Izumis (Metformin Hydrochloride)

Metformin Hydrochloride is used to improve glycaemic control in conditions related to insulin resistance and hyperglycaemia.

• Type 2 diabetes mellitus: lowers fasting and post‑prandial blood glucose levels.
• Prediabetes: delays progression to overt diabetes by improving insulin sensitivity.
• Polycystic ovary syndrome (PCOS): reduces insulin resistance and helps regulate menstrual cycles.

• Metformin Hydrochloride acts primarily by inhibiting hepatic gluconeogenesis, thereby reducing hepatic glucose output. It also enhances peripheral glucose uptake by increasing insulin‑stimulated activation of AMP‑activated protein kinase (AMPK), which improves insulin sensitivity in muscle and adipose tissue. Additionally, it modestly decreases intestinal absorption of glucose.

Metformin Hydrochloride may cause a range of adverse reactions, most of which are mild and transient.

Common Side Effects

• Gastrointestinal upset: nausea, abdominal discomfort, or loss of appetite.
• Diarrhoea: loose stools occurring especially after dose initiation.
• Metallic taste: transient alteration in taste perception.
• Mild hypoglycaemia: when combined with other glucose‑lowering agents.

Serious or Rare Side Effects

• Lactic acidosis: a rare but potentially fatal accumulation of lactate.
• Severe skin reactions: such as Stevens‑Johnson syndrome or toxic epidermal necrolysis.
• Hepatotoxicity: liver enzyme elevations indicating liver injury.
• Vitamin B12 deficiency: long‑term therapy may reduce B12 absorption.
• Pancreatitis: inflammation of the pancreas in rare cases.

Metformin Hydrochloride requires careful monitoring in several clinical situations.

• Renal function: assess creatinine clearance before initiation and periodically thereafter.
• Hepatic function: evaluate liver enzymes, especially in patients with existing liver disease.
• Cardiovascular status: avoid in patients with unstable or acute heart failure.
• Pregnancy: use only if clearly needed; category B indicates no proven risk in animal studies.
• Vitamin B12 monitoring: consider periodic testing during long‑term therapy.
• Store at room temperature: keep in the original container, protect from moisture and heat.

Metformin Hydrochloride can interact with other medicines, altering its efficacy or safety.

Major Interactions (Avoid)

• Iodinated contrast agents: increase risk of lactic acidosis; discontinue metformin before and after imaging.
• Cimetidine: may raise metformin plasma concentrations.
• Alcohol: potentiates risk of lactic acidosis.

Moderate Interactions (Monitor Closely)

• Sulfonylureas or insulin: heightened risk of hypoglycaemia; dose adjustments may be required.
• Beta‑blockers: may mask hypoglycaemic symptoms.
• ACE inhibitors or ARBs: monitor renal function as combined effect may affect clearance.