Do you also have Type 2 Diabetes? If so, there is a good chance that your doctor has prescribed you a medicine called Metformin. Today we are talking about this very common medicine among us in Sri Lanka, which is used by many people to control diabetes. We will look at everything in a very simple and understandable way, such as how to take it, what things to be careful about, and whether there are any side effects.
What exactly is Metformin?
Simply put, Metformin is a medication given to people with type 2 diabetes. It mainly works by controlling your blood sugar levels, or glucose levels. It also helps your body use the hormone insulin properly.
Doctors usually prescribe this medication along with a good diet and exercise. Taking the medication alone is not enough, you need to take care of those things as well. Sometimes this medication may be prescribed not only for diabetes, but also for other conditions such as Polycystic Ovary Syndrome (PCOS).
Things to tell your doctor before starting metformin
It is very important that your doctor is fully aware of your health condition before prescribing Metformin. Therefore, if you have any of the conditions below, be sure to tell your doctor about it.
- If you have anemia.
- Dehydration is a condition in which the body lacks water.
- If you have heart disease.
- If you are a regular drinker.
- If you have kidney disease.
- If you have liver disease.
- If you have polycystic ovary syndrome (PCOS).
- If you have a serious infection or injury.
- If there is persistent vomiting.
- If you have an allergic reaction to metformin or any other medicine, food, or dye.
- If you are trying to get pregnant or are already pregnant.
- If you are a breastfeeding mother.
It is very important for your own safety to tell the doctor this information without hiding it.
How exactly do I use this medicine?
You should use this medicine exactly as your doctor tells you. Follow the instructions on the medicine bottle exactly.
- Take with a meal: This medicine is usually taken with or after a meal. This will reduce stomach discomfort.
- Correct measurement: If this is given as a solution, use only a special spoon or cup that is designed to measure it. Do not use regular kitchen teaspoons, as they are not accurate.
- On time: Make it a habit to take your medicine at the same time every day. Do not take more than the doctor tells you to.
What to do if you miss a dose of medication?
If you forget to take a dose, take it as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and take your next dose at the scheduled time. Never take a double dose to make up for a forgotten dose.
What if I take too much medicine?
If you have even the slightest suspicion that you have taken an overdose, go to the nearest hospital Emergency Department (ETU) immediately. Or, call the National Poisons Information Centre at the Colombo National Hospital for advice.
Other medications that may interact with metformin
Metformin is a medication that can interact with some other medications, so it's important to tell your doctor about all the medications you're taking.
| Type of medicine | Description |
|---|---|
| Medications that should never be taken with Metformin | |
| Contrast Dyes | Certain types of dyes are injected into the body before tests such as X-rays, CT scans, and MRIs. |
| Dofetilide | A special medicine for heart disease. |
| Other things that can cause problems with metformin | |
| Alcohol | Drinking alcohol can cause blood sugar levels to drop dangerously low or increase lactic acid levels. |
| Other medications | Medications for high blood pressure, HIV/Hepatitis, birth control pills, steroids, thyroid hormone medications, some vitamins (Niacin), and many others can interact with this. |
Most importantly: Tell your doctor not only about the pills you take, but also about any Ayurvedic medicines, vitamins, traditional herbs, and supplements you use.
Things you should be careful about when taking medication
HbA1C test
Your doctor will order a blood test called HbA1C to see how well your diabetes is controlled. This test measures your average blood sugar levels over the past 2-3 months. It's important to have this test at least every 3-6 months.
Low blood sugar (Hypoglycemia)
If you take insulin or other diabetes medications with metformin, your blood sugar may suddenly drop (hypo). Be aware of the symptoms of this (sweating, shaking, excessive hunger, restlessness). Always keep something like a candy bar or sugar cube nearby. If you lose consciousness, tell your family not to put anything in your mouth. If this happens, you should go to the hospital immediately.
Illness and surgery
If you are going to have any surgery or an MRI/CT scan, tell your doctor in advance that you are taking Metformin. You may need to stop taking the medication a few days before the test/surgery.
Vitamin deficiencies
Long-term use of metformin may cause low levels of folic acid and vitamin B12 in some people. Talk to your doctor about this and take supplements if necessary.
Side effects that may occur due to medication
Like any medicine, Metformin can cause side effects in some people. Most of these are not serious.
| Type of side effect | Characteristics |
|---|---|
| Serious side effects that should be reported to the doctor immediately | |
| Allergic reactions | Skin rash, itching, swelling of the face, lips, tongue or throat. |
| Lactic acidosis (High lactic acid level) | Muscle cramps or pain, stomach aches, difficulty breathing, extreme tiredness. (This is a very rare but serious condition). |
| Vitamin B12 deficiency (Low vitamin B12 level) | Numbness, pain, muscle weakness, dizziness, memory loss. |
| Side effects that are usually not serious, but should be reported to the doctor if they persist | |
| Stomach discomfort | Diarrhea, gas, and nausea (these are common in the early stages of taking the medicine and then subside). |
| Other | Headache, metallic taste in the mouth. |
Take-Home Message
- Always take Metformin as prescribed by your doctor, in the prescribed amount, with a meal.
- Inform your doctor about all other medications, vitamins, and any medical conditions you are taking.
- Be aware of the symptoms of low blood sugar (hypoglycemia). Always keep something sugary (like a candy bar) nearby.
- Never stop taking medication or change the dosage without consulting your doctor.
- Don't skip scheduled medical tests, such as HbA1C.
- If a serious side effect occurs, seek medical advice immediately.
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