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Metformin Hcl Side Effects

Metformin hydrochloride is an oral medication used in the treatment of Type 2 diabetes mellitus. Metformin controls blood glucose levels by reducing production of glucose by the liver, increasing the body's sensitivity to the activity of internal insulin and decreasing intestinal absorption of glucose. Metformin may also be used in the treatment of infertility secondary to polycystic ovary disease.

Metformin is marketed under its generic name as well as the brand name products Glucophage and Glucophage XR. It is also a secondary ingredient in certain combination products used for diabetes.

GI effects are the most commonly experienced with metformin therapy, but other effects have also been reported.

  1. Gastrointestinal/Hepatic Effects

    • Metformin patients may commonly experience gastric distress in the form of flatulence, nausea, vomiting or diarrhea. Indigestion, abnormal stool, abdominal discomfort, heartburn, dry mouth and taste disturbances occur less often.

    Circulatory and Respiratory System Effects

    • Discomfort in the chest, flushing and palpitations have been noted with metformin use. An increased frequency of upper-respiratory infection and/or shortness of breath may also occur.

    Metabolic and Endocrine Effects

    • Lower than desired blood sugar levels have also been reported with metformin use. Some patients may experience a decrease in Vitamin B12 levels. A rare but serious condition, lactic acidosis, may occur if metformin levels accumulate in the body. Patients with altered renal function should be monitored closely during metformin therapy. In patients undergoing procedures involving iodine-based dyes, metformin should be discontinued for 48 hours after the procedure.

    Dermatologic Effects

    • Metformin make cause a rash in some patients. Nail disorders have also been noted.

    Central Nervous System and Musculoskeletal Effects

    • Dizziness, lightheadedness, chills, sweating and headache have been reported. Muscle pain or weakness may also occur.

    Other Useful Information and Precautions

    • Metformin should be taken with food. Metformin typically will not cause low blood sugar by itself, but patients should still be educated on signs and symptoms of both low and high blood sugar, and should not skip meals. Extended-release formulations should be swallowed whole, never crushed or chewed. Patients with renal or liver failure should avoid metformin therapy in favor of alternative agents.

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