Metformin Teva (Metformin)

• Metformin Teva is a biguanide that acts on glucose metabolism to manage several insulin‑related conditions.
• Type 2 diabetes mellitus: lowers fasting and post‑prandial blood glucose levels.
• Prediabetes: helps delay progression to overt diabetes by improving insulin sensitivity.
• Polycystic ovary syndrome (PCOS): reduces insulin resistance and may improve menstrual regularity.

• Metformin decreases hepatic gluconeogenesis and increases peripheral glucose uptake by activating AMP‑activated protein kinase (AMPK). This results in reduced liver glucose output and enhanced insulin‑mediated glucose utilization in muscle and adipose tissue, thereby lowering circulating blood glucose without stimulating insulin secretion.

Metformin may cause a range of adverse reactions, most of which are related to the gastrointestinal tract, while rare events can be serious.

Common Side Effects

• Nausea: mild to moderate upset stomach.
• Diarrhea: loose stools, often transient.
• Abdominal discomfort: cramping or pain.
• Metallic taste: transient alteration of taste.
• Loss of appetite: reduced desire to eat.
• Flatulence: increased gas production.

Serious or Rare Side Effects

• Lactic acidosis: rare but life‑threatening metabolic disturbance.
• Severe hypoglycemia: usually when combined with other glucose‑lowering agents.
• Hepatic failure: rare liver dysfunction.
• Allergic reactions: rash, pruritus, or angioedema.
• Vitamin B12 deficiency: long‑term use may reduce absorption.
• Skin discoloration: rare hyperpigmentation.

• Metformin should be used with careful clinical monitoring and patient education.
• Renal function: assess creatinine clearance before initiation and periodically thereafter.
• Liver disease: avoid in patients with significant hepatic impairment.
• Contrast imaging: discontinue at least 48 hours before iodinated contrast procedures.
• Alcohol consumption: limit intake to reduce risk of lactic acidosis.
• Pregnancy and lactation: evaluate risk‑benefit; use only if clearly needed.
• Store at ambient temperature (below 25°C): keep in the original container, protect from moisture.

Metformin may interact with several medicines, requiring dose adjustments or monitoring.

Major Interactions (Avoid)

• Iodinated contrast agents: increase risk of lactic acidosis.
• MAO inhibitors: may potentiate hypotensive effects.
• Cimetidine: can raise metformin plasma concentrations.

Moderate Interactions (Monitor Closely)

• Alcohol: enhances risk of lactic acidosis.
• Diuretics: may affect renal clearance of metformin.
• Corticosteroids: can raise blood glucose, requiring dose titration.
• Beta‑blockers: may mask hypoglycemia symptoms.
• Other antidiabetic agents: increase risk of hypoglycemia.