Drug Notebook
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metformin
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(met FOR min)
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What is the most important information I should know about metformin?

Do not use metformin if you have kidney disease, or if you are in a state of diabetic ketoacidosis (call your doctor for treatment with insulin).

Before taking metformin, tell your doctor if you have liver disease or a history of heart disease.

Some people have developed a life-threatening condition called lactic acidosis while taking metformin. Get emergency medical help if you have any of these symptoms of lactic acidosis: weakness, increasing sleepiness, slow heart rate, cold feeling, muscle pain, shortness of breath, stomach pain, feeling light-headed, and fainting.

If you need to have any type of x-ray or CT scan using a dye that is injected into a vein, you may need to temporarily stop taking metformin. Be sure the doctor knows ahead of time that you are using this medication.

Know the signs of low blood sugar (hypoglycemia) and how to recognize them, including hunger, headache, confusion, irritability, drowsiness, weakness, dizziness, tremors, sweating, fast heartbeat, seizure (convulsions), fainting, or coma (severe hypoglycemia can be fatal). Always keep a source of sugar available in case you have symptoms of low blood sugar.

What is metformin?

Metformin is an oral diabetes medicine that helps control blood sugar levels.

Metformin is for people with type 2 (non-insulin-dependent) diabetes. Metformin is sometimes used in combination with insulin or other medications, but it is not for treating type 1 diabetes.

Metformin may also be used for purposes other than those listed in this medication guide.

What should I discuss with my healthcare provider before taking metformin?

Some people have developed a life-threatening condition called lactic acidosis while taking metformin. Get emergency medical help if you have any of these symptoms of lactic acidosis: weakness, increasing sleepiness, slow heart rate, cold feeling, muscle pain, shortness of breath, stomach pain, feeling light-headed, and fainting.

You may be more likely to develop lactic acidosis if you have congestive heart failure. Older adults may also have a higher risk of developing lactic acidosis. Talk with your doctor about your individual risk.

Do not use this medication if you are allergic to metformin, if you have kidney disease or kidney failure, or if you are in a state of diabetic ketoacidosis (call your doctor for treatment with insulin).

Before taking this medication, tell your doctor if you are allergic to any drugs, or if you have:

  • liver disease; or

  • a history of heart disease.

If you have any of these conditions, you may not be able to use metformin, or you may need a dosage adjustment or special tests during treatment.

FDA pregnancy category B. This medication is not expected to be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. It is not known whether metformin passes into breast milk or if it could harm a nursing baby. Do not take metformin without first talking to your doctor if you are breast-feeding a baby. Metformin should not be given to a child younger than 10 years old. Extended-release metformin (Glucophage XR) should not be given to a child younger than 17 years old.
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FDA Alerts

  • Lactic acidosis rare but potentially fatal. Increased risk of lactic acidosis in patients with renal impairment, advanced age, metformin plasma concentrations >5 mcg/mL.
  • Generally has occurred in diabetic patients with severe renal insufficiency who frequently had concomitant medical and/or surgical problems and were receiving multiple drugs.
  • Periodically monitor renal function and use the minimum effective dosage. Withhold promptly in patients with any condition associated with hypoxemia, sepsis, or dehydration. Avoid use in patients with clinical or laboratory evidence of hepatic impairment. Discontinue therapy temporarily in patients undergoing surgery or receiving parenteral iodinated radiographic contrast media. Drugs that may affect renal function or alter metformin elimination should be used with caution.
  • Advise patients not to consume excessive amounts of alcohol.
  • If lactic acidosis occurs, discontinue metformin. Immediate hospitalization and treatment required.

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