Metformin

GP and surgeon, Dr Shane Charles (MBBS, MRCS, PgDip SEM) provides a simple explanation of the medication below:

'Metformin is an antidiabetic medication that works by lowering blood glucose levels and increasing insulin sensitivity. '.

If you think Metformin is a treatment that can help you, start an online consultation now for a registered prescriber to review. If treatment is deemed suitable, they can prescribe it, and we can deliver it to you from the comfort of your own home with a range of convenient delivery and payment options for you to choose from. If you have any questions about a medication, you should always consult your doctor with any questions prior to starting treatment, to ensure that it is safe and suitable for you.

What is Metformin?

Metformin Diabetes

Metformin is a prescription medicine used to manage and treat type 2 diabetes and gestational diabetes (diabetes during pregnancy). It may also help prevent type 2 diabetes in people who are at high risk of developing it.

Type 2 diabetes happens when the body either doesn’t make enough insulin or the insulin doesn’t work properly. This causes high blood sugar levels, which can lead to serious health problems if not managed.

Metformin is often prescribed when diet and exercise alone are not enough to control blood sugar levels. It works by lowering the amount of sugar your liver makes and helping your body respond better to insulin.

If you're concerned about managing diabetes, speak to your GP or a healthcare provider to see if Metformin could be right for you.

How Does Metformin Work?

Metformin helps to lower blood sugar levels in three main ways:

1. Reduces sugar production – It tells your liver to make less glucose (sugar).
2. Improves insulin use – It helps your muscles use insulin better, so sugar moves out of your blood and into your muscles for energy.
3. Absorbs less sugar – It makes your intestines take in less glucose from the food you eat.

This all helps to keep your blood sugar levels under control and reduce the risks linked to high blood sugar. Always follow your doctor’s advice when taking Metformin.

Metformin is a medicine that helps control blood sugar levels. It works by:

1. Improving insulin response – It helps your body respond better to insulin, which is the hormone that moves sugar from your blood into your cells for energy.
2. Reducing sugar production – It lowers the amount of sugar your liver makes.
3. Limiting sugar absorption – It reduces how much sugar your stomach and intestines take in from food.

In people with type 2 diabetes, the insulin made by their pancreas struggles to move sugar into the cells where it’s needed. Metformin helps lower high blood sugar levels and supports your body in turning food into energy more effectively.

Metformin is also sometimes prescribed to manage polycystic ovary syndrome (PCOS). By reducing insulin and blood sugar levels, it can improve ovulation and regulate periods, even in people without diabetes. However, it is not officially approved for PCOS in the UK, so always speak to your doctor to make sure it’s safe and suitable for your needs.

For personalised advice, consult a healthcare professional.

How do I know if Metformin is working for me?

You can tell Metformin is working if you notice:

• Lower blood sugar levels – Your blood sugar readings are closer to normal.
• Improved HbA1c levels – This is a blood test that shows your average blood sugar over a few months. Lower numbers mean better control.
• Weight changes – Some people lose weight or avoid gaining extra weight.

Everyone’s experience can be different, so if you’re unsure whether Metformin is helping, it’s important to talk to your doctor. They can check your progress and make any needed adjustments.

Video: A Guide to Metformin

UK Meds have created a video guide to explain what Metformin is. Watch it below:

@uk.meds

What is Metformin? @uk.meds #MedsTok #metformin #diabetes #pcos

♬ original sound - UK.Meds

What are benefits of taking Metformin?

You can tell Metformin is working if you notice:

• Lower blood sugar levels – Your blood sugar readings are closer to normal.
• Improved HbA1c levels – This is a blood test that shows your average blood sugar over a few months. Lower numbers mean better control.
• Weight changes – Some people lose weight or avoid gaining extra weight.

Everyone’s experience can be different, so if you’re unsure whether Metformin is helping, it’s important to talk to your doctor. They can check your progress and make any needed adjustments.

Metformin offers several benefits for people with type 2 diabetes:

1. Improves insulin response – It helps your body use insulin more effectively.
2. Lowers sugar production and absorption – It reduces the amount of sugar made by your liver and absorbed from food.

By controlling blood sugar, Metformin also helps reduce the risk of serious complications of diabetes, including:

• Kidney damage
• Nerve problems
• Blindness
• Limb loss
• Sexual health problems
• Heart attacks or strokes

Taking Metformin as prescribed can help protect your overall health and prevent long-term issues caused by high blood sugar. Always speak with your doctor to ensure it's the right treatment for you.

Each type-2 diabetes patient has a unique individual experience when taking Metformin tablets as a treatment prescribed by their doctor.

Metformin Reviews

There are a large selection of Metformin reviews describing what people think about their experiences with the medication available above from other UK Meds customers and also at Drugs.com and Web MD.

It is important to note that people may have different experiences when they use Metformin. If someone states that their medication did not work as they had hoped, it does not mean that it will not work for you. If you believe that Metformin tablets are the right medication for you then the best thing to do is to consult your doctor or healthcare professional, and judge the medication based on your own experiences if they recommend it as a treatment.

For more information on the prescription medication patients should refer to the Metformin patient information leaflet.

How do I use Metformin?

Using Metformin correctly is important to manage your diabetes effectively:

1. Read the leaflet – Always read the patient information leaflet that comes with your medicine, even if you've used it before.
2. Follow your doctor’s instructions – Take Metformin as prescribed, usually 1–3 times a day with meals. Drink plenty of fluids unless your doctor advises otherwise.
3. Dosage adjustments – Your doctor may start you on a low dose to minimise side effects, gradually increasing it over time.
4. Switching medications – If you’re on another diabetes medicine, follow your doctor’s guidance on how to stop or combine it with Metformin.
5. Monitor blood sugar – Regularly check your blood sugar levels and share results with your doctor, especially if your readings are too high or too low. Your doctor may adjust your treatment as needed.

How long do I take Metformin for?

Metformin is usually taken for life to manage diabetes. However, if you develop conditions like kidney problems or experience side effects, your doctor may switch you to another medicine. Never stop taking Metformin without consulting your doctor, as this can cause blood sugar spikes and worsen your diabetes.

By following your doctor’s advice and monitoring your health, Metformin can help you effectively manage your condition.

What is the typical dosage for Metformin?

The dosage of Metformin depends on your needs and how your body responds to treatment.

Metformin 500mg or 850mg

• Starting Dose: Usually 500mg or 850mg, taken 2–3 times daily with meals or after eating.
• Adjusting Dose: After 10–15 days, your doctor may adjust your dose based on your blood sugar levels. Slowly increasing the dose can reduce side effects.
• Maximum Dose: The highest recommended dose is 3,000mg daily, divided into three doses.
• Switching Medications: If you’re switching from another diabetes medicine, your doctor will stop the old one and start you on Metformin at the usual starting dose.

Dosage Example

For standard 500mg tablets:

• You may take up to 4 tablets daily, with a maximum dose of 2,000mg per day.

Can Dosages Change Over Time?

Yes, your doctor may adjust your dosage based on your blood sugar levels. When starting, your dose is increased gradually to reduce side effects:

• Week 1: 500mg with or after breakfast.
• Week 2: 500mg with or after breakfast and your evening meal.
• Week 3: 500mg with or after breakfast, lunch, and evening meal.

Always follow your doctor’s instructions for a safe and effective dosage.

What Should I Do If I Miss a Dose of Metformin?

If you forget to take your dose:

• Skip the missed dose – Do not double up to make up for it.
• Take your next dose as usual at the regular time.

Can You Overdose on Metformin?

Yes, taking too much Metformin can cause lactic acidosis, a rare but serious condition. Watch for these symptoms:

• Extreme tiredness
• Fast heart rate
• Trouble breathing
• Muscle cramps
• Fever
• Stomach pain
• Vomiting or feeling unwell

If you think you’ve taken too much, stop taking Metformin and call NHS 111 or go to A&E immediately. Always take the exact dose prescribed by your doctor to avoid complications.

For personalised advice, consult with your healthcare provider.

What are common side effects of Metformin?

Like all medicines, Metformin can cause side effects, but not everyone will experience them. Common side effects occur in more than 1 in 100 people.

Common Side Effects and How to Manage Them

If these side effects persist or bother you, consult your doctor.

How Long Do Metformin Side Effects Last?

Most side effects are mild and should subside as your body adjusts to the medication. However, if they continue, speak to your doctor.

Can Metformin Cause Serious Side Effects?

Serious side effects are rare, occurring in less than 1 in 10,000 people.

Call your doctor or 111 immediately if you experience:

• Severe tiredness, shallow breathing, or feeling cold (possible signs of lactic acidosis).
• Yellowing of the eyes or skin (jaundice), which could indicate liver problems.
• Symptoms of a severe allergic reaction (anaphylaxis).

Low Blood Sugar (Hypoglycaemia)

Metformin usually doesn’t cause low blood sugar unless combined with other diabetes medicines like insulin.

Signs of Low Blood Sugar:

• Feeling hungry
• Shaking or trembling
• Sweating
• Confusion or difficulty concentrating

Low blood sugar can also occur at night, causing you to wake up feeling sweaty, tired, or confused.

Common Triggers for Low Blood Sugar:

• Skipping meals or fasting
• Taking too much diabetes medication
• Exercising without eating enough carbohydrates
• Drinking alcohol on an empty stomach
• Other health conditions like kidney or liver issues

How to Prevent and Manage Low Blood Sugar

1. Eat Regularly – Don’t skip meals and include carbohydrates like bread, pasta, or cereal.
2. Prepare for Exercise – Eat a carbohydrate-rich snack before or after exercising.
3. Carry Fast-Acting Sugars – Always have sweets, fruit juice, or sugar cubes with you in case your blood sugar drops.
4. Educate Your Support Network – Make sure friends and family know how to recognise and help with low blood sugar symptoms.

When to Seek Help:

If eating sugar doesn’t improve your symptoms or they keep returning, call your doctor or 111 immediately.

By following these tips and working closely with your doctor, you can manage any side effects of Metformin effectively.

Who Should Not Take Metformin?

Metformin isn’t suitable for everyone. Avoid taking Metformin if:

• You have severe kidney disease, metabolic acidosis, or diabetic ketoacidosis. Contact your doctor for alternative treatments.
• You are allergic to Metformin.

Before Taking Metformin

Let your doctor know if you:

• Have had kidney, heart, or liver disease, or high ketone levels in your blood.
• Use insulin or other diabetes medications.
• Are scheduled for surgery or an x-ray with injected dye. You may need to temporarily stop Metformin.

Risks and Precautions

• Lactic Acidosis: A rare but serious condition where lactic acid builds up in the blood. Symptoms include unusual muscle pain, trouble breathing, dizziness, or feeling very weak. Seek urgent medical help if you experience these.
• Higher Risk Groups: If you are over 65, have severe infections, chronic alcoholism, or other medical conditions, your risk of lactic acidosis may increase.
• Unintended Pregnancy: Metformin may stimulate ovulation in premenopausal women. Discuss contraception with your doctor.
• Breastfeeding: Do not breastfeed unless your doctor confirms it’s safe.
• Children: Metformin is not recommended for children under 10, and some forms are not approved for those under 18.

Interactions

Metformin can interact with other medicines, making it less effective or unsafe. Let your doctor or pharmacist know about any medications you’re taking, including:

• High blood pressure medicines
• Beta-2 agonists (e.g., salbutamol for asthma)
• NSAIDs (e.g., ibuprofen)
• Diuretics
• Corticosteroids
• Medicines that affect Metformin levels (e.g., rifampicin, trimethoprim, dolutegravir).
• Other diabetes medicines

Avoid excessive alcohol, as it increases the risk of lactic acidosis.

Is Metformin Safe During Pregnancy?

Yes, Metformin is safe during pregnancy and may be used alone or with insulin. Managing diabetes during pregnancy is essential to prevent complications for both mother and baby. Always follow your doctor’s instructions.

Can You Take Metformin While Breastfeeding?

Yes, Metformin is safe while breastfeeding if your baby is healthy. It passes into breast milk in tiny amounts and is unlikely to cause side effects in breastfed babies. However, contact a healthcare professional if your baby shows signs such as:

• Unusual restlessness, irritability, or sleepiness
• Pale or sweaty skin
• Feeding difficulties or increased hunger
• Any other concerning symptoms

Final Advice

Always consult your doctor, midwife, or pharmacist before starting Metformin, especially if you are pregnant, breastfeeding, or taking other medications. For any unusual symptoms or concerns, seek medical advice promptly.

UK Meds spoke with Dr. Ibrahim Alrabi to get answers to the common questions you’ve asked us about the diabetes and PCOS treatment, Metformin.

Below UK Meds answer some of your most commonly asked questions about the diabetes medication:

Can metformin cause diarrhoea?

Yes, diarrhoea is one of the most common side effects of metformin. Most common side effects of using metformin are related to the stomach including abdominal pain, nausea, indigestion and a loss of appetite (Foss & Clement, 2012).

Does Metformin make you tired?

Metformin can cause vitamin B12 deficiency if taken for a long time, which can make you feel very tired, breathless, and faint. Your doctor may check your vitamin B12 levels and, if they're too low, recommend vitamin B12 supplements.

Does Metformin cause weight gain?

No, Metformin does not cause weight gain.

Does Metformin help you lose weight?

Metformin isn't a magic weight loss pill and is primarily a treatment for diabetes in the UK. However, it might help you lose a modest amount of weight and prevent weight gain (WebMD, 2023).

You probably won't lose as much weight with metformin as with other diabetes drugs like semaglutide (Ozempic, Wegovy) or tirzepatide (Mounjaro). The MHRA has approved Wegovy and Mounjaro for treating weight loss specifically.

Metformin's weight-loss effects aren't consistent enough for it to be considered a weight-loss drug, and it can't replace a healthy diet and regular exercise.

Speak to your doctor for advice on how different medications can help you, to ensure that they are safe and suitable for your individual medical needs.

Does Metformin cause Dementia?

There is no evidence that Metformin causes dementia. Some studies suggest that taking Metformin might even reduce the risk of developing dementia later in life (Chin-Hsiao, T., 2019; Ji et al, 2022; Huang et al, 2023). However, you should only take Metformin for the condition it has been prescribed for.

Does Metformin cause high blood pressure?

No, Metformin will not increase blood pressure. In fact, it can help lower it by improving insulin resistance and reducing blood sugar production in the liver. Better blood sugar control helps prevent damage to blood vessels that leads to high blood pressure. A study even suggests that Metformin has no significant impact on increasing blood pressure in hypertension (Snorgaard et al, 1997). If you have high blood pressure, there are treatments available to help manage it.

How Can I Buy Metformin Online?

You can safely purchase Metformin online at UK Meds. Before placing an order, you’ll need to complete an online consultation with a registered independent prescriber. If the doctor determines that Metformin is suitable for your condition, you can proceed with your order. This process ensures the medication is appropriate for your health needs. You'll be issued a free prescription for the purpose of your order, if approved.

Do I Need a Prescription to Buy Metformin?

Yes, Metformin is a prescription-only medicine. You can:

• Obtain a prescription from your GP and provide it to UK Meds.
• Complete UK Meds’ online clinical consultation. A registered independent prescriber will review your information and decide whether to prescribe Metformin.

Can I Get Metformin on the NHS?

Yes, Metformin is available on the NHS. If you have diabetes, you are eligible for free prescriptions for all related medications, including Metformin. Your doctor can help you apply for a medical exemption certificate to cover your prescriptions.

For more details or to begin your online consultation, choose UK Meds.

Are there any alternative diabetes treatments to Metformin?

If Metformin isn’t suitable for you, other diabetes medications are available. These include:

• Ozempic (semaglutide) – An injectable medication.
• Mounjaro (tirzepatide) – Another injectable option.
• Glucophage SR – A slow-release version of Metformin.
• Gliclazide – A tablet that helps control blood sugar.
• Jardiance – A tablet that helps the body remove excess sugar through urine.

Your doctor will guide you in choosing the best medication based on your health needs.

• Metformin - NHS
• Metformin and Reduced Vitamin B12 Levels - GOV.UK
• Metformin - Drugs.com
• Metformin for Diabetes - Patient.info
• Metformin Oral - WebMD
• Metformin - EMC
• Metformin Containing Medicines - EMA
• Metformin Hydrochloride - BNF
• Metformin - ScienceDirect
• Metformin Oral Route - Mayo Clinic

• A Beginner's Guide to Metformin: A Treatment For Diabetes
• Metformin & Weight Loss: Understanding The Link
• Doctor's Corner: Your Questions About Metformin Answered By A Doctor
• Difference between type 1 and type 2 diabetes