Metformin Sr Teva (Metformin Hydrochloride)

Metformin Sr Teva, a biguanide antidiabetic, is used to improve glycemic control in type 2 diabetes mellitus.

• Type 2 diabetes mellitus: lowers fasting and post‑prandial blood glucose levels.
• Prediabetes (impaired glucose tolerance): reduces progression to type 2 diabetes.
• Polycystic ovary syndrome: improves insulin resistance and may help regulate menstrual cycles.

• Metformin Hydrochloride primarily inhibits hepatic gluconeogenesis and reduces hepatic glucose output. It activates AMP‑activated protein kinase (AMPK), which enhances peripheral glucose uptake in muscle and adipose tissue, improves insulin sensitivity, and decreases intestinal absorption of glucose, collectively contributing to lower blood glucose concentrations.

Metformin is generally well tolerated, but adverse reactions can occur.

Common Side Effects

• Gastrointestinal upset: nausea, abdominal discomfort, and loss of appetite.
• Diarrhea: frequent loose stools, especially during treatment initiation.
• Metallic taste: transient alteration in taste perception.

Serious or Rare Side Effects

• Lactic acidosis: a rare but potentially fatal accumulation of lactic acid.
• Severe skin reactions: such as Stevens‑Johnson syndrome or toxic epidermal necrolysis.
• Hepatic dysfunction: abnormal liver enzymes or hepatic failure in susceptible individuals.

Metformin should be used with careful clinical assessment and monitoring.

• Renal function assessment: evaluate creatinine clearance before initiation and periodically thereafter.
• Hepatic function monitoring: avoid use in patients with significant liver disease.
• Contraindicated in severe renal impairment: do not prescribe if eGFR is below 30 mL/min/1.73 m².
• Use with caution in elderly patients: increased risk of lactic acidosis.
• Pregnancy and breastfeeding: safety not established; weigh benefits against potential risks.
• Store at room temperature: keep in the original pack, protect from moisture.

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

Major Interactions (Avoid)

• Iodinated contrast agents: can precipitate acute renal failure, increasing lactic acidosis risk.
• Cimetidine: may raise metformin plasma concentrations, enhancing toxicity.
• Excessive alcohol intake: heightens risk of lactic acidosis.

Moderate Interactions (Monitor Closely)

• ACE inhibitors or ARBs: may affect renal function, necessitating renal monitoring.
• Diuretics: can reduce renal clearance of metformin.
• Other antidiabetic agents (e.g., sulfonylureas, insulin): increase risk of hypoglycemia when combined.
• NSAIDs: may impair renal function, requiring dose adjustment or monitoring.