Metformin: Dosage, Usage, Side Effects, Metformin For Weight Loss And PCOS

Metformin

Wondering what that metformin is in your prescription? Metformin is on its way to becoming the most popular and useful anti-diabetic drug. Its wide range in the medical field is likely to create a number of questions in our mind. The confused times will be left behind as today we will tell you all it is to Metformin and its uses, mechanism of action, dosage and side effects. Hang in there and go through this article to find answers to all your questions.

What Is Metformin?

Metformin is often known by its commercial term Glucophage. It belongs to the drug group of biguanide.  It is used as a first line drug for the treatment of type 2 diabetes but it’s not the only situation where this medicine proves useful. It is known to be of great help in the condition of polycystic ovary syndrome or PCOS. This drug proves to be a boon in cases when the victim is obese or overweight. Although it is advised not to use Metformin in case of liver and kidney problems, they are found to be quite useful in such situations too (The condition of the liver and kidney malfunction must not be too severe).

This drug was first introduced in the year 1922 by a well-known French physician of that time Jean Sterne. Its wide scale usage only began in the late 1950s. Metformin is the generic name of the drug and it is available with different commercial names.

Uses Of Metformin:

Metformin can come in as a useful drug in many medical conditions. It impacts the weight of the person less as compared to other diabetic drugs.  Rather, it is known to be helpful in the reduction of weight. It does not cause hypoglycemia. The usage of metformin has also shown a little reduction in LDL and triglyceride.

Below we have mentioned the use of metformin in various conditions in detail.

  • Type 2 Diabetes: It is used as the first line treatment in this case.
  • Prediabetes: Other than being used for the treatment of diabetes type 2, it is also used for the treatment in the pre-diabetic stage. Doctors may prescribe this drug and ask you to have a strictly healthy diet and include exercise as a part of your life.
  • Polycystic ovary syndrome (PCOS): This condition is becoming more and more rampant among woman around the globe nowadays. Metformin is used in women as a treatment if they are found to be insulin resistant. It was first used in this way back in 1994. It is not used as a first-line drug in this case. It is often used after the failure of other types of treatments and is administered only to those women who have a high glucose intolerance and have a body mass index (BMI) higher than 25.
  • Female Infertility: Metformin is often combined with Clomiphene and is used as a first-line treatment in this case. This combination of the two drugs is said to have a positive effect on the anovulation and insulin resistance. In the case of hirsutism and obesity too, this combination is known to work very well. This combination improves the ovulation in the female body thus increasing the chances of getting pregnant.
  • Gestational Diabetes: This drug can be used in the management of such problems but this is often considered to be the last resort when the condition is found to be very severe. The usage of the drug in this case greatly reduces the chance of getting diabetes later in life.
  • The other uses of metformin include its use as a counter drug for weight gain. It is used in this way when the person gains weight due to antipsychotic drugs. It can be used in type 1 diabetes treatment too but the usage is very rare.

Metformin’s Mechanism Of Action:

The mechanism of metformin includes decreasing the amount of glucose production in the liver. The administration of Metformin causes an insulin-sensitizing effect on the various tissues and cells of the body. The metformin also initiates another reaction on the other body parts like liver, skeletal muscles, endothelium, adipose tissues and ovary resulting in the decrease of high blood sugar. In type 2 diabetes, we find that the amount of blood sugar in the patient’s blood is three-fold times greater than the normal amount. Usage of metformin inhibits the greater production of glucose in the liver and as a result, the blood sugar in the blood decreases by one-third and becomes closer to the normal range. The molecular mechanism of the drug is not completely known. There are a number of proposed theories for the same case.

Below we have mentioned the proposed theories about the molecular mechanism of metformin:

  • The first and the most widely accepted theory is that the drug metformin inhibits the chain of mitochondrial respiration (complex1).
  • The second theory states that by the administration of the drug in the body the AMP-activated protein kinase (AMPH) is activated. This causes insulin sensitivity in the tissues of the body.
  • The other theory proposes that the drug has an effect on the gut microbiota

Metformin’s usage is known to reduce and suppress the production of hepatic glucose. This results in the increased insulin sensitivity. As a chain reaction to this effect, the peripheral glucose uptake in the body is increased.  The insulin transportation to the insulin receptors improves too. The fatty acid oxidation is also reduced to a large extent. This leads to a decrease in the absorption of glucose in the gastrointestinal tract.

Metformin’s Interaction With Other Drugs:

A report shows that metformin interacts with up to 74 different kinds of drugs. The interaction between the drugs can greatly reduce their effectiveness and can have negative effects. The reaction of the drugs can give rise to various complications in the body. The list of a few of such drugs that interact with Metformin is given below:

  • Blood Pressure drugs: The use of such diuretic drugs increases the amount of blood sugar in the body. Thus, it is not a good idea to take the two drugs simultaneously. Another reason is the presence of Nitrendipine in the diuretics which acts to block calcium channels. This can result in the increased chances of lactic acidosis.
  • Cholesterol drugs: Nicotine acid is found to be present in these drugs. This can render the metformin ineffective.
  • Glaucoma Drugs: The usage of metformin with such drugs can increase your chances of getting lactic acidosis.
  • Topiramate: The interaction of metformin and this drug is likely to make you more prone to lactic acidosis.
  • Thyroid Drugs: These drugs lower the effectiveness of metformin in the body.
  • Tuberculosis drugs: The isoniazid from this drug can cause problems when they react with metformin.
  • Hormone Drugs: They are known to render metformin ineffective.

Dosage:

The dosage of this drug depends upon the person’s age and condition. There are differences based on the form of the drug that is taken.  These are available in a large variety of extended-release tablets and immediate release tablets. The dosage may vary a little depending upon the brand.  Below we have mentioned the general dosage for the drug in different age groups.

  • Adult dosage for immediate release

Begin with an initial amount of 500 mg. Take it orally and two times a day. Alternatively, you may consider taking a dosage of 850 mg once a day orally. It should be increased by 500 mg per week or 850 mg per fortnight. The maintenance dose is 2000 mg per day divided into parts. The maximum dosage for one day is 2550 mg.

 

  • Adult dosage for Extended Release tablets:

The initial amount is supposed to be 500 mg taken once in a day orally. The dose titration is fixed at 500 mg per week. The maintenance dosage is put up at 2000 mg for one day. One must not take more than 2500 mg of the drug in one day.

  • Pediatric usual dosage (10 years and above):

Oral dosage of 500 mg is administered twice a day. The dosage titration is 500 mg per week. The maintenance dosage is fixed at 2000 mg per day. The maximum amount to be administered in a day is fixed at 2000 mg.

Extended-release drugs are not to be given to a person less than 18 years of age.

Note: The drug’s dosage varies widely when the patient has a kidney or a liver problem. The patient is made to go through a series of tests to check the functioning of the liver and kidney in such cases. The drugs are not administered when the condition is found to be very severe.

Side Effects Of Metformin :

Metformin can cause some side effects. The most common side effect experienced after taking this drug is Gastrointestinal issues. The most serious side effect known to occur after taking this drug is lactic acidosis. Let us now probe deep into the different side effects caused by this drug:

  • Gastrointestinal problems: The most common symptoms of occurring because of this issue is vomiting, nausea, episodes of severe abdominal pain and diarrhea. You will feel the discomfort as soon as you take your first dose if the dose is high. This problem also occurs when the dosage is increased suddenly. This can be avoided by a slower dosage titration or by making a daily 15% increase in the dosage. One must make sure to start this drug at a lower dosage. If the drug is used for a very long time, it can cause an increase in the homocysteine levels. This may cause malabsorption of the vitamin B12 in the body.
  • Lactic Acidosis: This happens in very rare cases. The reason for this issue to occur is because the lactate uptake by the liver is reduced. The cause behind this is that lactate is a known substrate for hepatic glycogenesis, a process that the drug suppresses. This kind of issue can be treated with sodium bicarbonate. One must make sure to avoid high dosage in order to avoid this issue.
  • Overdose: There are cases where poisoning was caused due to an overdose of the drug. The elderly people are more prone to this kind of issue. Death because of this drug overdose is rare. The common symptoms of overdosage are nausea, vomiting, abdominal pain and discomfort, drowsiness, hyperglycemia or hypoglycemia. Supportive treatment is provided in such issues. Extracorporeal treatment is performed to deal with overdosage situations.

Can Metformin Cause Weight Loss?

Metformin can indeed make us lose weight. It occurs because our appetite is decreased because of the drug and we are prompted to eat less. Also, when we start taking this drug, the pattern of using fat in our body changes and there is a change even in the way our body stores fat. Although, such loss in weight can take a long time. It typically takes a year or two before we shed any fat, even belly fat. The weight loss is not too much either. It is found to be around 6 to 8 pounds. This loss is also subject to the condition that we are engaged in some, or the other physical activity. The weight loss stops once we stop the medication and thus the loss is not permanent. It is prescribed to obese or overweight people who suffer from type 2 diabetes. At times, a doctor may prescribe it just for the weight loss but this kind of usage is still not approved.

Metformin 500 Mg

It is a first line drug to control high glucose level in the body. One must exercise and maintain a healthy diet when taking this drug. The side effects and uses of this drug are almost the same as metformin. The peak effect of this drug is seen after 3 hours after the drug is administered. It lasts in the body for 4 to 8 hours depending upon the condition and age. The amount to be taken must be according to the prescription of an expert. Metformin 500 mg must not be used in the following conditions:

  • It is not to be taken in case of severe kidney or liver impairment.
  • It should not be given to a pregnant woman.
  • It should not be administered to a nursing mother.
  • It must be discontinued in case of allergies.
  • It must not be taken in case of metabolic acidosis.

Metformin Hydrochloride (HCL):

These are white round tablets that are used for the treatment of diabetes mellitus. It can be administered alone or in combination with other oral anti-diabetic drugs or insulin. It must not be administered to children less than 10 years of age. It belongs to the drug group of biguanide and is a hypoglycemic agent.

It is a hydrochloric salt of metformin with antihyperglycemic and antineoplastic activities. It inhibits complex 1. It prevents hepatic glycogenesis and leads to high insulin sensitivity.

This was all from our side on metformin. Still, have lingering questions and doubts? Please shoot it at us in the comments section below. Feel free to write your views and advises. Have a great time ahead and don’t forget to live beautifully!