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Discovered in 1922 by Emil Werner and James Bell and officially approved by the Food and Drug Administration only in 1994, Metformin is a single representative of the whole class belonging to the group of oral antihyperglycemic agents. As its quite popular all over the world, various versions of the medicine, both brand and generic, have been created.

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Metformin is used in patients suffering from type 2 diabetes. It helps control blood sugar levels by decreasing hepatic production and intestinal absorption of glucose. Metformin activates AMP-activated protein kinase which is necessary to start the inhibition of gluconeogenesis in liver. Also, Metformin makes tissues more sensitive to insulin and increases peripheral glucose uptake. A special mechanism of action makes the drug unique and safer than other drugs usually prescribed to treat diabetes type 2 which might cause hypoglycemia and hyperinsulinemia.

Contraindications and Precautions

This medicine is contraindicated if a patient belongs to the group of high risk of lactic acidosis development. They are patients with severe kidney, lung or liver disorders, as well as alcoholism. People with heart diseases can also suffer from lactic acidosis caused by Metformin usage, but its the most acceptable way of therapy for them compared with other drugs. However, acute myocardial infarction is a direct contraindication for Metformin usage. If lactacidemia appears, its necessary to stop Metformin therapy, as it can worsen the state of the patient. Other contraindications include hyperglycemic coma and diabetic ketoacidosis when insulin injection is urgently needed. Pregnant women and breastfeeding mothers should not take the medicine as well because there has been made no research whether Metformin can harm an unborn or nursing baby. In addition, its forbidden for children under 10.

Certainly, people with hypersensitivity or allergy to any component of the drug shouldnt take it. Apart from Metformin HCl, USP each tablet contains microcrystalline cellulose, povidone, magnesium stearate and croscarmellose sodium. The coating contains titanium dioxide, polyvinyl alcohol, maltodextrin, talc, propylene glycol, polyethylene glycol and gum acacia. Due to the fact that Metformin may affect renal function, it is to be permanently assessed. Thats why the maximum dose for elderly people is lower as they usually have reduced renal function.

Those patients for whom radiologic studies are planned must stop taking Metformin two days before the manipulation and renew the therapy after renal function test.

Drug Interactions

In case you are taking some medicines, its necessary to inform your doctor before starting the therapy with Metformin as some drugs can change the effect of the medicines making it either useless or dangerous. If you are suffering from diabetes, its crucial to be careful with medicines which affect blood sugar levels. Also, its not recommended to combine Metformin with other drugs raising the risk of lactacidemia. You should avoid taking Metformin together with such drugs as furosemide, digoxin, H2-receptor antagonist cimetidine or chlorpropamide.

Side Effects

Most of the side effects caused by Metformin are connected with the gastrointestinal system. The most common of them are nausea, vomiting, windiness, diarrhea and metallic taste in the mouth. The most serious side effect is development of lactic acidosis. Other possible serious side effects are abnormal breathing, cough or hoarseness, fever, painful urination, pain in the muscles and sleepiness. An allergic reaction might result in itchy skin, rash, swelling and dizziness. If some side effect doesnt disappear itself or causes much discomfort, its necessary to inform your doctor as well as in case of overdose.

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