Metformin
Synonyms in a broader sense
Diabetes medication, medication Diabetes mellitus, Biguanide, Glucophage®, Mescorit®, Diabesin®, Siofor®
How do biguanides like metformin work?
According to the medical guidelines currently in force, metformin is first used when diabetes mellitus cannot be controlled well through exercise, sport and weight loss. Metformin has been on the market for decades and has proven to be the safest and most effective agent in the group of oral anti-diabetic drugs.
Info: package insert
Don't let the length of the package insert put you off! The longer a drug has been on the market, the more detailed it explains its side effects! The legislator has made it mandatory that every rare side effect that has occurred over the course of many years of use of a drug must be mentioned on the package insert.
Metformin has two main effects that help a diabetic:
On the one hand, the body cells are opposite to the self-produced insulin more sensitive and ready to absorb sugar again. As a result, the blood sugar level drops faster again after eating and the sugar cannot cause any damage elsewhere.
Metformin, on the other hand, inhibits the release of glucose from the liver, which means that the sugar levels do not reach dangerous peaks when fasting or at night.
The unwanted high blood sugar levels in the morning are effectively treated with metformin. The general low blood sugar levels during metformin therapy also reduce the appetite somewhat, which is particularly desirable in overweight diabetics. Metformin also has a beneficial effect on blood lipid levels and blood clotting. Especially in patients with a risk of heart attack (see Coronary artery disease / CHD and Heart attack) Studies have shown that metformin reduces mortality.
dosage
Metformin will one to three times a day with meals taken. You have agreed the dosage with your doctor beforehand. You start off with a low dose and then increase your metformin intake up to a maximum of 1 gram per day. To the function of the kidney, of the liver and to check the correct dosage of the drug, your doctor will call you regularly.
Side effects
Metformin can Gastrointestinal complaints how
- Bloating
- Loss of appetite
- stomach pain
- nausea
- Vomit
and - diarrhea
cause.
In some patients, a change in taste in the sense of a metallic perception in the mouth was also observed.
Further Side effects are skin reactions (redness, itching, hives), decrease in vitamin B12 absorption Anemia (megaloblastic anemia), Liver dysfunction and Inflammation of the liver (hepatitis).
There is one dreaded undesirable effect that rarely or never occurs with regular medical check-ups and precise intake: if too much lactic acid accumulates in the blood, it can lead to one Lactic acidosis lead that can be fatal. Even with acute dehydration of the body (desiccosis) or fever lactic acidosis can occur. Lactic acidosis is announced by symptoms such as strong stomach jokes, nausea, Vomit, Freezing, dizziness, fatigue, Muscle aches, Impaired consciousness and breathing problems. If you should experience these or similar symptoms while taking metformin, you must consult a doctor immediately.
It should be mentioned again at this point that lactic acidosis is only Rare occurs!
If you and your doctor observe all the counter-signs of taking metformin, the organ functions are checked regularly and you are taking the medication as prescribed, you must be aware of this serious side effect never fear!
While using metformin should refrained from alcoholic beverages and food become.
Read extensive information on the side effects under our topic: Side effects of metformin
diarrhea
Treatment with metformin very often leads to gastrointestinal complaints. It just doesn't come to nausea, Vomit, constipation and Flatulence, but also very common too diarrhea. In principle, diarrhea is not a major problem, provided it is only weak or has disappeared after a few days. However, if there is a long-lasting impairment due to diarrhea in the course of therapy, you should urgently consult a doctor. What sounds so harmless can cause big problems. With diarrhea, patients not only often lose valuable kilos, but also a great deal liquid. This can often become very quick dry out or also to Kidney damage to lead. It is important to the body sufficient fluids, electrolytes and minerals are fed. If you can't do it yourself for whatever reason, you have to urgently Infusions Administer in the hospital or at the family doctor. In addition, it must be discussed with the responsible doctor whether the therapy may be replaced by another in order to counteract gastrointestinal complaints and restore quality of life.
Lactic acidosis
The Lactic acidosis is a rather rare, but no less dangerous side effect of therapy with metformin and also of excessive alcohol consumption in connection with the drug metformin. Lactic acidosis means that Blood in the body and the tissues become acidic is. So you have one low pH, because increased in the body Lactate is available. Lactate is the anion of lactic acid and is the end product of anaerobic glycolysis. Lactic acidosis occurs predominantly in those patients who have kidney and / or liver disease in addition to diabetes. It is important that the function of these organs is checked before starting therapy with metformin. Lactic acidosis is a special form of metabolic disease AcidosisHowever, it is easy to differentiate between them, since lactic acidosis not only has a lower pH value, but, as I said, also increases the lactate value. The disorder is caused by a disturbed metabolism in which lactate can no longer be broken down sufficiently. In lactic acidosis, it is not enough to just treat the symptoms; it is important to find the cause and correct it. Possible symptoms of this disorder include deeper ones breathing, stomach pain, nausea and in particularly severe forms it can go up to shock or Kidney failure to lead.
For more information, see: Lactatacidosis
When should you not take metformin?
In order to avoid the undesirable effects of taking metformin, the following counter-signs should be observed.
If your Kidneys just work inadequately, should be metformin Not be taken. Just at Diabetics kidney performance is often limited. Your doctor will check your blood for a certain kidney value (creatinine) and thus assess the organ performance. At a With a creatinine value above 1.2 mg / dl, kidney performance is too lowto be responsible for treatment with metformin. The risk of lactic acidosis would be too great. However, for laboratory reasons, blood values always have a relative value. You should therefore trust the individual assessment by your treating doctor.
Metformin and the desire to have children
If pregnancy is desired and diabetes is present, the patient should not be treated with metformin.
Instead, it makes sense to adjust the blood sugar value with the help of insulin syringes, whereby the attending doctor must check the values regularly.
Treatment with metformin should also be avoided during pregnancy and therapy should be continued with insulin injections until the child has been weaned. Only then can the therapy be switched to metformin without harming the child.
Metformin and Weight Loss
When in overweight adult patients Diet measures fail and already one Diabetes (Type 2 diabetes mellitus) is present, metformin can lead to a Lowering the risk for diabetes-related complications. In these cases, metformin is the first choice therapy.
Taking the drug metformin represents no weight loss aid in the classic sense, but interferes with the body's sugar balance.
To lose weight is one Diet change and regular exercise unavoidable, otherwise you may gain weight while taking metformin.
Polycystic Ovary Syndrome (PCO)
The PCO Syndrome is one Metabolic diseasewhich affects women and is very common. PCO is short for Polycystic Ovary Syndrome. The disease affects sexually mature women in whom the Hormone production not true. Too many male hormones (Androgens), which also brings typical features such as male hair with it. Most patients also suffer from Menstrual cycle disorders and infertility. The causes of this disease are diverse and not yet sufficiently clarified. But one suspects that genetic Underlying factors and it is noticeable that many overweight Women suffer from the disease. Those affected also often suffer from Hair loss and badly blemished skin. The disease is often discovered very late, usually when a unfulfilled desire to have children consists. The disease can be due to a hormonal status, a good one anamnese and physical exam, as well Ultrasonic be diagnosed. In order for the disease to be declared as a polycystic ovary syndrome, at least two of the three symptoms must be present. And cycle disorders, Cysts in the uterus and androgen levels that are too high. There are many options for therapy, such as Medication (for example metformin), an operation to remove the cysts, administration and adjustment of hormones, changes in diet and in all cases where Obesity one issue is definitely weight loss.
For more information, see: Metformin PCO
Planned operations under metformin
At operational interventions or examinations in which a contrast agent is used (Cardiac catheter; Computed Tomography) comes, the Kidneys strongly challenged. For this reason, metformin should be stopped two days before such procedures. It can be resumed no earlier than two days after the procedure.
For infections of the lower urinary tract (Cystitis, Pelvic inflammation) the use of metformin should be interrupted, as the kidney function may be impaired due to the infection.
Should a limitation of the Liver function your doctor will be very careful about taking metformin. Here it depends on the individual Liver values that your doctor will check.
If the blood sugar level is already very high around 250 mg / dl and acidosis (blood acid) has already occurred, the intake of metformin should initially be avoided.
In the case of acute, serious illnesses or severe injuries, the body is more likely to accumulate acids. Even with acute gastrointestinal diseases, the body loses a lot of fluids and minerals, which favors an "acidification" of the body and the risk of it Lactic acidosis promotes.
If your body has a Lung disease (asthma, Chronic bronchitis, COPD) or one Heart disease (coronary heart desease, Angina pectoris, State after Heart attack) or another Circulatory disorder (Intermittent claudication, arterial occlusive disease (PAOD), Smoker's leg) is insufficiently supplied with oxygen, metformin should not be taken due to the risk of lactic acidosis.
If you're at a Alcohol sickness do not take metformin. Copious consumption of alcohol, be it continuously or only occasionally, will increase the liver heavily loaded. The accumulation of acids in the blood and thus the risk of lactic acidosis are favored. You should limit your alcohol consumption to a low level while taking metformin! A glass of wine or a beer with a meal a day is acceptable, however.
Interactions
The combination with other blood sugar lowering drugs (antidiabetic agents) can be a Hypoglycaemia (Hypoglycemia) favor. Other drugs can in turn increase the effect of the metformin itself and make a dose reduction necessary. Which includes Heartburn medication and drugs that are used in high blood pressure be used (ACE inhibitors: Enalapril, Verapamil, Captopril, Ramipril, Lisinopril). If you regularly take pain or rheumatic drugs (Diclofenac, Ibuprofen, Indomethacin, Piroxicam), the effect of metformin is increased. A dose reduction is absolutely necessary under medical supervision in order to avoid the risk of lactic acidosis!
Metformin and alcohol
If you take metformin, the excessive consumption of alcohol harbors a number of dangers that should be taken seriously in any case. A particularly important point is that you can Drunk much faster is than without taking the drug. It is very easy to overlook the point when alcohol is enough. The drug does not lose its effect, but it increases that of alcohol drastically. Are not uncommon Alcohol poisoning recorded when metformin users do not have alcohol consumption under control. However, it is usually not a problem to drink a small amount of alcohol. It should be noted that men are allowed to drink almost twice as much as women. Not only is the effect of the alcohol increased, it can also lead to further complications. There is a risk of a Lactic acidosis, which is described above, and the risk of Hypoglycaemiawhich, if not treated immediately, can be seriously dangerous.
Exclusion of liability / disclaimer
We would like to point out that medication must never be discontinued, applied or changed independently without consulting your doctor.
Please note that we cannot claim that our texts are complete or correct. The information may be out of date due to current developments.
