Metformin Hydrochloride Sandoz (Metformin Hydrochloride)

Metformin Hydrochloride is indicated for conditions affecting glucose metabolism and insulin sensitivity.

• Type 2 diabetes mellitus: lowers fasting and post‑prandial blood glucose levels to achieve glycaemic targets.
• Prediabetes: helps delay progression to overt diabetes by improving insulin sensitivity.
• Polycystic ovary syndrome: reduces insulin resistance and may improve menstrual regularity.

• Metformin Hydrochloride reduces hepatic gluconeogenesis, decreases intestinal glucose absorption, and enhances peripheral insulin‑mediated glucose uptake. By activating AMP‑activated protein kinase (AMPK), it modulates cellular energy balance, leading to lowered circulating glucose without stimulating insulin secretion.

Metformin Hydrochloride may cause a range of adverse reactions.

Common Side Effects

• Nausea: mild to moderate stomach upset, often transient.
• Diarrhoea: loose stools, usually early in therapy.
• Abdominal discomfort: cramping or bloating.
• Metallic taste: transient alteration in taste perception.
• Loss of appetite: reduced desire to eat.
• Flatulence: increased intestinal gas.

Serious or Rare Side Effects

• Lactic acidosis: rare but life‑threatening metabolic disturbance.
• Severe skin reactions: such as Stevens‑Johnson syndrome.
• Hepatic dysfunction: signs of liver injury.
• Significant hypoglycaemia: when combined with other glucose‑lowering agents.
• Vitamin B12 deficiency: may develop with long‑term use.
• Acute pancreatitis: rare inflammatory condition of the pancreas.

Metformin Hydrochloride requires careful patient assessment and monitoring.

• Renal function: evaluate creatinine clearance before initiation and periodically thereafter.
• Hepatic function: avoid use in patients with severe liver disease.
• Risk of lactic acidosis: contraindicated in severe renal impairment or acute metabolic acidosis.
• Pregnancy: use only if potential benefit justifies potential risk to the fetus.
• Alcohol consumption: limit intake to reduce risk of acidosis.
• Store at ambient temperature: keep in the original container, protect from moisture and heat.

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

Major Interactions (Avoid)

• Iodinated contrast media: may precipitate renal dysfunction and lactic acidosis.
• Cimetidine: can increase metformin plasma concentrations.
• Alcohol: potentiates risk of lactic acidosis.

Moderate Interactions (Monitor Closely)

• Beta‑blockers: may mask hypoglycaemic symptoms.
• Diuretics: can affect renal clearance of metformin.