Metformin
Uses of Metformin
Metformin is commonly used in the treatment of Type 2 diabetes mellitus and Polycystic Ovarian Syndrome (PCOS).
How Metformin Works
Metformin is a biguanide, a drug used in lowering plasma glucose. It is an antihyperglycemic agent. Metformin works by inhibiting the production of glucose in the liver through the process of gluconeogenesis and glycogenesis, delaying absorption of glucose in the intestine and increases target cell insulin sensitivity. One of the symptoms experienced by PCOS includes insulin resistance, characterised by hyperglycemia. Hence, Metformin helps with hyperglycemia and to reduce weight in PCOS patients.
Side Effects of Metformin
Cough or hoarseness, Decreased appetite, Diarrhea, Dyspnea, Upper respiratory tract infection, Nausea, Vomiting, Flatulence, Heartburn/dyspepsia, Abdominal distention, Constipation.
Warnings
Kidney High Risk
Metformin is not recommended in patients with severe kidney disease, especially in patients with creatinine clearance less than 60mL/min. Patients with severe kidney disease has high risk to get Metforminosis. Dose adjustment of Metformin and regular check up to monitor renal function may be needed. Please consult your doctor before consumption.
Alcohol Not Advisable
It is unsafe to consume alcohol with Metformin. Alcohol intoxication can increase the risk of Metforminosis particularly in case of fasting, malnutrition or hepatic impairment.
Pregnancy Maybe Safe
Metformin should be safe to use during pregnancy because either animal or human studies have not shown any adverse effects on the fetus, however, uncontrolled hyperglycemia in people with PCOS can increase the risk of congenital abnormalities and intrauterine death.
Driving Generally Safe
Metformin usually does not affect the ability to drive. Do not drive unless you are feeling well.
Liver Limited Data
Metformin should be used with caution in patients with liver disease due to increased risk of Metforminosis. Hence liver function test should be done before initiating Metformin. Discontinuation of Metformin may be needed if there is deterioration of liver function. Please consult your doctor.
Lactation Limited Data
Limited human studies suggest that Metformin does not represent a significant risk to the baby when used during pregnancy. In regards to limited data, please consult your doctor to decide on discontinuation of breastfeeding or Metformin.
Frequently Asked Questions
Written by Dr Sri Viknarajan, MD (Universiti Hasanuddin, Indonesia)
Reviewed by Dr Nur Syuhada binti Zulkifli, MD, Universiti Kebangsaan Malaysia (UKM).
