Metformin Sandoz (Metformin Hydrochloride)

Metformin Sandoz is a biguanide indicated for the management of type 2 diabetes mellitus, helping to achieve better glycaemic control.

• Type 2 diabetes mellitus: lowers fasting and post‑prandial blood glucose levels and improves overall glycaemic control.

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

Metformin Sandoz may cause a range of adverse reactions. Patients should be aware of both frequent and rare events.

Common Side Effects

• Nausea: mild to moderate stomach upset.
• Diarrhoea: loose stools, often transient.
• Abdominal discomfort: cramping or pain.
• 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: severe metabolic acidosis, potentially life‑threatening.
• Severe skin reactions: such as Stevens‑Johnson syndrome.
• Hepatic dysfunction: elevated liver enzymes or hepatitis.
• Hypoglycaemia (when combined with insulin or sulfonylureas).
• Vitamin B12 deficiency: may cause neuropathy with long‑term use.
• Acute pancreatitis: rare inflammation of the pancreas.

Metformin Sandoz requires careful consideration of patient‑specific factors before initiation.

• Renal function: assess creatinine clearance; avoid if severe impairment.
• Hepatic function: use with caution in liver disease.
• Lactic acidosis risk: discontinue before radiographic contrast studies.
• Vitamin B12 monitoring: periodic assessment recommended for long‑term therapy.
• Pregnancy and breastfeeding: evaluate risk‑benefit; use only if clearly needed.
• Storage: Store at ambient temperature below 25°C: keep in the original container, protect from moisture and light.

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

Major Interactions (Avoid)

• Iodinated contrast agents: may precipitate lactic acidosis.
• Cimetidine: can increase metformin plasma concentrations.
• MAO inhibitors: risk of severe hypotension.

Moderate Interactions (Monitor Closely)

• Diuretics (e.g., thiazides): may affect renal clearance.
• Corticosteroids: can raise blood glucose, requiring dose adjustment.
• Beta‑blockers: may mask hypoglycaemia symptoms.
• ACE inhibitors/ARBs: monitor renal function and electrolytes.
• Alcohol: excessive intake increases lactic acidosis risk.