Metformin

Metformin reduces the liver’s glucose production and it may reduce the absorption of sugar from the intestines. In connection with a meal, it may also increase the GLP-1 (glucagon-like peptide) content and have an effect on the intestinal microbiome. Metformin supports weight loss.

Initially, the metformin dose is small: one 500–750 mg tablet once a day either with breakfast or the main meal of the day. Normally, the dose is increased every 1–2 weeks. You should slow down with increasing the dose if the product causes intestinal side effects, such as diarrhoea. The usual treatment dose is one 1000 mg tablet taken twice a day with breakfast and the main meal of the day. For some users, the best time to take the drug is at supper.

The recommendation is to take metformin with a meal or straight after eating to reduce potential stomach trouble. The tablets are swallowed whole. Some of the products can be broken in half to make them easier to swallow. A product that can be halved can be identified by the score line on the tablet

When used on its own, metformin does not result in blood sugar dropping too low. Quantity of food should not be increased after starting the medication. Rather, quantity of consumed food should be reduced, if you are overweight. The dose does not need to be adjusted according to eating or exercise.

Metformin can be used during pregnancy and breastfeeding.

Metformin exits the body via the kidneys. Therefore, the dose can be reduced in the case of kidney failure. If you have a severe kidney failure, metformin can't be used.

Metformin medication is paused during a serious general illness, contrast medium examination or major surgeries. Special care is taken in the treatment of the elderly, i.e. persons over the age of 75, because they often have other diseases and use additional medications.

If you have a stomach bug with fever, you are vomiting or have diarrhoeaor or if your system is dehydrated for some other reason, you should stop taking metformin until the symptoms have stopped.

During metformin treatment, heavy alcohol use is not recommended.

The most common side effects of metformin include various stomach problems, such as stomach ache, loose stomach, diarrhoea or nausea. Some may experience a metallic taste in the mouth or loss of appetite. Side effects are particularly common during the early stages of the treatment or if the dose has been rapidly increased.

Usually, the stomach issues are temporary or they can be alleviated by reducing the dose. Sometimes, changing to a different brand may help. For approximately 10% of people, the issues are so severe that they will have to stop using metformin.

In long-term care, metformin may reduce the absorption of vitamin B12 from the intestines. The vitamin B12 level is measured using blood tests every few years. For an elderly person, the level should be tested before the start of the treatment because they may have a vitamin B12 deficiency due to other reasons. A vitamin B12 deficiency may exacerbate nerve symptoms, such as numbness or tingling of the feet, changes in sensation or anaemia. If necessary, a vitamin B12 product is started as a tablet or injection.