Glucophage (Metformin Hydrochloride)

Glucophage is indicated for the management of type 2 diabetes mellitus as part of a comprehensive treatment plan that includes diet and exercise.

• Improves glycemic control in adults with type 2 diabetes.
• Can be used as monotherapy when diet and exercise alone are insufficient.
• May be combined with other antidiabetic agents for enhanced effect.
• Sometimes prescribed off‑label for polycystic ovary syndrome (PCOS) under medical supervision.
• Utilized in clinical practice to reduce cardiovascular risk factors associated with diabetes.

Glucophage may cause a range of side effects, most of which are mild and transient. Serious adverse reactions are less common but require prompt medical attention.

Common

• Gastrointestinal upset such as nausea, diarrhea, or abdominal discomfort.
• Metallic taste in the mouth.
• Decreased appetite.
• Mild headache.
• Weight loss or reduced body weight.

Serious

• Lactic acidosis, a rare but potentially life‑threatening condition.
• Severe hypoglycemia when combined with insulin or sulfonylureas.
• Hepatotoxicity indicated by jaundice or elevated liver enzymes.
• Allergic reactions including rash, itching, or swelling.

Before starting Glucophage, certain health considerations should be reviewed with a healthcare professional.

• Assess kidney function; contraindicated in severe renal impairment.
• Evaluate liver function, as hepatic disease may increase risk of lactic acidosis.
• Use cautiously in patients with heart failure or a history of cardiovascular disease.
• Monitor vitamin B12 levels during long‑term therapy, as deficiency can occur.
• Discontinue before any radiographic studies involving iodinated contrast agents.
• Pregnancy and breastfeeding decisions should be made in consultation with a physician.

Glucophage can interact with several medications, affecting its efficacy or safety profile.

Avoid

• Iodinated contrast media used in imaging studies, due to increased risk of renal dysfunction.
• Alcohol excess, which may potentiate lactic acidosis.
• Cimetidine, which can raise metformin plasma concentrations.

Use with caution

• Other antidiabetic agents (e.g., insulin, sulfonylureas) that increase hypoglycemia risk.
• Diuretics that may affect renal function.
• Corticosteroids, which can raise blood glucose levels.
• ACE inhibitors or ARBs, requiring monitoring of renal function.