1. What’s metformin
Metformin is a medication used to deal with kind 2 diabetes, and to assist stop kind 2 diabetes if you happen to’re at excessive threat of growing it. Metformin is used when treating polycystic ovary syndrome (PCOS), though it isn’t formally accepted for PCOS.
Kind 2 diabetes is an sickness the place the physique doesn’t make sufficient insulin, or the insulin that it makes doesn’t work correctly. This may trigger excessive blood sugar ranges (hyperglycaemia). PCOS is a situation that impacts how the ovaries work.
Metformin lowers your blood sugar ranges by bettering the way in which your physique handles insulin. It is often prescribed for diabetes when weight loss plan and train alone haven’t been sufficient to manage your blood sugar ranges.
For girls with PCOS, metformin lowers insulin and blood sugar ranges, and can even stimulate ovulation. Metformin is accessible on prescription as tablets and as a liquid that you simply drink.
2. Key info
- Metformin works by lowering the quantity of sugar your liver releases into your blood. It additionally makes your physique reply higher to insulin. Insulin is the hormone that controls the extent of sugar in your blood.
- It is best to take metformin with a meal to scale back the unwanted side effects.
- The most typical unwanted side effects are feeling and being sick, diarrhoea, abdomen ache and going off your meals.
- Metformin doesn’t trigger weight acquire, not like another diabetes medicines.
- Metformin might also be known as by the model names Bolamyn, Diagemet, Glucient, Glucophage and Metabet. Liquid metformin is known as by the model title Riomet.
3. Who can and can’t take metformin
Metformin is prescribed for adults, and kids aged 10 years and older.
Metformin will not be appropriate for some individuals. Inform your physician earlier than beginning the medication if you happen to:
- have had an allergic response to metformin or different medicines prior to now
- have uncontrolled diabetes
- have liver or kidney issues
- have a extreme an infection
- are being handled for coronary heart failure or have just lately had a coronary heart assault
- have extreme issues along with your circulation or respiration difficulties
- drink a number of alcohol
Chances are you’ll have to cease taking metformin earlier than having surgical procedure and sure medical exams. Inform your physician if you could have:
- a take a look at corresponding to an X-ray or scan involving the injection of a dye that incorporates iodine into your blood
- surgical procedure the place you may be put to sleep
4. How and when to take it
It is best to take metformin tablets with a meal to scale back the unwanted side effects. Swallow your metformin tablets complete with a glass of water. Don’t chew them.
The utmost each day dose is 2,000mg a day (for instance, 4 x 500mg tablets). Metformin tablets come in numerous strengths. Your physician will let you know what number of tablets to take a day.
Several types of metformin
- Metformin comes as 2 various kinds of pill: standard-release tablets and slow-release tablets.
- Commonplace-release tablets launch metformin into your physique shortly. Chances are you’ll have to take them a number of instances a day relying in your dose.
- Gradual-release tablets dissolve slowly so that you shouldn’t have to take them as usually. One dose is often sufficient, and you may take it along with your night meal.
- Your physician or pharmacist will clarify what kind of metformin tablets you are on and learn how to take them.
- Metformin can also be obtainable as a liquid for kids and individuals who discover it troublesome to swallow tablets.
Will my dose go up or down?
Your physician will test your blood sugar ranges frequently and will change your dose of metformin if crucial. Once you first begin taking metformin standard-release tablets, you may be suggested to extend the dose slowly. This reduces the possibilities of getting unwanted side effects.
- one 500mg pill with or after breakfast for a minimum of 1 week, then
- one 500mg pill with or after breakfast and your night meal for a minimum of 1 week, then
- one 500mg pill with or after breakfast, lunch and your night meal
For those who discover you can not tolerate the unwanted side effects of standard-release metformin, your physician might recommend switching to slow-release tablets.
What if I neglect to take it?
For those who miss a dose of metformin, take the subsequent dose on the regular time. Don’t take a double dose to make up for a forgotten dose. For those who usually neglect doses, it could assist to set an alarm to remind you.
You may additionally ask your pharmacist for recommendation on different methods that will help you bear in mind to take your medication.
What if I take an excessive amount of?
An overdose of numerous metformin tablets may cause critical well being issues. The signs are extreme and fast to seem.
- abdomen ache
- quick or shallow respiration
- feeling chilly
- uncommon sleepiness
- tiredness or weak point
Pressing recommendation: Go to A&E now if:
- you’re taking too many metformin tablets
Take the metformin packet or leaflet inside it, plus any remaining medication, with you.
Discover your nearest A&E
5. Negative effects
Like all medicines, metformin may cause unwanted side effects, though not everybody will get them.
Widespread unwanted side effects
Widespread unwanted side effects occur in additional than 1 in 100 individuals. Speak to your physician or pharmacist if these unwanted side effects hassle you or don’t go away after 1 week:
- feeling sick (nausea)
- being sick (vomiting) or diarrhoea
- abdomen ache
- lack of urge for food
- a metallic style within the mouth
Critical unwanted side effects
Critical unwanted side effects are uncommon and occur in lower than 1 in 10,000 individuals. Name your physician right away if you happen to get warning indicators of:
- a normal feeling of discomfort with extreme tiredness, quick or shallow respiration, being chilly and a sluggish heartbeat
- yellow pores and skin or the whites of your eyes flip yellow – these will be indicators of liver issues
- excessive tiredness, lack of power, pins and needles, a sore and pink tongue, mouth ulcers, muscle weak point and disturbed imaginative and prescient – these might be indicators of vitamin B12 deficiency anaemia
- a pores and skin rash, redness or itching – this might be an indication of a pores and skin dysfunction
Low blood sugar
Metformin doesn’t often trigger low blood sugar (referred to as hypoglycaemia, or “hypos”) when taken by itself. However hypos can occur whenever you take metformin with different diabetes medicines, corresponding to insulin or gliclazide.
Early warning indicators of low blood sugar embrace:
- feeling hungry
- trembling or shaking
- problem concentrating
It is also potential in your blood sugar to go too low when you’re asleep. If this occurs, it could actually make you are feeling sweaty, drained and confused whenever you get up.
Low blood sugar might occur if you happen to:
- take an excessive amount of of some kinds of diabetes medicines
- eat meals irregularly or skip meals
- are fasting
- don’t eat a nutritious diet and aren’t getting sufficient vitamins
- change what you eat
- improve your bodily exercise with out consuming extra to compensate
- drink alcohol, particularly after skipping a meal
- take another medicines or natural medicines on the identical time
- have a hormone dysfunction, corresponding to hypothyroidism
- have kidney or liver issues
To stop hypoglycaemia, it is vital to have common meals, together with breakfast. By no means miss or delay a meal.
For those who’re planning to train greater than regular, ensure you eat carbohydrates like bread, pasta or cereals earlier than, throughout or after train.
At all times carry a fast-acting carbohydrate with you, like sugar cubes, fruit juice or some sweets, in case your blood sugar degree will get low. Synthetic sweeteners won’t assist.
You might also have to eat a starchy carbohydrate, like a sandwich or a biscuit, to take care of your blood sugar for longer.
If taking in sugar doesn’t assist or the hypo signs come again, contact your physician or the closest hospital.
Be sure that your family and friends know What’s your diabetes and the signs of low blood sugar ranges to allow them to recognise a hypo if it occurs.
Critical allergic response
It is potential to have a critical allergic response (anaphylaxis) to metformin.
Speedy motion required:
- you get a pores and skin rash that will embrace itchy, pink, swollen, blistered or peeling pores and skin
- you are wheezing
- you get tightness within the chest or throat
- you might have hassle respiration or speaking
- your mouth, face, lips, tongue or throat begin swelling
You may be having a critical allergic response and might have speedy remedy in hospital. These aren’t all of the unwanted side effects of metformin.
6. How to deal with unwanted side effects
What to do What’s:
- feeling sick – take metformin with meals to scale back the possibilities of feeling sick. It might additionally assist to slowly improve your dose over a number of weeks. Ask a pharmacist or your physician for recommendation.
- being sick (vomiting) or diarrhoea – drink plenty of fluids, corresponding to water or squash, to keep away from dehydration. Take small, frequent sips if you happen to’re being sick. Communicate to a pharmacist when you’ve got indicators of dehydration, corresponding to peeing lower than regular or having darkish, strong-smelling pee. Don’t take another medicines to deal with diarrhoea or vomiting with out chatting with a pharmacist or physician.
- abdomen ache – attempt to relaxation and chill out. It will probably assist to eat and drink slowly and have smaller and extra frequent meals. Placing a warmth pad or coated sizzling water bottle in your abdomen might also assist. For those who’re in a number of ache, communicate to your pharmacist or physician.
- lack of urge for food – eat whenever you’d often anticipate to be hungry. If it helps, eat smaller meals extra usually than regular.
- a metallic style within the mouth – if you happen to discover that metformin is supplying you with a metallic style within the mouth, attempt chewing sugar-free gum
7. Being pregnant and breastfeeding
Metformin is often protected to take throughout being pregnant, both alone or together with insulin. For extra info What’s how metformin can have an effect on you and your child throughout being pregnant.
Metformin and breastfeeding
You possibly can take metformin when you’re breastfeeding. Metformin passes into breast milk, however the quantity is simply too small to have an effect on your child.
Non-urgent recommendation: Inform your physician if you happen to’re:
- making an attempt to get pregnant
8. Cautions with different medicines
There are some medicines that intrude with the way in which metformin works. For those who’re taking any of the next medicines, your blood sugar ranges might should be checked extra usually and your dose adjusted:
- steroid tablets, corresponding to prednisolone
- tablets that make you pee extra (diuretics), corresponding to furosemide
- medicines to deal with coronary heart issues and hypertension
- female and male hormones, corresponding to testosterone, oestrogen and progesterone
- different diabetes medicines
Some ladies would possibly want a small adjustment of their metformin dose after beginning contraceptive capsules. That is as a result of contraceptive capsules change how your physique handles sugar.
Mixing metformin with natural cures and dietary supplements
There’s little or no info What’s taking natural cures and dietary supplements with metformin.
Inform your physician or pharmacist if you happen to’re taking another medicines, together with natural medicines, nutritional vitamins or dietary supplements.
9. Widespread questions
How does metformin work in diabetes?
Metformin reduces the quantity of sugar your liver releases into your blood. It additionally makes your physique reply higher to insulin. Insulin is the hormone that controls the extent of sugar in your blood.
How does metformin work in PCOS?
Metformin stimulates ovulation in ladies with PCOS and might encourage common intervals, even if you happen to shouldn't have diabetes. PCOS can't be cured, however the signs will be managed.
Metformin will not be licensed to deal with PCOS particularly, however it could actually generally be prescribed to enhance fertility. You might have to see a specialist physician for this.
It's going to usually be prescribed when different remedies, corresponding to clomifene, haven't labored. With remedy, most girls with PCOS are in a position to get pregnant.
When will I really feel higher?
Chances are you'll not have any signs of diabetes, so you'll not essentially really feel any totally different whenever you take metformin. This doesn't imply that metformin will not be working, and it is vital to maintain taking it.
Metformin will assist maintain your blood sugar degree steady and scale back your possibilities of diabetes-related issues sooner or later.
How lengthy will I take metformin for?
Therapy for diabetes is often for all times. Hold taking metformin tablets, except your physician tells you to cease.
Can I take metformin for a very long time?
Metformin is protected to take for a very long time. It won't make you placed on weight, and will even aid you lose some weight. It additionally helps maintain your ldl cholesterol at a wholesome degree. Your physician will test how effectively your kidneys work a minimum of annually. Chances are you'll want extra checks if you happen to're an older individual or your kidneys aren't working usually.
In case your kidneys aren't working correctly, your physician will let you know to cease taking metformin. Metformin may cause vitamin B12 deficiency if you happen to take it for a very long time. Your physician might also test the vitamin B12 degree in your blood. For those who grow to be poor, this may be handled by taking vitamin B12 dietary supplements.
Can I come off metformin?
Don't cease taking metformin with out speaking to your physician. For those who cease taking metformin immediately, chances are you'll scale back the management over your diabetes.
Therapy for diabetes is often for all times. But when your kidneys aren't working correctly, your physician will let you know to cease taking metformin.
Are there different diabetes medicines?
Metformin is often the primary selection of medication prescribed to deal with kind 2 diabetes. There are different teams of medicines that decrease blood sugar ranges:
-sulphonylureas, corresponding to gliclazide
-DPP-4 inhibitors, corresponding to saxagliptin
-SGLT2 inhibitors, corresponding to dapagliflozin
-GLP-1 agonists, corresponding to exenatide
All of those medicines will be prescribed on their very own or along with metformin.
Can I get diabetes medicines free of charge?
When you've got diabetes, you are entitled to free prescriptions for your entire medicines, not simply your diabetes ones. To assert your free prescriptions, you may have to have a medical exemption certificates.
The applying type for the medical exemption certificates is known as FP92A. You will get this out of your physician's surgical procedure. You'll need to fill within the type, then your physician will signal it and ship it off.
Will it have an effect on my contraception?
Metformin won't have an effect on the mixed capsule or emergency contraception. However some ladies would possibly want a small adjustment of their metformin dose after beginning contraceptive capsules. That is as a result of contraceptive capsules change how your physique handles sugar.
Will it have an effect on my fertility?
There is no clear proof to recommend that taking metformin will scale back fertility in both males or ladies. However communicate to a pharmacist or a health care provider if you happen to're making an attempt to get pregnant. They might need to evaluation your remedy.
Can I take metformin earlier than surgical procedure?
Your physician might let you know to cease taking metformin a couple of days earlier than having an operation or medical exams. Metformin might work together with the dye used for an X-ray or CT scan. A normal anaesthetic that places you to sleep can even conceal low blood sugar.
Can I drink alcohol with it?
Sure, you possibly can drink alcohol whereas taking metformin, however it's finest for women and men to drink not more than 2 items per day. Ingesting greater than this may improve the chance of low blood sugar. Attempt to maintain to the really helpful tips of not more than 14 items of alcohol per week. A regular glass of wine (175ml) is 2 items. A pint of lager or beer is often 2 to three items of alcohol.
Is there any meals or drink I have to keep away from?
It is a good suggestion to chop down on meals with added sugar. Examine the diet labels, as many meals and drinks are excessive in sugar, corresponding to:
-some fizzy drinks
Watch out consuming food and drinks containing karela. It's because it could actually decrease your blood sugar ranges and imply your diabetes will not be managed as effectively correctly. Karela (additionally known as bitter gourd) is used to flavour meals, corresponding to curries like bitter gourd masala. It has a bitter style and can also be made into juice and tea.
Can I drive or trip a motorbike?
In case your blood sugar ranges are steady, taking metformin shouldn't have an effect on your capacity to drive, cycle or use equipment and instruments.
Metformin itself won't make your blood sugar ranges too low, however your physician would possibly prescribe it alongside different medicines for diabetes that may have an effect on your blood sugar.
In case your blood sugar ranges grow to be too low, this may scale back your focus. If this occurs to you, don't drive, cycle or use machines or instruments till you are feeling higher.
Can life-style modifications assist diabetes and PCOS?
There are some life-style modifications you can also make to assist management the signs of diabetes and PCOS. These embrace:
-consuming a nutritious diet
-shedding any extra weight
reducing down on alcohol – attempt to maintain to the really helpful tips of not more than 14 items of alcohol per week. A regular glass of wine (175ml) is 2 items. A pint of lager or beer is often 2 to three items of alcohol.
exercising – as much as half-hour a day, 5 instances per week is good
Metformin is often prescribed when weight loss plan and train alone has not been sufficient to manage your blood sugar ranges.
- Persistent kidney illness
- Gestational diabetes
- Polycystic ovary syndrome
- Kind 2 diabetes
- Diabetes Analysis and Wellness Basis: charity
- Diabetes UK: charity
- Wholesome consuming: discussion board
- Metformin: boards
- Kind 2 diabetes: movies of actual tales