects and drug interactions. as always,   all information in this video is for informational  purposes only and it’s not intended to serve as   a substitute for professional medical

Advice,  diagnosis or treatment. always, seek the advice   is metformin, metformin is an anti-diabetic   agent that belongs to a group called biguanide.  metformin is usually the first line treatment   of type 2 diabetes mellitus when lifestyle changes  alone are not sufficient. metformin lowers blood   glucose level

Using three different mechanisms.  it reduces the amount of sugar that your liver   respond better to insulin and it also decreases   how much sugar is absorbed from your intestines.  it has multiple brand names, glucophage riomet   fortamet glumetza and it comes in tablet or liquid  foam. the tablets come either as immediate

Release   combination with other oral anti-diabetic agents,   combination products are not available in the   united states. metformin has an fda indication  for treatment of type 2 diabetes, but it also   has off-label use and for off-label use it can be  used for gestational diabetes, and when it’s used  

For gestational diabetes your healthcare provider  might need to increase your dose during your third   trimester due to increased clearance and some  patients might end up needing insulin. it also   can be used for prevention of type 2 diabetes and  for prevention is used for select patients with   pre-diabetes with a bmi of

Greater than 35, age  less than 60, and patients with prior gestational   diabetes. also, it can be used for polycystic  ovary syndrome (pcos) and it can also be used for   antipsychotic induced weight gain. uncontrolled  blood sugars are associated with long-term damage   to body tissue. it can lead to kidney damage, 

Blindness, heart diseases, and heart attack,   stroke, nerve problem, loss of limbs and sexual  function problems. metformin dosages range between   500 milligrams to 2550 milligram. and on this  table, the doses that are taken multiple times   a day are the immediate release tablet or the  liquid form, the ones that are taken

Once daily   are the extended-release tablet. to minimize side  effects the therapy is usually initiated with   500 milligrams once daily and titrated up in 500  milligram increments every couple days two weeks   based on patient tolerability. metformin should  be taken with food to help minimize the abdominal   side

Effects, and for the extended-release tablet  you should swallow it whole, do not crush, cut,   largest meal of the day which is typically   extended-release tablet, don’t be alarmed if   you see a ghost tablet or capsule in your stool.  the ghost tablet contains only the outer layer   don’t think that the medicine did not

Dissolve   or it did not work. if you are taking the solution  riomet, use the supplied dosing cup to measure the   medicine just to make sure that you’re getting the  right dose riomet is a good option for people with   swallowing difficulties but it is more expensive  compared to other formulations, which if you have  

Tablet can be crushed. metformin may cause various   common side effects are gastrointestinal   related side effects. these are nausea, bloating,  gas, diarrhea, constipation, and abdominal pain.   to help avoid the gastrointestinal symptoms your  healthcare provider might start the medicine at   metformin with meal will help

With the side   effects. and if that doesn’t help, switching it  to an extended release tablet might help with a   gastrointestinal side effect. the gi side effects  typically occur at the initiation of therapy,   but late onset of diarrhea has been reported.  the adverse reaction decreases after several   weeks of therapy

However some patients require  discontinuation. metformin also has some rare   side effects like metallic taste in the mouth,  headache, rash, lactic acidosis, anemia, and   hypoglycemia and also decreased appetite. there  are some risk factors that can increase the side   effects of metformin. these include liver disease, 

Kidney disease, heart diseases, previous allergic   reaction to metformin, concurrent use of certain  drugs that impair kidney function, dehydration,   excessive alcohol consumption, older age, so age  greater than 65 years old are at increased risk   of having metformin side effects. metformin can  cause two rare severe side

Effects this includes   lactic acidosis. this is where the ph or acid  level drops in your blood and can result in   hypothermia, hypotension, bradycardia, and death.  lactic acidosis has non-specific symptoms that   include stomach pain, nausea, vomiting, muscle  pain, trouble breathing, feeling very weak, tired,  

Uncontrolled or slow heart rate. risk factors  for lactic acidosis include heart disease,   heart attack, excessive alcohol consumption,   liver disease and kidney disease. also be aware if  you’re getting a medical procedure that requires   angiogram that you might need to stop the   metformin prior to the procedure and

Probably  48 hours after the procedure to help reduce the   risk of lactic acidosis. also, metformin can cause  vitamin b12 deficiency, and this happens because   metformin can affect vitamin b12 absorption this  can lead to irreversible issues like neuropathy,   anemia, signs and symptoms of depression. the risk  factors

For b12 deficiency are low calcium level,   which calcium and b12 depend on each other for  absorption. so, if your calcium is low, your b12   will be low due to less absorption. you can take  b12 from food sources like beef, chicken, fish,   fortified cereal milk and dairy products and if  these dietary resources are not enough

To provide   b12, b12 supplements are available as tablets  and they are over the counter, and also people   get intravascular or subcutaneous injection   to help with b12 deficiency. metformin can have  interaction between one or more co-administered   medications which can lead to reduced therapeutic  efficacy or

Enhanced toxicity. you can see on   this table things like contrast media, iodine can  increase risk of toxic accumulation of metformin   which can lead to lactic acidosis, also medication  like the topiramate that is used for epilepsy or   which is used for glaucoma can increase the   side effect of metformin. and also,

Excessive  alcohol use or non-steroidal anti-inflammatory   in the middle this medication increases the   like seligeline which is used for parkinson,   zofran which is used for nausea and vomiting,  ace inhibitors that are used for blood pressure,   prozac or lexapro all those can increase the   serum concentration

Of metformin. the medicine  that can decrease the therapeutic effect of   metformin are medicine like verapamil and thiazide  diuretic, and also patiromer so if you’re taking   patiromer and metformin at the same time make  sure to administer metformin three hours before   or three hours after patiromer to help reduce 

The risk of under absorption of metformin.   thank you for watching, please like the video and  subscribe to the channel if you like to see this   type of content and also hit the notification bell  so that you can be notified of any future videos.

Transcribed from video
How To Take Metformin | Metformin Side Effects and How to Reduce Them! By Lucy The Pharmacist