Metformin Teva (Metformin Hydrochloride)

Metformin Teva is a Biguanide that improves glucose regulation in several metabolic conditions.

• Type 2 diabetes mellitus: improves glycaemic control by lowering fasting and post‑prandial blood glucose.
• Prediabetes (impaired glucose tolerance): helps delay progression to overt diabetes when combined with lifestyle measures.
• Polycystic ovary syndrome: reduces insulin resistance and may improve menstrual regularity and ovulation.

• Metformin acts primarily by inhibiting mitochondrial respiratory‑chain complex I, which reduces hepatic gluconeogenesis. The resulting decrease in liver glucose output, together with enhanced peripheral glucose uptake in muscle and adipose tissue, improves insulin sensitivity. It also modestly lowers intestinal glucose absorption and may influence gut microbiota, contributing to its overall antihyperglycaemic effect. Additionally, metformin activates AMP‑activated protein kinase (AMPK), which further promotes catabolic pathways and inhibits lipogenesis.

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

Common Side Effects

• Nausea: mild stomach upset, often transient.
• Diarrhea: loose stools, usually resolves with continued therapy.
• Abdominal discomfort: cramping or bloating.
• Metallic taste: transient alteration in taste perception.

Serious or Rare Side Effects

• Lactic acidosis: rare but life‑threatening metabolic acidosis.
• Severe hypoglycaemia: uncommon, usually when combined with other glucose‑lowering agents.
• Hepatotoxicity: rare liver injury presenting with jaundice or elevated enzymes.

When prescribing Metformin Teva, clinicians should consider several safety considerations to minimise risk.

• Renal function: assess eGFR before initiation and monitor periodically.
• Hepatic impairment: use with caution; avoid in severe liver disease.
• Cardiovascular status: monitor for signs of heart failure, especially in high‑risk patients.
• Vitamin B12 levels: long‑term therapy may reduce absorption; consider periodic testing.
• Contraindications: avoid in patients with known hypersensitivity to metformin.
• Store at ambient temperature: keep below 25 °C in original packaging, protect from moisture.

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

Major Interactions (Avoid)

• Iodinated contrast agents: can precipitate acute renal failure and increase risk of lactic acidosis.
• Cimetidine: may raise metformin plasma concentrations, increasing toxicity risk.
• Rifampicin: can reduce metformin exposure, diminishing glucose‑lowering effect.

Moderate Interactions (Monitor Closely)

• Beta‑blockers: may mask hypoglycaemia symptoms.
• Diuretics (thiazides): can impair renal function, affecting metformin clearance.
• ACE inhibitors/ARBs: monitor renal function and electrolytes when combined.
• Alcohol: excessive intake may increase lactic acidosis risk.