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What Is Metformin HCl Used For?

Metformin hydrochloride (HCl) is a prescription drug used in the treatment of type 2 diabetes. It is available under several brand names and as a generic drug. Metformin can be prescribed alone or in conjunction with other drugs for diabetes. It is available in extended-release formulas and in compound formulas with other drugs.

  1. Pharmaceutical Class and Brand Names

    • Metformin HCl is an oral antihyperglycemic in the biguanide class. Its full chemical name is N,N-dimethylimidodicarbonimidicdiamide hydrochloride. Brand names include Actoplus Met, Avandamet (a compound with rosiglitazone), Fortamet Extended-Release and Glucophage.

    Mechanism of Action

    • Metformin HCl improves glucose tolerance in patients with type 2 diabetes. It works by decreasing glucose production in the liver and glucose absorption in the intestine, and increasing glucose uptake and utilization in the peripheral cells of the body. Excess blood sugar levels are reduced without changing insulin secretion.

    Dosage and Administration

    • Dosing of metformin HCl varies greatly from formula to formula. Immediate-release metformin is usually taken twice daily. Extended-release formulations are taken once daily, usually after dinner. Different patients will require different dosing strategies.

    Side Effects

    • Common side effects of metformin include headache, weakness, dizziness, drowsiness, agitation, nausea, vomiting and diarrhea. Dangerous side effects include thrombocytopenia (low blood platelet count; signs include easy bruising) and lactic acidosis (a change in the body's metabolism; signs include muscle and abdominal pains). Report any side effects to the prescribing doctor immediately.

    Contraindications and Interactions

    • Metformin should not be used by anyone with liver, kidney or heart disease; alcoholism; a history of lactic acidosis; or a sensitivity to the drug. Metformin can interact with several common medications, including estrogens and oral contraceptives; morphine and other painkillers; diuretics; corticosteroids; and several heart medications. Inform the prescribing doctor of all medications and supplements you are taking.

    Considerations

    • When taking metformin, be alert for symptoms of lactic acidosis: hyperventilation, fatigue, malaise, muscle pains, and unexplained sleepiness. This is a life-threatening condition and must be treated immediately.
      Blood tests should be performed before starting metformin and a complete blood count (CBC) should be run every three months during treatment.
      Liver function tests, blood urea nitrogen (BUN) and creatinine level should also be checked regularly. These tests will identify potential dangerous effects of the drug.
      Monitor blood glucose levels regularly, and follow any dietary instructions closely.

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