Metformine Sandoz (Metformin Hydrochloride)

Metformine Sandoz is an oral biguanide used to improve glycaemic control in patients with disorders of glucose metabolism.

• Type 2 diabetes mellitus: lowers fasting and post‑prandial blood glucose levels.
• Combination therapy with other oral antidiabetics: enhances overall glycaemic control when monotherapy is insufficient.
• Adjunct to diet and exercise: supports lifestyle measures aimed at reducing hyperglycaemia.

• Metformin Hydrochloride reduces hepatic gluconeogenesis and increases peripheral insulin sensitivity by activating AMP‑activated protein kinase (AMPK). This leads to decreased glucose output from the liver and enhanced glucose uptake in muscle and adipose tissue, resulting in lower circulating blood glucose without stimulating insulin secretion.

Metformine Sandoz is generally well tolerated, but adverse reactions can occur.

Common Side Effects

• Nausea: mild to moderate stomach upset.
• Diarrhoea: frequent loose stools, especially during treatment initiation.
• Metallic taste: transient alteration of taste perception.
• Abdominal discomfort: cramping or bloating.
• Weight loss: modest reduction in body weight.
• Vitamin B12 deficiency: gradual decrease 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 or hepatitis.
• Hypoglycaemia: when combined with insulin or secretagogues.
• Electrolyte imbalance: especially in renal impairment.
• Anemia: due to chronic B12 deficiency.

Metformine Sandoz requires careful patient assessment and monitoring.

• Renal function: evaluate eGFR before starting and periodically thereafter.
• Lactic acidosis risk: avoid in patients with severe renal or hepatic impairment.
• Alcohol consumption: limit intake to reduce lactic acidosis potential.
• Vitamin B12 monitoring: assess levels during long‑term therapy.
• Pregnancy and lactation: weigh benefits against potential risks.
• Store at room temperature: keep in the original pack, protect from moisture and heat.

Metformine Sandoz may interact with several medicines, altering its efficacy or safety.

Major Interactions (Avoid)

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

Moderate Interactions (Monitor Closely)

• Beta‑blockers: may mask hypoglycaemia symptoms.
• Diuretics: affect renal clearance of metformin.
• ACE inhibitors or ARBs: monitor renal function and electrolytes.
• Alcohol: potentiates lactic acidosis, especially with excessive intake.