Metformin Lek (Metformin Hydrochloride)

Metformin Lek belongs to the biguanide class and is used to manage disorders of glucose metabolism.

• Type 2 diabetes mellitus: improves glycemic control and reduces HbA1c levels.
• Gestational diabetes mellitus: helps control maternal blood glucose when diet alone is insufficient.
• Prediabetes (impaired glucose tolerance): delays progression to overt diabetes by enhancing insulin sensitivity.

• Metformin reduces hepatic gluconeogenesis, decreases intestinal absorption of glucose, and increases peripheral insulin sensitivity by activating AMP‑activated protein kinase (AMPK). These actions lower fasting plasma glucose and improve overall glycemic control without stimulating insulin secretion.

Metformin may cause a range of adverse reactions, from mild to serious.

Common Side Effects

• Nausea: mild to moderate stomach upset.
• Diarrhea: frequent loose stools, especially at treatment initiation.
• Abdominal discomfort: cramping or bloating.
• Metallic taste: transient alteration of taste perception.
• Loss of appetite: reduced desire to eat.
• Vitamin B12 deficiency: gradual decrease with long‑term use.

Serious or Rare Side Effects

• Lactic acidosis: rare but potentially fatal metabolic acidosis.
• Severe skin reactions: such as Stevens‑Johnson syndrome or toxic epidermal necrolysis.
• Hepatic dysfunction: elevated liver enzymes or hepatitis.
• Hypoglycemia: when combined with other glucose‑lowering agents.
• Anemia: due to reduced red blood cell production.
• Pancreatitis: inflammation of the pancreas.

Before initiating Metformin Lek, several safety considerations should be reviewed.

• Renal function monitoring: assess creatinine clearance to avoid accumulation.
• Hepatic function assessment: ensure liver enzymes are within normal limits.
• Vitamin B12 status: periodic testing for deficiency during long‑term therapy.
• Elderly patients: start at lower doses and monitor for intolerance.
• Heart failure: avoid in severe cases due to lactic acidosis risk.
• Store at room temperature: keep in the original container, protect from moisture and direct sunlight.

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

Major Interactions (Avoid)

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

Moderate Interactions (Monitor Closely)

• ACE inhibitors or ARBs: may affect renal function, requiring dose adjustment.
• Diuretics: can reduce renal clearance of metformin.
• Beta‑blockers: may mask hypoglycemia symptoms.
• NSAIDs: may impair renal function and increase metformin levels.
• Warfarin: may require INR monitoring due to potential interaction.