Metformin

Metformin is used alone or with other medications, including insulin, to treat type 2 diabetes (condition in which the body does not use insulin normally and, therefore, cannot control the amount of sugar in the blood). Metformin helps to control the amount of glucose (sugar) in your blood. It decreases the amount of glucose you absorb from your food and the amount of glucose made by your liver. Metformin also increases your body's response to insulin, a natural substance that controls the amount of glucose in the blood. Metformin is not used to treat type 1 diabetes (condition in which the body does not produce insulin and therefore cannot control the amount of sugar in the blood).

Metformin comes as a liquid, a tablet and an extended-release (long-acting) tablet to take by mouth. The liquid is usually taken with meals one or two times a day. The regular tablet is usually taken with meals two or three times a day. The extended-release tablet is usually taken once daily with the evening meal. To help you remember to take metformin, take it around the same time(s) every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take metformin exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor. Swallow metformin extended-release tablets whole; do not split, chew, or crush them. Your doctor may start you on a low dose of metformin and gradually increase your dose not more often than once every 1 to 2 weeks. You will need to monitor your blood sugar carefully so your doctor will be able to tell how well metformin is working. Metformin controls diabetes but does not cure it. Continue to take metformin even if you feel well. Do not stop taking metformin without talking to your doctor.

<p>This medication may cause changes in your blood sugar. You should know the symptoms of low and high blood sugar and what to do if you have these symptoms.</p> <p>You may experience hypoglycemia (low blood sugar) while you are taking this medication. Your doctor will tell you what you should do if you develop hypoglycemia. He or she may tell you to check your blood sugar, eat or drink a food or beverage that contains sugar, such as hard candy or fruit juice, or get medical care. Follow these directions carefully if you have any of the following symptoms of hypoglycemia:

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shakiness</li>
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dizziness or lightheadedness</li>
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sweating</li>
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nervousness or irritability</li>
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sudden changes in behavior or mood</li>
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headache</li>
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numbness or tingling around the mouth</li>
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weakness</li>
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pale skin</li>
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hunger</li>
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clumsy or jerky movements</li></ul>If hypoglycemia is not treated, severe symptoms may develop. Be sure that your family, friends, and other people who spend time with you know that if you have any of the following symptoms, they should get medical treatment for you immediately:

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confusion</li>
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seizures</li>
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loss of consciousness</li></ul></p> <p>Metformin may cause side effects. Tell your doctor if any of these symptoms are severe, do not go away, go away and come back, or do not begin for some time after you begin taking metformin:

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diarrhea</li>
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bloating</li>
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stomach pain</li>
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gas</li>
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constipation</li>
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unpleasant metallic taste in mouth</li>
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heartburn</li>
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headache</li>
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sneezing</li>
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cough</li>
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runny nose</li>
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flushing of the skin</li>
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nail changes</li>
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muscle pain</li></ul></p> <p></p> <p>Some side effects can be serious. The following symptoms are uncommon, but if you experience any of them or those listed in the IMPORTANT WARNING section, call your doctor immediately:

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chest pain</li>
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rash</li></ul>Some female laboratory animals given high doses of metformin developed non-cancerous polyps (abnormal growths of tissue) in the uterus (womb). It is not known if metformin increases the risk of polyps in humans. Talk to your doctor about the risks of taking this medication.Metformin may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online [at <a href='http://www.fda.gov/Safety/MedWatch'>http://www.fda.gov/Safety/MedWatch</a>] or by phone [1-800-332-1088].</p>

Before taking metformin, tell your doctor and pharmacist if you are allergic to metformin or any other medications. tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking. Be sure to mention the medications listed in the IMPORTANT WARNING section and any of the following: amiloride (Midamor, Moduretic); antihistamines; beta-blockers such as atenolol (Tenormin), labetalol (Normodyne), metoprolol (Lopressor, Toprol XL), nadolol (Corgard), and propranolol (Inderal); calcium channel blockers such as amlodipine (Norvasc), diltiazem (Cardizem, Dilacor, Tiazac, others), felodipine (Lexxel, Plendil), isradipine (DynaCirc), nicardipine (Cardene), nifedipine (Adalat, Procardia), nimodipine (Nimotop), nisoldipine (Sular), and verapamil (Calan, Isoptin, Verelan); cimetidine (Tagamet); digoxin (Lanoxin, Lanoxicaps); furosemide (Lasix); hormone replacement therapy; insulin or other medications for diabetes; isoniazid (INH, Nydrazid); medications for asthma and colds; medications for mental illness and nausea such as fluphenazine (Prolixin), mesoridazine (Serentil), perphenazine (Trilafon), prochlorperazine (Compazine), promethazine (Phenergan), thioridazine (Mellaril), thiothixene (Navane), trifluoperazine (Stelazine), and triflupromazine (Vesprin); medications for thyroid disease; morphine (MS Contin, Roxanol, others); nicotinic acid; oral contraceptives ('birth control pills'); oral steroids such as dexamethasone (Decadron, Dexone), methylprednisolone (Medrol), and prednisone (Deltasone); phenytoin (Dilantin, Phenytek); procainamide (Procanbid); quinidine (Quinidex); quinine; ranitidine (Zantac); triamterene (Dyazide, Maxzide, others); or trimethoprim (Proloprim, Trimpex). Your doctor may need to change the doses of your medications or monitor you carefully for side effects. tell your doctor if you have or have ever had any medical condition, especially those mentioned in the IMPORTANT WARNING section. if you are using the extended-release tablets, you should know that sometimes the tablet shell may appear in your stool. If this occurs, it is not harmful and will not affect the way the medication works. tell your doctor if you eat less or exercise more than usual. This can affect your blood sugar. Your doctor will give you instructions if this happens.

In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911. Symptoms of overdose may include:

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extreme tiredness</li>
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weakness</li>
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discomfort</li>
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vomiting</li>
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nausea</li>
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stomach pain</li>
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decreased appetite</li>
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deep, rapid breathing</li>
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shortness of breath</li>
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dizziness</li>
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lightheadedness</li>
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abnormally fast or slow heartbeat</li>
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flushing of the skin</li>
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muscle pain</li>
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feeling cold</li></ul>