Metformin (Glyciphage) 250 mg is an an anti-hyperglycemic medication used to control high blood sugar levels. It is the preferred first-line treatment for patients with type 2 diabetes mellitus (a condition wherein your body does not respond to and use insulin properly) in adults and children ten (10) years or older when diet and exercise are not effective in achieving blood sugar control. It helps reduce diabetes-associated complications, such as blindness, kidney damage, nerve damage, stroke, and heart attack. It is also used in the prevention and treatment of polycystic ovarian syndrome (PCOS).

What does metformin (Glyciphage) 250mg contain?

It contains metformin, which belongs to the class of antidiabetic drugs biguanides. Metformin is an FDA-approved anti-diabetic agent used in the treatment of type 2 diabetes mellitus. It is often used as a single drug or in combination with other anti-hyperglyemic medications when diet and exercise are not effective in lowering high blood sugar. 

Metformin also has several non-FDA-approved indications, including management of:

• Gestational diabetes (diabetes during pregnancy which disappears after giving birth)
• Weight gain due to antipsychotic drugs
• Polycystic ovarian syndrome

Currently, it is the only approved drug for the prevention of type 2 diabetes mellitus among those at risk, particularly those who are overweight and have pre-diabetic blood sugar levels.

How does metformin (Glyciphage) 250mg work?

In the management of diabetes, it works by decreasing the production of glucose in the liver, decreasing intestinal absorption, and increasing the body’s response to insulin. It lowers baseline blood sugar level and blood sugar level after eating.

In PCOS, it decreases insulin levels, which, in turn, decreases hormones that are responsible for the symptoms of PCOS. This normalizes the menstruation cycle.

Who should not take metformin (Glyciphage) 250mg?

This drug is not recommended if you have any of the following. Tell your doctor before starting the medicine if you:

• Are allergic to metformin or any ingredients of the Glyciphage tablet
• Have type 1 diabetes 
• Have kidney failure (eGFR < 30) or liver disease
• Have severe infection, dehydration, and shock
• Have acid-base imbalance in the body, metabolic acidosis, or diabetes complication of ketoacidosis
• Have lung failure or blood clot in the lungs
• Are being treated for heart failure or have recently had heart attack 
• Drink a lot of alcohol

How should you take metformin (Glyciphage) 250mg?

This drug is an oral medication typically dosed from 500mg-3,000mg per day in divided doses. Take this drug at a dose, frequency, and duration advised by your doctor. You may view Additional Information tab for recommended doses. The dose of this medicine will be different for different patients. Follow your doctor’s orders or the directions on the label. Your doctor will check your blood sugar levels regularly and may change your dose as necessary.  

It is taken with or just after meals to minimize stomach upset. Take the drug at the same time every day. Swallow your tablets whole and do not crush or chew them. 

Treatment for diabetes is usually for life. Do not stop taking this drug without talking to your doctor. If you stop taking it suddenly, your blood sugar levels will go up and your diabetes will get worse.

What if you miss a dose?

If you miss a dose of metformin, skip the missed dose and take the next dose at the usual time. Do not take 2 doses to make up for a missed dose.

What if you take too much?

Taking too much of the drug can cause serious side effects:

• Stomach pain, diarrhea
• Anxiety, unusual sleepiness
• Tiredness, weakness
• Fast heartbeat
• Shaking, sweating
• Hunger

Seek medical help immediately.

What are the side effects of metformin (Glyciphage) 250mg?

This drug is generally safe and well-tolerated. 

Gastrointestinal symptoms are the most common side effects, occurring in 30% of patients taking metformin. These include:

• Diarrhea
• Nausea
• Vomiting

Long-term use is associated with decreased vitamin B12 levels and should be monitored. Vitamin B12 deficiency manifests with tiredness, weakness, problems with vision, sore red tongue, mouth ulcers, and pale skin. Vitamin B12 supplementation may be needed with long-term use.

This drug is unlikely to cause low blood sugar levels when taken alone. However, if you take metformin and other anti-diabetic drugs, like insulin, you have an increased risk of having hypoglycemic episodes: feeling hungry, shaking, sweating, confusion, or difficulty concentrating.

Serious side effects are rare and happen in less than 1 in 10,000 people. Seek medical help immediately if you experience:

• Severe allergic reaction
• Feeling unwell with unusual tiredness
• Fast and shallow breathing
• Flow heartbeat
• Yellowing of the eyes or skin.

What other precautions should be taken?

Children

Metformin is the only oral drug approved for diabetes treatment in children 10 years and older and has been used off-label to achieve weight loss in obese children. Dosage recommendations may vary.

Elderly

This drug should be used conservatively among the elderly due to their decreased kidney function. Dose adjustments may be needed depending on their kidney function.

Pregnancy

Metformin is generally safe to use during pregnancy if prescribed by your doctor. Inform your healthcare provider first if you are pregnant and trying to get pregnant before taking this medication.

Breastfeeding

Metformin is known to pass into the breast milk but has not been linked with side effects in breastfed babies. Take this drug only as prescribed by your doctor.

Fertility

There is no evidence that this drug reduces fertility among men and women. In fact, it is used in managing PCOS, in addition to lifestyle changes, to improve ovulation and increase chances of conceiving a child.

Drug-Disease Interactions

• Kidney: Patients with mild to moderate kidney disease should take caution when taking this drug. Dose adjustments may be necessary. Please consult your doctor first.
• Liver: Avoid taking metformin if you have liver disease due to risk of adverse events.
• Surgery: Intake of this drug should be stopped temporarily when you have a surgery wherein you will be put to sleep (general anesthesia). Resume as advised by your doctor.

Drug-Drug Interactions

Intake of this drug should be stopped temporarily when you were injected with an iodinated dye for a test, like x-ray, in the past 48 hours, due to risk of adverse events. Resume as advised by your doctor.

Inform your doctor if you are taking any of the following medications due to increased risk of hypoglycemia:

• Other anti-diabetic drugs
• Male and female hormones (testosterone, progesterone)

Inform your doctor if you are taking any of the following medications due to increased risk of lactic acidosis:

• Topiramate, lamotrigine 
• Acetazolamide
• Bupropion 
• Non-steroidal anti-inflammatory drugs (mefenamic acid, ibuprofen)
• Enalapril, captopril
• Losartan, telmisartan
• Furosemide, thiazide diuretics

Inform your doctor if you are taking steroids and contraceptives. These affect how your body handles sugar. Your doctor may need to check your blood sugar levels more often and adjust your dose.

Supplements and herbal medicines – There’s limited data on their safety and efficacy. Tell your doctor if you are taking any supplement.

Alcohol

Drinking alcohol should be avoided when taking this drug due to increased risk of lactic acidosis.

Driving

This drug does not affect your ability to drive, but if your blood sugar level is low, you may experience dizziness. Do not drive or operate machinery if this happens.

Diet and Lifestyle

• To work properly, the amount of metformin you take must be balanced against the amount and type of food you eat and the amount of exercise you do.
• Cut down on foods that are high in added sugar, like sweets, cakes, and juice/fizzy drinks.
• Avoid food and drinks that contain karela, which lowers your blood sugar level.
• Avoid skipping meals as it interferes with the balance of sugar and insulin in the body. It can lead to dangerously high or low blood sugar levels.

How should you store metformin (Glyciphage) 250mg?

• Keep out of reach of children and pets.
• Store at room temperature in a cool and dry place away from light and moisture.
• Get rid of unused medication after expiry date.

Quick Tips

• Your doctor will regularly monitor your blood sugar control and kidney function.
• If you are using this drug on a long-term basis, your doctor may need to check your vitamin B12 levels or check for signs of vitamin B12 deficiency. Vitamin B12 supplementation may be needed.
• Carry a sugar source, like candy, around with you for immediate relief of hypoglycemia.

What company produces metformin (Glyciphage) 250mg?