Glucophage Sr (Metformin Hydrochloride)

Glucophage Sr is prescribed primarily for the management of type 2 diabetes mellitus.

• As initial monotherapy for adults whose diet and exercise alone do not achieve target glycemic levels.
• In combination with other oral antidiabetic agents when additional glucose lowering is needed.
• As adjunct therapy with insulin to improve overall glycemic control.
• To help reduce the risk of diabetes‑related complications when used as part of a comprehensive treatment plan.
• Occasionally used off‑label for conditions such as polycystic ovary syndrome under specialist supervision.

Side effects of Glucophage Sr vary in frequency and severity.

Common

• Gastrointestinal upset, including nausea, vomiting, or abdominal discomfort.
• Diarrhea or loose stools.
• Metallic taste in the mouth.
• Decreased appetite.
• Mild skin rash or itching.

Serious

• Lactic acidosis, a rare but potentially life‑threatening metabolic condition.
• Severe hypoglycemia when combined with other glucose‑lowering drugs.
• Hepatotoxicity manifested by elevated liver enzymes.
• Persistent or worsening gastrointestinal symptoms that may indicate intolerance.
• Allergic reactions such as angioedema or severe skin eruptions.

Before starting Glucophage Sr, certain precautions should be considered.

• Assess renal function; avoid use in patients with severe renal impairment.
• Monitor liver enzymes periodically, especially in patients with existing hepatic disease.
• Use cautiously in the elderly, who may have reduced renal clearance.
• Discontinue before any radiographic studies that use iodinated contrast agents.
• Educate patients about signs of lactic acidosis and advise immediate medical attention if they occur.
• Review pregnancy and breastfeeding status; the safety profile is not fully established.

Glucophage Sr can interact with several medications, requiring attention to avoid adverse outcomes.

Avoid

• Iodinated contrast media used in imaging studies, due to risk of acute renal failure.
• Cimetidine, which may increase metformin plasma concentrations.
• Certain diuretics that can impair renal function and elevate metformin levels.

Use with caution

• Alcohol, which may increase the risk of lactic acidosis.
• Beta‑blockers, as they can mask hypoglycemia symptoms.
• Other antidiabetic agents, to prevent excessive lowering of blood glucose.
• Corticosteroids, which may raise blood glucose and affect metformin efficacy.