Metformin is used to treat type 2 diabetes. Thanks to many 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 in certain forms of the cycle disorder. However, some contraindications and side effects must be considered in order for metformin to be taken safely. For patients with type 1 diabetes, metformin is completely unsuitable.
Effect of Metformin
Metformin lowers the blood sugar level and improves the sugar utilization of the body. In addition, this drug reduces 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 used alone on the one hand and only combined with other drugs if it does not succeed. 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 cycle disorders as well as high blood sugar levels, but is not yet approved for use in Germany and must therefore be worn as part of an off-label-use.
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 metformin therapy 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 may 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 complaints: 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 highly dangerous, is lactic acidosis. Overdosage of metformin or overloading 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 should not be taken before 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 increased 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 can, taking into account a few special features, the blood sugar levels permanently and reliably lower.