Metformin Hydrochloride Lyrus (Metformin Hydrochloride)

• Metformin Hydrochloride is indicated for conditions that involve impaired glucose regulation or insulin resistance.
• Type 2 diabetes mellitus: lowers fasting and post‑prandial blood glucose levels to achieve glycaemic targets.
• Polycystic ovary syndrome: improves insulin sensitivity, helping to restore ovulation and reduce androgen excess.
• Prediabetes: delays progression to overt type 2 diabetes by improving insulin action.

• Metformin Hydrochloride reduces hepatic gluconeogenesis, decreases intestinal glucose absorption, and enhances peripheral glucose uptake by activating AMP‑activated protein kinase (AMPK). These actions collectively improve insulin sensitivity and lower circulating glucose concentrations without stimulating insulin secretion.

Metformin Hydrochloride may cause a range of adverse reactions. Most are mild and transient, but serious events can occur.

Common Side Effects

• Gastrointestinal upset: nausea, abdominal discomfort, or loss of appetite.
• Diarrhea: frequent loose stools, especially during treatment initiation.
• Metallic taste: transient alteration in taste perception.
• Vitamin B12 deficiency: reduced absorption with long‑term use.

Serious or Rare Side Effects

• Lactic acidosis: rare but life‑threatening metabolic acidosis.
• Severe skin reactions: such as Stevens‑Johnson syndrome or toxic epidermal necrolysis.
• Hepatic dysfunction: marked elevation of liver enzymes or hepatitis.
• Hypoglycaemia: when combined with insulin or secretagogues.
• Pancreatitis: inflammation of the pancreas.

• Metformin Hydrochloride requires careful assessment of patient factors and monitoring during therapy.
• Renal function: evaluate eGFR before starting and periodically thereafter.
• Hepatic disease: avoid use in patients with severe hepatic impairment.
• Lactic acidosis risk: discontinue if patient develops unexplained acidosis, hypoxia, or severe infection.
• Pregnancy and lactation: use only if potential benefit justifies potential risk to fetus or infant.
• Store at ambient temperature: keep in original container, protect from moisture and heat.

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

Major Interactions (Avoid)

• Iodinated contrast agents: may precipitate acute renal failure and increase lactic acidosis risk.
• Alcohol: potentiates lactic acidosis, especially in chronic heavy drinkers.
• Cimetidine: can raise metformin plasma concentrations.

Moderate Interactions (Monitor Closely)

• Beta‑blockers: may mask hypoglycaemia symptoms.
• Diuretics and ACE inhibitors: can affect renal function, requiring dose adjustment.
• NSAIDs: may reduce renal clearance of metformin.
• Thyroid hormones: may alter glycaemic control, necessitating monitoring.