Metformin

WHAT IS IT?

Metformin (biguanide) is an oral hypoglycemic drug whose exact mechanism is unknown, however it causes the following outcomes:

  • Decreased glujconeogeneis by the liver
  • Increased glycolysis
  • Increased glucose uptake
  • Increased insulin sensitivity
  • Moderate weight loss
  • Decreased lactic acid uptake by the liver

*Euglycemic medication because it prevents hyperglycemia vs. causing hypoglycemia

One proposed mechanism of metformin activity (source)
One proposed mechanism of metformin activity (source)
WHEN DO WE USE IT? 

Type 2 diabetes mellitus (first-line therapy), can be used in patients without islet function

Also used in polycystic ovary syndrome

WHEN DO WE AVOID USING IT?

Renal insufficiency is a contraindication because metformin can cause lactic acidosis.

HOW IS IT ADMINISTERED?

Administered orally.

Source
Source
WHAT ARE THE SIDE EFFECTS/TOXICITY?

Diarrhea, lactic acidosis (can be fatal)

ANYTHING ELSE TO KEEP IN MIND?

Patients should avoid consuming excessive alcohol while on this medication

FURTHER READING

DynaMed

UpToDate

Page Updated: 02.17.2016