What is Metformin used for?
Metformin is a biguanide-type drug used to lower blood-sugar levels in Type II diabetics. In general, it is prescribed to help maintain diabetic control as part of a regimen that may also include insulin, other medications, and/or changes to diet and activity levels. The medication acts on the endocrine system in three basic ways: 1) reduces absorption of glucose from food, 2) reduces glucose produced naturally in the liver, and 3) allows the body to use insulin more effectively. Overall, it can decrease the likelihood of serious diabetic complications. It is not typically used to treat Type I (juvenile or insulin-dependent) diabetes.
Which companies sell this drug?
In the US, it was originally licensed by Bristol-Myers Squibb in 1994 under the name Glucophage; however, the drug was first described in scientific literature in 1922 and available in Great Britain as early as 1958. Until diabetes reached epidemic levels, few pharmaceutical companies were interested in producing or marketing the drug; however, after diabetes became a national health crisis, interest in medications that reduced blood-sugar levels increased. Generic formulations are now widely available, and some sources claim the drug in its various forms is among the most prescribed drugs internationally. It is sold under several other brand names as well, including Fortamet, Glumetza, and Riomet to name a few. Combination drugs are also available, composed of this medication and other agents to improve performance.
The most common side effects from this medication are gastrointestinal in nature. They include stomach irritation, belching, nausea, vomiting, diarrhea, cramping, bloating, excess gas, and constipation. These are strongly associated with higher doses and are most common at the beginning of treatment. Gradual increases in dosage are less likely to cause these side effects. Nevertheless, the majority of users do experience some gastrointestinal while taking the medication. Some small studies suggest than nearly 54% of users will experience diarrhea while on the medication, compared to only 12% with placebo.
Another potentially serious effect is lactic acidosis. This is when lactic acid builds up in the blood stream and is more prevalent in users who also have liver or kidney damage. Symptoms of this effect include nausea or vomiting, abdominal/stomach pain, hyperventilation, anxiety, low blood-pressure, and an irregular heartbeat or tachycardia. If left untreated, this condition can become fatal. Treatment may include discontinuation or reduction of the medication. Because of the potential for this reaction, the drug is frequently withdrawn before surgeries.
Other adverse effects may occur; however, they are generally considered uncommon. Not all patients experience symptoms or adverse effects due to taking the drug.
Cephalexin, an antibiotic used to treat Gram-positive bacteria, interacts with this medication. It can prevent the body from metabolizing the anti-diabetic drug at the expected rate, increasing the chance of adverse effects, like nausea, and the potential for accidental overdose. Other drugs of this class may have similar effects.
Levothyroxine may interact with it as well, reducing the efficacy of both drugs. Since levothyroxine is used to treat hypothyroidism, a condition with which many diabetics may be potentially diagnosed, this is an interaction that should be monitored closely if it cannot be avoided.
Lasix (furosemide), used to treat edema or congestive heart failure, can increase the likelihood of developing lactic acidosis. Patients using furosemide should inform their doctor before beginning to take other treatments.
Many types of insulin, including Lantus, interact with this drug; however, this can sometimes be used to clinical benefit as both reduce blood-sugar levels. A high number of Type II diabetics also use insulin in their treatment regimen. Patients should use insulin only under clinical supervision.
Use of Metformin with alcohol
If this drug is used in combination with alcohol, its effects may become less predictable. At first, the risk of hypoglycemia (low blood-sugar) increases due to the alcohol's effect on the medication. The body processes it more quickly and experiences a sharper drop in blood-sugar; however, later, high blood-sugar levels are also possible due to the increased calories from the alcohol.
Low blood-sugar can result in dizziness, hunger, altered consciousness, irritability, loss of consciousness, and/or death. Diabetics should learn to recognize these symptoms of low blood-sugar. High blood-sugar has severe long-term consequences for the body in the form of diabetic complications. These can include fatigue, muscle pain, damage to organs, damage to nerves, blindness/deafness, coma, and/or death. Together, these possible outcomes explain why the effects of alcohol should be avoided while using the medication.
By Eszter Hazai, PhD Google+