Metformin

What is it?

Composition

The composition of metformin is usually represented by the main active substance - metformin, which can be in the form of hydrochloride. Each tablet or capsule contains a certain dose of the active component, for example, 500 mg, 850 mg or 1000 mg. Depending on the form of release, the dosage and auxiliary components may differ.

As additional ingredients, substances that improve the absorption and stabilize the structure of the drug are most often used. They can include:

• Microcrystalline cellulose
• Povidone
• Magnesium stearate
• Talc
• Starch

These additives help ensure the stability of the drug, its ease of administration and preservation for a long time. However, the composition may vary slightly depending on the manufacturer. If necessary, you can clarify the information on the packaging or in the instructions for a specific drug.

How to use?

Metformin should be taken strictly as prescribed by a doctor, taking into account the individual characteristics of the patient and the severity of the disease. Usually, the drug is taken orally with a sufficient amount of water, preferably during or immediately after meals to reduce the risk of side effects from the digestive system.

A standard regimen may include the following steps:

1. The initial dose is usually 500-850 mg once or twice a day, depending on the blood glucose level and the doctors recommendations.
2. After a few weeks, the dose can be gradually increased to achieve optimal blood sugar levels, but not more than 2000-3000 mg per day, divided into several doses.
3. If an extended-release form is prescribed, the drug is taken once a day in the evening.

It is important to follow the dosing regimen and not skip doses to avoid fluctuations in blood sugar levels. If you miss a dose, do not double the next one, but rather continue taking it as scheduled.

How does it work?

Metformin has a complex effect, affecting the main mechanisms of blood sugar regulation. The drug does not stimulate insulin production, but improves the use of glucose by tissues and reduces its entry into the blood. This makes it especially useful for people with type 2 diabetes, who often have insulin resistance.

The main mechanisms of metformin action include:

Reducing glucose production in the liver by suppressing the process of gluconeogenesis.
Increasing the sensitivity of cells to insulin, which promotes better absorption of sugar by muscle and fat tissue.
Slowing down the absorption of carbohydrates from the gastrointestinal tract.
In addition to controlling sugar levels, metformin can have additional beneficial effects, such as lowering blood lipid levels and controlling body weight in overweight patients. This makes it one of the most preferred drugs for the treatment of type 2 diabetes.

Indications

Metformin is widely used in the treatment of type 2 diabetes, especially in overweight patients, when other methods of controlling sugar levels, such as diet and physical activity, are not effective enough. The drug is prescribed both as monotherapy and in combination with other hypoglycemic agents, including insulin.

Main indications for use:

• Type 2 diabetes mellitus with insulin resistance.
• Obesity accompanied by elevated blood sugar levels.
• Prevention of diabetes mellitus in people with a prediabetic condition (elevated fasting glucose or impaired glucose tolerance).
• Polycystic ovary syndrome (PCOS) in some cases, as part of combination therapy.

The drug is often considered a first-line drug for type 2 diabetes mellitus due to its safety, effectiveness and ability to improve the overall metabolic state of the body.

Contraindications

Despite its effectiveness and wide applicability, metformin has a number of contraindications that must be taken into account before starting treatment. It is important to consult a doctor in advance to exclude health risks and possible complications.

Contraindications include:

• Hypersensitivity to metformin or any of the components of the drug.
• Severe renal impairment (eg, chronic renal failure with creatinine clearance below 30 ml/min).
• Acute or chronic metabolic acidosis, including diabetic ketoacidosis.
• Conditions accompanied by hypoxia (eg, cardiac or respiratory failure).
• Acute alcohol intoxication or chronic alcoholism.
• Liver failure or severe liver disease.
• Pregnancy and breastfeeding (prescription is possible only with strict indications).

In addition, the drug should be used with caution in elderly patients and in the presence of risk factors for lactic acidosis. It is important to follow your doctors recommendations, especially in situations involving surgery or examinations using contrast agents.

Side effects

Like any other drug, metformin can cause side effects. However, most of them are temporary and often associated with the bodys adaptation to the drug. The most common side effects are observed from the gastrointestinal tract, especially at the beginning of treatment.

Possible side effects:

• Nausea, vomiting, diarrhea, flatulence and abdominal pain. These symptoms often occur at the beginning of therapy and gradually disappear.
• Decrease in vitamin B12 levels with prolonged use, which can lead to anemia.
• Metallic taste in the mouth.
• Very rare - development of lactic acidosis (accumulation of lactic acid), which is a serious but extremely rare complication.
• Allergic reactions, such as skin rash or itching, are rare.

To reduce the risk of side effects, it is recommended to start taking the drug with a minimum dose and gradually increase it. If side effects persist or worsen, you should consult a doctor to adjust the dosage or choose an alternative therapy.