Meguan (Metformin Hydrochloride)

Meguan (metformin) is employed in the management of disorders related to glucose metabolism.

• Type 2 diabetes mellitus: improves glycaemic control by reducing hepatic glucose output and enhancing insulin sensitivity.
• Prediabetes (impaired glucose tolerance): helps delay progression to overt diabetes by lowering fasting glucose levels.
• Polycystic ovary syndrome (off‑label): may improve insulin resistance and restore ovulatory cycles.

• Metformin Hydrochloride acts primarily by inhibiting mitochondrial respiratory‑chain complex I, which reduces hepatic gluconeogenesis. It also increases peripheral glucose uptake in muscle and adipose tissue through activation of AMP‑activated protein kinase (AMPK), thereby enhancing insulin sensitivity and lowering circulating glucose concentrations.

Metformin is generally well tolerated, but several adverse reactions have been reported.

Common Side Effects

• Gastrointestinal upset: nausea, abdominal discomfort, and diarrhoea are frequent during treatment initiation.
• Metallic taste: a transient metallic sensation in the mouth may occur.
• Vitamin B12 deficiency: long‑term therapy can reduce absorption of vitamin B12.

Serious or Rare Side Effects

• Lactic acidosis: a rare but life‑threatening accumulation of lactate, especially in patients with renal impairment.
• Severe skin reactions: such as Stevens‑Johnson syndrome or toxic epidermal necrolysis.
• Hepatic dysfunction: rare cases of liver enzyme elevation have been observed.

Meguan should be used with careful clinical monitoring.

• Renal function: assess creatinine clearance before initiation and periodically thereafter.
• Hepatic disease: avoid in patients with significant liver impairment.
• Alcohol consumption: limit intake as it may increase the risk of lactic acidosis.
• Pregnancy and lactation: use only if the potential benefit outweighs the risk; consult a healthcare professional.
• Drug interactions: review concomitant medications for potential interactions that may affect metformin levels.

Store at ambient temperature: keep in the original container, protect from moisture and direct sunlight.

Metformin may interact with several medicines, altering its efficacy or safety profile.

Major Interactions (Avoid)

• Iodinated contrast agents: can precipitate acute renal failure, increasing lactic acidosis risk.
• Cimetidine: may raise metformin plasma concentrations, heightening toxicity.

Moderate Interactions (Monitor Closely)

• Diuretics (thiazides, loop): can affect renal function and electrolyte balance.
• ACE inhibitors or ARBs: may enhance renal protective effects but require monitoring of kidney function.
• Beta‑blockers: may mask hypoglycaemia symptoms; monitor blood glucose closely.