Metformin Sr Accord Healthcare (Metformin Hydrochloride)

Metformin Sr is a biguanide antidiabetic medication used to improve glycemic control in type 2 diabetes and related metabolic conditions.

• Type 2 diabetes mellitus: lowers fasting and post‑prandial glucose levels and improves overall glycemic control.
• Prediabetes: reduces the risk of progression to type 2 diabetes by improving insulin sensitivity.
• Polycystic ovary syndrome (PCOS): helps restore ovulatory cycles and reduces hyperinsulinemia.

• Metformin Hydrochloride acts primarily by inhibiting hepatic gluconeogenesis through activation of AMP‑activated protein kinase (AMPK). It also enhances peripheral glucose uptake in muscle and adipose tissue and improves insulin sensitivity, resulting in reduced circulating glucose concentrations without stimulating insulin secretion.

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

Common Side Effects

• Nausea: mild to moderate upset stomach.
• Diarrhea: loose stools, especially during treatment initiation.
• Abdominal discomfort: cramping or bloating.
• Metallic taste: transient alteration of taste perception.
• Loss of appetite: reduced desire to eat.
• Flatulence: increased intestinal gas.

Serious or Rare Side Effects

• Lactic acidosis: a rare but life‑threatening metabolic complication.
• Severe hypoglycaemia: when combined with other glucose‑lowering agents.
• Vitamin B12 deficiency: may develop with long‑term use.
• Hepatic dysfunction: abnormal liver enzymes.
• Skin rash or hypersensitivity reactions.
• Pancreatitis: inflammation of the pancreas.

Metformin Sr should be used with careful clinical assessment and monitoring.

• Renal function: evaluate creatinine clearance before initiation and periodically thereafter.
• Hepatic impairment: avoid in patients with significant liver disease.
• Cardiovascular disease: monitor for signs of heart failure.
• Alcohol consumption: limit intake to reduce risk of lactic acidosis.
• Pregnancy and lactation: use only if clearly needed after risk‑benefit evaluation.
• Store at ambient temperature: keep below 25 °C, retain in original packaging, protect from moisture and direct sunlight.

Metformin Sr can interact with several medicines, requiring attention to avoid adverse outcomes.

Major Interactions (Avoid)

• Iodinated contrast agents: may precipitate acute renal failure and increase lactic acidosis risk.
• Cimetidine: can raise metformin plasma concentrations.
• Alcohol: potentiates risk of lactic acidosis.
• Rifampicin: may reduce metformin efficacy.
• High‑dose vitamin B12 supplements: may mask deficiency.

Moderate Interactions (Monitor Closely)

• Beta‑blockers: may mask hypoglycaemia symptoms.
• Diuretics: can affect renal clearance of metformin.
• ACE inhibitors/ARBs: monitor renal function and electrolytes.
• Other antidiabetic agents: increase risk of hypoglycaemia.
• Thyroid hormones: may alter glucose metabolism.