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The active ingredient Metformin belongs to the oral diabetes drugs (antidiabetics) and is used in type 2 diabetes mellitus. He is one of the active ingredients used and most studied longest in the oral diabetes therapy. Metformin is generally well tolerated, but may cause in rare cases, particularly during initiation of therapy gastrointestinal complaints. Here you can read everything about the effect of Metformin, side effects and dosage.
How Metformin acts
effects and side effects of Metformin arise from a variety of effects in the body.
After a carbohydrate meal, the pancreas pours insulin in order to keep blood sugar levels within the normal range. The sugar contained in food are digested in the intestines and added to form the basic unit of glucose. The circulating in the blood glucose is introduced through the undistributed insulin into the target cells and is available there for energy. The liver and muscles can store excess glucose as well and easily release into the blood again if necessary. In addition, the liver can also make glucose from other nutrients like fats and amino acids (building blocks of proteins).
The most important Metformin effect is the inhibition of glucose production by the liver, causing the characteristic of diabetes high blood sugar levels in the fasting state (basal blood glucose levels) can be avoided. Other modes of action are the delay of glucose absorption in the intestine and, consequently, lower blood sugar levels after meals (postprandial blood glucose levels) and an increase in insulin sensitivity (the target cells respond strongly to insulin, which the glucose uptake and – utilization improved)
Metformin also has a favorable effect on lipid metabolism, which is why it is preferred in overweight patients applies.
Following oral administration, approximately half is taken up two thirds of the active ingredient into the blood. In the body Metformin is not metabolized and excreted is about 6.5 hours after ingestion halfway through the kidneys. Uniformly high drug levels in the body make up after one or two days straight.
When is Metformin used?
The Metformin is approved for use in type 2 diabetics than oral antidiabetic if not let their blood sugar levels by diet and exercise to reduce enough.
Outside the approved indications (“off-label”), it is also at a preliminary stage of diabetes (pre-diabetes) and gestational diabetes (GDM) used.
Most Metformin is term used to influence the metabolic situation positively.
Metformin & amp; Fertility in Polycystic Ovary Syndrome
The polycystic ovary syndrome (PCO) is a hormonal disorder in women, which can among other things lead to infertility. Some studies and individual therapy experiments have shown that Metformin can help here. It may at the PCO often present insulin resistance and pathologically increased testosterone production treat well what the patients allows to get pregnant.
The use of Metformin after pregnancy is judged individually very different and should be decided by the physician on an individual basis.
How Metformin is applied
The Metformin is applied as a single or combination therapy in tablet form or in the form of a drinkable solution.
Individual therapy: At the beginning of therapy to 850 milligrams of Metformin are 500 two to three times a day or after meals given. After 10 to 15 days, the effect is evaluated on blood sugar levels and if necessary increase the dose by your doctor. The Metformin dose can be up to three times daily 1000 milligrams – increased
If the blood sugar levels this does not reduce sufficiently, a combination therapy can be considered. Combination preparations of Metformin and pioglitazone, vildagliptin, sitagliptin, saxagliptin and glibenclamide are available on the German market. The combination with insulin may be considered.
What are the side effects of Metformin?
side effects from Metformin usually only occur at the beginning of therapy and improve after a few days to weeks significantly. Very common (occurring in more than one in ten patients) leads to complaints of the digestive tract, such as nausea, vomiting, and abdominal pain. These side effects may get better when Metformin is taken with meals -. The digestive tract is then less irritated
Often, so with every tenth to hundredth patients occur taste changes. These have no disease value, but can be very annoying.
Very rare (affects less than one in ten thousand patients), but serious side effect occurs, the lactic acidosis on. Here there is an acidification of the body due to lactic acid, which has been mostly observed in patients with kidney disease. Signs of lactic acidosis are Metformin, gasping and a low body temperature. On suspicion of lactic acidosis, a doctor should be informed immediately.
What should be considered when taking Metformin?
In children and adolescents from ten years Metformin has been tested in controlled clinical trials. Here, there were no specific side effects with respect to the development, but the treatment should be particularly monitored by the doctor.
The use in pregnant women is not an absolute contraindication, an untreated gestational diabetes presents itself as much more harmful for the child. However, insulin is used in pregnant women as more common alternative for lowering blood sugar.
In the lactation should be avoided Metformin because it passes into breast milk. Is an application absolutely necessary, should not be continued.
Not recommended concomitant use of Metformin and the following medications:
- blood glucose affecting drugs such as glucocorticoids (cortisone) and circulatory stimulants (sympathomimetic)
- iodinated contrast media
- Certain diuretic drugs (loop diuretics)
In addition, experts recommend, during therapy with Metformin to avoid alcohol.
How to obtain drugs with Metformin
Because of the potential for side effects with Metformin preparations can be obtained in any dosage only on prescription through pharmacies.
Since when Metformin is known?
the biguanide class to which it belongs Metformin, chemically resembles a natural product of goat’s rue, which has long been used in folk medicine takes.
For the first time in 1929 was detected in rabbits that the blood sugar level can be effectively reduced with Metformin. Once there, however, about the same time succeeded in extracting insulin, which can be much better affect the blood glucose, Metformin was not investigated further.
It was not until the 1950s, interest in Metformin came on again. This was followed by studies in humans. The diabetologist Jean Stern published his studies in 1957, after which Metformin was marketed from 1958 as a drug in the UK. In the US, Metformin was approved in 1994.