Metformin Fairmed (Metformin Hydrochloride)

• Metformin is used to improve glycemic control in conditions related to insulin resistance and elevated blood glucose.
• Type 2 diabetes mellitus: improves blood glucose levels and reduces HbA1c.
• Prediabetes (impaired glucose tolerance): delays progression to overt diabetes.
• Polycystic ovary syndrome (PCOS): helps restore ovulatory function and lower androgen levels.

• Metformin acts primarily by inhibiting hepatic gluconeogenesis, thereby decreasing the amount of glucose released into the bloodstream. It also enhances peripheral glucose uptake by increasing insulin‑stimulated translocation of GLUT‑4 transporters in muscle and adipose tissue, and modestly reduces intestinal glucose absorption. Additionally, metformin activates AMP‑activated protein kinase (AMPK), which contributes to its metabolic effects.

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

Common Side Effects

• Gastrointestinal upset: nausea, abdominal discomfort, and diarrhea.
• Metallic taste: transient metallic sensation in the mouth.
• Decreased appetite: reduced hunger leading to mild weight loss.
• Vitamin B12 deficiency: gradual reduction in serum B12 levels with long‑term use.

Serious or Rare Side Effects

• Lactic acidosis: rare but life‑threatening accumulation of lactate.
• Severe hypoglycemia: usually when combined with insulin or sulfonylureas.
• Hepatotoxicity: uncommon liver enzyme elevation.
• Skin reactions: rash or Stevens‑Johnson syndrome in rare cases.

Before initiating Metformin, certain precautions should be considered to ensure safe use.

• Renal function assessment: evaluate creatinine clearance; avoid use in severe renal impairment.
• Hepatic disease evaluation: use cautiously in patients with liver dysfunction.
• Cardiovascular status: monitor in patients with heart failure due to lactic acidosis risk.
• Concomitant medications: review for drugs that may increase risk of hypoglycemia or affect renal clearance.
• Pregnancy and lactation: discuss potential risks with healthcare provider.
• Store at ambient temperature: keep below 25°C in original packaging, protect from moisture.

Metformin can interact with other 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.
• Alcohol excess: enhances risk of lactic acidosis.

Moderate Interactions (Monitor Closely)

• ACE inhibitors or ARBs: may affect renal function, requiring monitoring.
• Diuretics: can reduce renal clearance of metformin.
• Sulfonylureas or insulin: increase risk of hypoglycemia when combined.
• Beta‑blockers: may mask hypoglycemia symptoms.