Metformin Teva (Metformin Hydrochloride)

Metformin Teva is an oral biguanide used to manage hyperglycaemia in the type 2 diabetes pathway.

• Type 2 diabetes mellitus: lowers fasting and post‑prandial glucose and reduces HbA1c.
• Newly diagnosed patients: can be used as first‑line monotherapy to achieve glycaemic targets.
• Combination therapy: added to other antidiabetic agents (e.g., sulfonylureas, insulin) to enhance overall glucose control.

• Metformin Hydrochloride acts primarily by inhibiting hepatic gluconeogenesis, thereby reducing hepatic glucose output. It also decreases intestinal glucose absorption and improves peripheral insulin sensitivity by activating AMP‑activated protein kinase (AMPK), which enhances glucose uptake in muscle and adipose tissue without stimulating insulin secretion.

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

Common Side Effects

• Nausea: mild to moderate upset stomach.
• Diarrhoea: loose stools, often early in therapy.
• Metallic taste: transient alteration of taste perception.
• Abdominal discomfort: cramping or bloating.
• Loss of appetite: reduced desire to eat.
• Vitamin B12 deficiency: may develop with long‑term use.

Serious or Rare Side Effects

• Lactic acidosis: rare but life‑threatening metabolic acidosis.
• Severe skin reactions: such as Stevens‑Johnson syndrome.
• Hepatic dysfunction: elevated liver enzymes.
• Hypoglycaemia: when combined with insulin or sulfonylureas.
• Acute pancreatitis: very uncommon.
• Anemia: due to B12 deficiency.

Metformin Teva requires careful assessment before initiation and during therapy.

• Renal function: avoid or adjust dose in patients with impaired creatinine clearance.
• Hepatic disease: use with caution; monitor liver enzymes.
• Lactic acidosis risk: discontinue before radiologic contrast studies.
• Pregnancy and lactation: evaluate risk‑benefit; generally avoided unless clearly needed.
• Vitamin B12 monitoring: consider periodic testing during long‑term therapy.
• Store at ambient temperature: keep below 25°C in the original container, protect from moisture and light.

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

Major Interactions (Avoid)

• Iodinated contrast agents: increase risk of lactic acidosis; hold metformin before and after exposure.
• Insulin or sulfonylureas: potentiate hypoglycaemia.
• Cimetidine: raises metformin plasma concentrations.
• Alcohol: may precipitate lactic acidosis.
• Renal‑impairing drugs (e.g., NSAIDs): exacerbate accumulation.

Moderate Interactions (Monitor Closely)

• Beta‑blockers: may mask hypoglycaemia symptoms.
• Diuretics: affect renal clearance of metformin.
• ACE inhibitors/ARBs: monitor renal function and electrolytes.
• Thyroid hormones: may alter glucose metabolism.
• Oral contraceptives: slight increase in metformin levels.