Metforem
Metforem (metformin hydrochloride) helps lower high blood sugar by reducing sugar production in the liver and improving how your body uses sugar.
How to Use
Dosage
The typical starting dose for adults is 500 mg, taken 2 to 3 times a day. For children 10 years and older, the typical starting dose is 500 mg once a day.
Method
Take Metforem with or after a meal. You can divide the tablet, but do not crush or chew it before swallowing.
The maximum daily dose for adults is 3 grams, divided into three doses. For children 10 years and older, the maximum daily dose is 2 grams, divided into two or three doses.
Possible Side Effects
- •Diarrhea
- •Vomiting
- •Nausea
- •Stomach pain
- •Loss of appetite
- •Taste disturbance (metallic taste in the mouth)
- •Low vitamin B12 levels in the blood
- •Abnormal liver function tests or liver inflammation (these usually improve after stopping Metforem)
- •Skin reactions like redness, itching, or hives
Important Warnings
- Do not take if you are allergic to metformin or any other ingredient in this medicine.
- Do not take if you have severe kidney problems.
- Do not take if your diabetes is not well-controlled (high blood sugar, nausea, vomiting, diarrhea, rapid weight loss) or if you have ketoacidosis. Symptoms of ketoacidosis include stomach pain, fast and deep breathing, drowsiness, or a fruity smell in your breath.
- Do not take if you are severely dehydrated (e.g., due to long-term diarrhea or vomiting). Stop taking the medicine and contact a doctor if you have a condition that may lead to dehydration (e.g., severe vomiting, diarrhea, fever, drinking less).
- Do not take if you have liver disease or severe heart, blood vessel, and/or lung disease.
Show 5 more warnings
- Do not take if you regularly or heavily drink alcohol. Avoid excessive alcohol during Metforem treatment as it can increase the risk of lactic acidosis.
- Do not take if you have a bacterial or viral infection that has not yet been treated.
- Do not take if you are having surgery or an imaging procedure with contrast. Metforem treatment must be stopped before and for some time after the procedure or imaging. Your doctor will decide when to stop and restart treatment.
- Stop taking Metforem and contact your doctor or nearest hospital immediately if you have symptoms of lactic acidosis, as it can lead to coma. Symptoms include vomiting, stomach pain, muscle cramps, a general feeling of being unwell and severe tiredness, difficulty breathing, decreased body temperature, and slowed heart rate.
- Contact your doctor if you have an inherited disease affecting mitochondria (like MELAS or MIDD diabetes) or if you experience seizures, impaired cognitive abilities, difficulty moving, symptoms suggesting nerve damage (like pain or numbness), migraine, or deafness.
Use in Elderly Patients
Suitable for older adults, with specific precautions. Reduce the dose already in mild renal impairment. Do not use in severe renal impairment or tissue hypoxia. May reduce the absorption of vitamin B12. Consider risk of lactic acidosis. The drug should be paused during fever, gastroenteritis or dehydration, and before surgery or imaging with a contrast agent. (updated 20.5.2024)