What is metformine?
Metformin is an oral antidiabetic from the group of biguanides and is considered a means of first choice in diabetes mellitus type 2. It lowers blood sugar levels without triggering hypoglycaemia, and is most commonly prescribed worldwide for the treatment of type 2 diabetes.
Metformin is available under various brand names, including Glucophage®, Siofor® and Metformin Lich®. Numerous generics are available.
The active substance is generally used as long-term therapy and is often combined with other antidiabetics or insulin if blood sugar control alone is not sufficient.
Active Ingredients & Mechanism of Action
Active ingredient: Metformin (Metforminhydrochlorid)
Metformin acts on glucose metabolism via several mechanisms:
Inhibition of glucose production in the liver:
- Reduces the hepatic glucoseogenesis (sugar new formation)
- This is the most important mechanism of action
Improving insulin sensitivity:
- Increases glucose absorption in muscle and fat cells
- The body cells react better to body-specific insulin
Delay of glucose absorption in the intestine:
- Slows sugar intake from food
Advantages over other antidiabetics:
- No increased hypoglycaemia risk for use alone
- Weight neutral to light weight reduction
- Proven cardiovascular benefits
Who is it suitable for?
Metformin is suitable for:
- Adults with diabetes mellitus type 2
- As the first drug therapy after lifestyle changes
- In combination with other antidiabetics or insulin
- Overweight patients with type 2 diabetes (especially benefits)
Not suitable:
- Diabetes type 1
- Heavy kidney function disorder (eGFR < 30 ml/min)
- Acute conditions with risk of lactatosis
- Pregnancy and breastfeeding
Available Dosages
Available starches:
- 500 mg film tablets
- 850 mg film tablets
- 1000 mg film tablets
Retard tablets:
- 500 mg, 750 mg, 1000 mg (delayed release)
Use dosage:
- Start: 500 mg 1-2x daily or 850 mg 1x daily
- Increase every 1-2 weeks
- Maximum dose: 3000 mg/day (usual: 2000 mg/day)
How to Take
Intake:
- Take at or after meals (reduced gastrointestinal discomfort)
- Swallow pills with water
- Do not disassemble or chew retard tablets
Dosing scheme (typical):
- Week 1-2: 500 mg in the evening
- Week 3-4: 500 mg morning and evening
- Then possibly increase to 3x 500 mg or 2x 1000 mg
Important notes:
- Regularly take, even if there are no symptoms
- Set off before contrast medium tests (CT/MRT) and then pause for 48 h
- In case of medical surgery
- Regular kidney value controls
Contraindications
**Metformin must not be taken at:* *
- Heavy kidney failure (eGFR < 30 ml/min)
- Diabetic ketoacidosis or diabetic precoma
- Acute conditions with risk of kidney damage (dehydration, severe infections, shock)
- Liver insufficiency
- alcohol intoxication, alcoholism
- Heart failure (NYHA IV)
- conditions with tissue hygiene (heart circulation shock, respiratory insufficiency)
Preview at:
- Restricted kidney function (eGFR 30-45 ml/min: max. 1000 mg/day
- Older patients (more frequent kidney value controls)
- Before contrasting (48 h break)
Pregnant period: Metformin is not permitted during pregnancy. Conversion to insulin required.
Possible Side Effects
Very common (>10%):
- nausea
- Break.
- diarrhea
- stomach pain
- Lost appetite
Note: These complaints occur mainly at the beginning of therapy and usually improve after a few weeks. Take for food and help slow dose increase.
Acid (1-10%):
- Flavour disorders (metallic)
Selten:
- Lactose (very rare, but potentially life-threatening)
- Vitamin B12 deficiency in long-term use
- Liver malfunction
- Skin reactions
Long term: With years of use, regularly control vitamin B12 levels.
Interactions
Alcohol: Increased risk of lactatosis. Avoid excessive alcohol consumption.
Contrast agent (joint): Delay Metformin 48 hours before and after the examination. Risk of kidney damage.
Preview with simultaneous use of:
- ACE inhibitors, diuretics – kidney function can deteriorate
- corticosteroids – can increase blood sugar
- Other antidiabetics or insulin – hypoglycemia risk increases in combination
Reactions over kidney: Medicines that affect the kidney function require special monitoring.
Frequently Asked Questions
Similar Medications
Is metformine right for you?
A licensed doctor will review your information and issue a prescription if suitable. Discreet and secure.
Important Notice
This information does not replace medical advice. If you have questions about your health or the suitability of this medication, please consult a doctor or pharmacist.
Important Safety Information
This service operates under German pharmaceutical law (HWG). For risks and side effects, read the package leaflet and consult your doctor or pharmacist. All medications are dispensed from a licensed pharmacy in Germany.