Metformin
- Atc Codes:A10BA02
- CAS Codes:1115-70-4
- PHARMGKB ID:1115-70-4
Table of contents
- Brand Names
- Drug Combinations
- Chemistry
- Pharmacologic Category
- Mechanism of Action
- Therapeutic Use
- Unlabeled Use
- Pregnancy and Lactation Implications
- Contraindications
- Warnings and Precautions
- Adverse Reactions
- Caution and personalized dose adjustment in patients with the following genotypes
- Other genes that may be involved
- Drug Interactions
- Nutrition/Nutraceutical Interactions
- Dosage
- Pharmacokinetics and Pharmacodynamics
- Special Considerations
Brand Names
Europe
Austria: Arcaphage, Diabetex, Glucophage, Meglucon, Metformin; Belgium: Glucophage, Metformax, Metformine; Bulgaria: Glibomet, Glucophage, Meglucon, Metfogamma, Metformin, Neoformin, Normaglic, Siofor; Cyprus: Brot, Glucophage, Glyformin, Metforal, Metformin, Neomid; Czech Republic: Adimet, Diaphage, Glucophage, Gluformin, Glumetsan, Langerin, Metfirex, Metfogamma, Metfogen, Metformin, Normaglyc, Siofor, Stadamet; Denmark: Metformin, Orabet-Hexal; Estonia: Glumetsan, Metfogamma, Metforal, Metformin, Stadamet; Finland: Diformin Retard, Glucophage, Metforem, Metformin, Metgol, Oramet; France: Diabamyl, Glucophage, Metformine; Germany: Biocos, Bonformin, Diabesin, Diabetase, Glucobon, Glucofree, Glucophage, Juformin, Mediabet, Meglucon, Mekoll, Mescorit, Met, Metfin, Metfogamma, Metfor, Metform, Metformdoc, Metformin, Metkar, Metnit, Metsop, Metsurrir, Mettas, Siofor; Greece: Formin, Glucofree, Glucophage, Glucoplus, Metforil, Metformin, Metformine, Sukontrol; Hungary: Adimet, Meforal, Meglucon, Merckformin, Metfogamma, Metformin, Metrivin, Normaglyc, Stadamet; Ireland: Bellformin, Gerformin, Glucophage, Metformin, Metophage; Italy: Glucophage, Metbay, Metfonorm, Metforal, Metforalmille, Metformina; Latvia: Formetic, Glucophage, Glumetsan, Metfogamma, Metforal, Metformin, Normaglyc, Stadamet; Lithuania: Glumetsan, Metfogamma, Metforal, Metformin, Normaglyc, Stadamet; Luxembourg: Glucophage; Malta: Brot, Glyformin, Glucophage, Metformin, Metforal; Netherlands: Metformine; Poland: Etform, Formetic, Glucophage, Gluformin, Glumetsan, Mefrin, Metfogamma, Metformax, Metformin, Metformina, Metifor, Metral-Warszawskie Zakł.Farm., Normaglic, Siofor, Stadamet; Portugal: Glucophage, Mekoll, Metformina, Risidon, Stagid; Romania: Altroin, Diaformin, Diguan, Dipimet, Formiran, Glucophage, Medifor, Meguan, Metfogamma, Metformin, Normaglyc, Siofor; Slovakia: Glucophage, Glumetsan, Metfogamma, Metfogen, Metformin, Normaglyc, Siofor, Stadamet; Slovenia: Aglurab, Glucophage, Metfogamma, Siofor; Spain: Dianben, Metformina; Sweden: Glucophage, Metformin; UK: Glucophage, Metformin.
North America
Canada: Glucophage, Glumetza, Glycon, Metformin; USA: Fortamet, Glucophage, Glumetza, Metformin, Riomet.
Latin America
Argentina: Baligluc, Diab Dos, Diabesil, Duburina, Glucaminol, Glucogood, Glucophage, Islotin, Mectin, Medobis, Melgib, Metforal, Metformin, Metformina, Metglucon, Oxemet, Redugluc; Brazil: Diaformin, Dimefor, Formyn, Glicefor, Glicomet, Glifage, Glucoformin, Meguanin, Metformed, Metformina, Merformix, Neo Metformin, Teutoformin; Mexico: Aglumet, Anglucid, Apozemia, Dabex, Debeone, Dimefor, Dinamel, Ficonax, Forlucyl, Glucotec, Glunovag, Harbamind, Ifor, Meglubet, Melbexa, Metbax, Metformina, Metixor, Mifelar, Pharmafet, Predial, Sibet.
Asia
Japan: Glycoran, Medet, Melbin, Metrion, Nelbis.
Drug combinations
Metformin and Chlorpropamide
Metformin and Glipizide
Metformin and Glyburide
Metformin and Pioglitazone
Metformin and Repaglinide
Metformin and Rosiglitazone
Metformin and Saxagliptin
Metformin and Sitagliptin
Metformin and Vildagliptin
Chemistry
Metformin Hydrochloride: C~4~H~11~N~5~ HCl. Mw: 165.62. (1) Imidodicarbonimidic diamide, N,N-dimethyl-, monohydrochloride; (2) 1,1-Dimethylbiguanide monohydrochloride. CAS-1115-70-4 (1995).
Pharmacologic Category
Antidiabetic Agents; Biguanides. (ATC-Code: A10BA02).
Mechanism of action
Decreases hepatic glucose production, decreasing intestinal absorption of glucose and improves insulin sensitivity (increases peripheral glucose uptake and utilization).
Therapeutic use
Management of type 2 diabetes mellitus (non-insulin-dependent) as monotherapy. In adults, may be used concomitantly with sulfonylurea or insulin to improve glycemic control.
Pregnancy and lactiation implications
Adverse events not observed in animal studies. Metformin crosses placenta. Insulin is drug of choice for control of diabetes mellitus during pregnancy. Use not recommended during lactation.
Unlabeled use
Gestational diabetes mellitus. Polycystic ovary syndrome.
Contraindications
Hypersensitivity to metformin or any component of the formulation. Renal disease or renal dysfunction (serum creatinine ≥1.5 mg/dL in males or ≥1.4 mg/dL in females) or abnormal creatinine clearance from any cause, including shock, acute myocardial infarction, or septicemia. Acute or chronic metabolic acidosis with or without coma (including diabetic ketoacidosis). Temporarily discontinue in patients undergoing radiologic studies in which intravascular iodinated contrast media are utilized.
Warnings and precautions
Lactic acidosis is rare, but potentially severe consequence of therapy with metformin. Risk of accumulation and lactic acidosis increases with degree of impairment of renal function. Use caution in congestive heart failure, particularly in unstable or acute heart failure (risk of lactic acidosis may be increased secondary to hypoperfusion). Avoid use in impaired liver function (potential for lactic acidosis). Metformin is substantially excreted by kidney (patients with renal function below limit of normal for their age should not receive therapy). Metformin should be withheld in dehydration and/or prerenal azotemia. Metformin should not be initiated in patients ≥80 years of age unless normal renal function confirmed. Ethanol might potentiate effect of metformin on lactate metabolism (excessive acute or chronic ethanol use should be avoided). Therapy should be temporarily discontinued prior to or at the time of intravascular administration of iodinated contrast media (potential for acute alteration in renal function). Therapy should be suspended for any surgical procedures.