Metformin Terapia (Metformin Hydrochloride)

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

• Type 2 diabetes mellitus: lowers fasting and post‑prandial blood glucose levels.
• Prediabetes (impaired glucose tolerance): helps delay progression to overt diabetes.
• Polycystic ovary syndrome: improves insulin sensitivity and may regularise menstrual cycles.

• Metformin reduces hepatic gluconeogenesis and increases peripheral glucose uptake by activating AMP‑activated protein kinase (AMPK). This leads to decreased liver glucose output and enhanced insulin‑mediated glucose utilization in muscle and adipose tissue, thereby improving overall glycaemic control without directly stimulating insulin secretion.

Metformin Terapia may cause a range of adverse reactions.

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 in taste perception.
• Loss of appetite: reduced desire to eat.
• Vitamin B12 deficiency: possible decrease with long‑term use.

Serious or Rare Side Effects

• Lactic acidosis: a rare but life‑threatening buildup of lactic acid.
• Severe skin reactions: such as Stevens‑Johnson syndrome or toxic epidermal necrolysis.
• Hepatic dysfunction: abnormal liver enzymes or hepatitis.
• Hypoglycaemia: when combined with other glucose‑lowering agents.
• Acute pancreatitis: inflammation of the pancreas.

Before prescribing Metformin Terapia, clinicians should consider several safety factors.

• Renal function: avoid or adjust dose in patients with impaired kidney function.
• Hepatic disease: use with caution in those with liver impairment.
• Cardiovascular status: monitor in patients with unstable heart failure.
• Alcohol intake: limit consumption to reduce risk of lactic acidosis.
• Pregnancy and lactation: assess risk‑benefit, as safety data are limited.
• Store at ambient temperature: keep below 25°C in the original container, protect from moisture and light.

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

Major Interactions (Avoid)

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

Moderate Interactions (Monitor Closely)

• Beta‑blockers: may mask hypoglycaemia symptoms.
• Diuretics (thiazides): can affect renal clearance of metformin.
• ACE inhibitors or ARBs: monitor renal function and electrolytes.
• Alcohol: potentiates risk of lactic acidosis.