Metformin

Dosage Forms Available

• Metformin is available in oral tablets and as an oral solution.

Age and Dose Restrictions

• Metformin is not typically recommended for children under ten years old. 

Contraindications

• Metformin is contraindicated in individuals with severe kidney impairment, metabolic acidosis (including diabetic ketoacidosis), or a known allergy to the medication. It should not be used in individuals with severe heart failure or those undergoing imaging procedures requiring contrast dye, as it may increase the risk of lactic acidosis.

Other Medications to Avoid

• Metformin may interact with diuretics (furosemide), corticosteroids (prednisolone), beta-blockers (propranolol), thyroid medications (levothyroxine), anticonvulsants (phenytoin), and certain antibiotics (rifampin). These medications may affect how Metformin works or increase the risk of side effects. Always inform your doctor about any other medications you are taking.

Overdose and Missed Dose

• An overdose of Metformin can cause lactic acidosis, a serious condition that requires immediate medical attention. Symptoms include extreme weakness, trouble breathing, slow heart rate, or severe drowsiness. 
• If you miss a dose, take it as soon as you remember, unless it is close to the time of your next dose. Do not take two doses at the same time.

Management of Side Effects

• To reduce stomach-related side effects such as nausea and diarrhea, take Metformin with food. Start with a lower dose and gradually increase as recommended by your doctor to allow your body to adjust. If severe side effects occur, such as persistent vomiting, unusual muscle pain, or breathing difficulty, seek medical help immediately.

Use in Driving and Operating Machinery

• Metformin does not usually cause dizziness or drowsiness. However, in rare cases, it may lead to hypoglycemia (low blood sugar) when combined with other diabetes medications. Be cautious while driving or operating heavy machinery, especially if taking Metformin with insulin or sulfonylureas.

Use in Pregnancy and Lactation

• Metformin is generally considered safe during pregnancy and is sometimes used in gestational diabetes. It may also be used in women with PCOS to help regulate ovulation. Metformin passes into breast milk in small amounts but is not known to harm nursing infants. However, always consult a doctor before taking Metformin while pregnant or breastfeeding.

Caution in Other Conditions

• Caution is advised in individuals with kidney or liver disease, heart conditions, or a history of alcohol abuse. Those undergoing surgery or medical imaging with contrast dye should temporarily stop Metformin to avoid complications related to kidney function.

Special Dietary and Lifestyle Recommendations

• Follow a diet rich in whole grains, vegetables, lean proteins, and healthy fats to help maintain stable blood sugar levels.
• Engage in regular physical activity, such as brisk walking or strength training, to improve insulin sensitivity.
• Monitor blood sugar levels regularly and adjust your treatment plan as advised by your doctor.