Metformin is an oral antidiabetic drug, especially used in Noninsulin dependent Diabetes Mellitus Patients who are obese because it doesn’t cause an increase in body weight. On another hand, body weight may be increased with insulin and sulphonylureas. It is excreted unchanged in the urine and its plasma half-life is 1.30-to 3 hours.
Clinical Uses:
- It is the drug of choice in Noninsulin dependent diabetes mellitus patients.
- It is also used along with sulphonylureas when blood glucose is not fully controlled with sulphonylureas alone.
- it is also used in polycystic ovary syndrome (Unlicensed use)
Dose Of Metformin:
Usual recommended dose is 0.5 -To 2.55g daily in two to three divided doses after meals.
Metformin in Pregnancy:
It can be used in pregnancy for both pre-existing and gestational diabetes.
Mechanism Of Action
Its exact mechanism of action is unknown but seems to inhibit the formation of glucose in the liver (gluconeogenesis)another possible mechanism of action may decrease glucose absorption from the GIT and its increased uptake by the skeletal muscle.
Adverse Effects:
- Anorexia, nausea abdominal pain, vomiting, and diarrhea are the most common adverse effects associated with metformin. These can be reduced by starting the drug with a small dose after meals and then gradually increasing the dose.
- Cold Feeling in your arms and legs.
- Chronic administration of metformin may decrease the absorption of vitamin B12 from the intestine. Hence serum vitamin B12 Should be monitored during chronic administration of biguanides and if a deficiency occurs then vitamin B12 should be given by injection.
- Lactic acidosis is a serious adverse effect that is more liable to occur in patients with renal failure, cardiorespiratory insufficiency, alcoholism, and elderly people.
- Trouble breathing.
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