Metformin is used to treat type 2 diabetes. Thanks to years of experience, metformin is a reliable active ingredient for lowering the elevated blood sugar level in diabetes mellitus. Meanwhile, this drug is also recommended for certain forms of cycle disorder. However, some contraindications and side effects must be considered in order for metformin to be taken safely. Metformin is completely unsuitable for patients with type 1 diabetes.
Effect of Metformin
Metformin lowers the blood sugar level and improves the sugar utilization of the body. In addition, this drug shuts down the body's sugar production and hinders the absorption of sugar from the intestine into the blood. It is suitable for patients with type 2 diabetes when other therapies are exhausted. Above all, overweight patients, in whom dietary measures and sports have no effect, can benefit from the action of this drug.
Metformin, which belongs to the group of biguanides, is one of the longest on the market antidiabetics and extremely reliable. It is often first used alone and combined with other drugs only in the absence of success. In addition, metformin is said to have heart and vascular protective properties.
A big advantage over other hypoglycaemic drugs is the low risk of hypoglycaemia.
Metformin in PCOS
Another application of metformin is cycle disorders in the context of polycystic ovarian syndrome (PCOS), which is often associated with diabetes mellitus. Metformin can be used against the cycle disorders as well as the high blood sugar level, but is not yet approved for this use in Germany and must therefore be worn as part of an off-label-use normally.
pregnancy and breast feeding period
Diabetes patients taking metformin and having a desire to have children or who are already pregnant should discontinue metformin and switch to insulin. Only in exceptional cases can treatment with metformin be continued during pregnancy. The same applies to diabetes, which occurs only during pregnancy (gestational diabetes).
There are no restrictions for nursing mothers and metformin can be taken after consultation with the attending physician.
Dosage of metformin
Metformin is a prescription drug. Which dosage is suitable, it is best to discuss it with your doctor. Metformin is available in the form of film-coated tablets and should be taken orally, preferably before or during meals. It is offered in dosage increments of 500, 850 and 1000 milligrams. Further information can be found on the leaflet.
Side effects of metformin
The most common side effects with metformin are gastrointestinal symptoms: nausea, vomiting, diarrhea and abdominal pain are some of the side effects that are very common. Also worth mentioning are changes in taste that, together with the first-mentioned side effects, can cause loss of appetite.
Very rare, but extremely dangerous, is lactic acidosis. Overdosage of metformin or congestion of the kidney leads to an accumulation of the active substance in the body, leading to a derailment of the acid-base balance. The symptoms of lactic acidosis are quite similar to the normal side effects of metformin: nausea with vomiting. This is often accompanied by further gastrointestinal complaints, muscle pain, cramps and accelerated breathing. In this case, a doctor should be consulted immediately.
Contraindications of Metformin
Some chronic diseases prohibit the use of metformin either as it interferes with its metabolism or increases the risk of lactic acidosis.
This is the case with heart failure, any disease affecting pulmonary function (COPD, asthma), liver dysfunction and impaired renal function. Circumstances that burden the kidney should always be a reason to rethink the use of metformin. Such circumstances may be, for example, severe vomiting, diarrhea or serious infections.
During pregnancy, metformin should also be discontinued and switched to another preparation. For example, insulin syringes are suitable.
In combination with alcohol, metformin carries an extremely high risk of lactic acidosis. The alcohol consumption should therefore be omitted or minimized.
Another special feature of metformin is the handling in the case of general anesthesia or spinal anesthesia, for example as part of an operation. Metformin should be discontinued two days before the procedure and the renal function should be checked before re-insertion. The same applies to X-ray examinations with iodine-containing contrast agents. Metformin must not be taken before the examination and for up to 48 hours thereafter. Again, a clarification of renal function after the examination is required.
Interactions of Metformin
In combination with some other drugs, the effectiveness of metformin is reduced. Examples include corticosteroids (cortisone), diuretics and some anti-asthma drugs (beta-sympathomimetics). The hypoglycemic effect of metformin is enhanced by antihypertensives such as ACE inhibitors.
Alcohol-containing medications (such as some cough medicine) and iodinated contrast media in combination with metformin are associated with the risk of lactic acidosis and should therefore be taken with caution. In the case of the contrast agent, metformin must even be discontinued for a while.
Metformin: This is to be considered
Metformin is a good drug for the treatment of type 2 diabetes and, taking into account a few peculiarities, can permanently and reliably lower the blood sugar level.
- Metformin is suitable for patients with type 2 diabetes for whom dietary and physical activity has shown no effect.
- Its advantage lies in the low risk of hypoglycaemia.
- The metformin is excreted through the kidneys, kidney function should be checked at least once a year.
- Metformin must be discontinued prior to surgery and X-ray studies with contrast administration. Renal function must be checked before taking it again.
- Important contraindications are pregnancy and increased alcohol consumption.