Boulderendo.com2

Metformin
(Glucophage, Glucophage XR, Fortamet®, Glumetza®)
Information for Patients

Basic Information About Metformin
 Metformin is a medication used to treat diabetes. Metformin may be used by itself, or it may be combined
with other diabetes pills or with insulin.

 Metformin tablets come in 500 mg, 850 mg, and 1000 mg sizes. Metformin extended release tablets come
in 500 mg, 750 mg, and 1000 mg sizes. Your dose is listed on the other side of this form.

 Metformin should generally be taken with food to minimize side effects, although it can be taken without

What Side Effects Can Metformin Cause?
 The most common side effects of metformin are diarrhea, nausea, abdominal bloating, flatulence (excessive
gas), and suppressed appetite. Occasionally metformin can cause a metallic taste. These side effects can be
limited by starting at a low dose, and then gradually increasing the dose over time. Even in people who
continue to take metformin, these side effects go away after one or two weeks in most people. If you have
severe side effects, or side effects do not resolve after a few weeks, you should report these to your doctor.

 Metformin by itself almost never causes low blood sugar. However, if metformin is added to other diabetes
medications it may increase the risk of having a low blood sugar. You may need to monitor your blood sugar
more carefully while starting metformin. You should tell your doctor if you are having problems with low
blood sugars.

 The most serious side effect of metformin is lactic acidosis. This is very, very rare. However, because it is a
serious side effect, if you have any unusual muscle aches, difficulty breathing, feelings of extreme weakness
or tiredness, confusion, or unusual stomach discomfort, please report these to your doctor.

Are There Special Precautions for People Who Take Metformin?
 Metformin should not be taken by people with certain types of kidney disease or liver disease, or people who
take medications to treat congestive heart failure. People who require oxygen therapy should not take
metformin unless specifically directed to do so by their doctor.

 Alcohol in excess may increase the likelihood that metformin causes serious side effects. People taking
metformin should not drink to excess.

 Metformin should be stopped temporarily if you are hospitalized or have surgery, if you are unable to drink
liquids, or if you have severe vomiting or diarrhea. You should discuss with your doctor when to restart
metformin. It may be necessary for your doctor to perform a blood test to ensure your kidney function is
normal.

 Metformin should be stopped if you have an x-ray test that involves having dye injected into your veins. The
last metformin tablet may be taken the day prior to the test or the day of the test. Metformin can be restarted
48 hours after the test, after your doctor has performed a blood test to ensure your kidney function is normal.

 If you become pregnant, you should notify your doctor. In some instances (such as polycystic ovary
syndrome), there may be benefit continuing metformin through the 1st trimester.
revised 1-06
Page 1 of 2
Metformin – Information for Patients

What Is My Dose of Metformin?

 To minimize side effects, metformin is generally started at a low dose and gradually increased to the target
dose. When starting metformin, you should take it with food.

 Please note your pill size. This is important for determining how many pills you take at a given time. There
may be more than one combination of pills that make a certain dose. For example, a 500 mg dose can be
taken as one 500 mg tablet or one-half of a 1000 mg tablet; a 1000 mg dose may be taken as two 500 mg
tablets or one 1000 mg tablet.
 If you are having trouble with gastrointestinal side effects, you can delay making a dose for an additional 1-2
weeks. If symptoms are not improving, please discuss with your doctor whether you should stay on
metformin.

YOU SHOULD BEGIN METFORMIN AS MARKED BELOW:

 TARGET DOSE: METFORMIN 1000 MG IN THE MORNING AND 1000 MG IN THE EVENING
WITH MORNING
WITH EVENING
* 500 mg = one 500 mg tablet or
½ of 1000 mg tablet
1000 mg 
1000 mg = two 500 mg tablets or
1000 mg 
1000 mg 
one 1000 mg tablet
AND BEYOND
 TARGET DOSE: METFORMIN _____ MG IN THE MORNING AND _____ MG IN THE EVENING
WITH MORNING
WITH EVENING
500 mg = one 500 mg tablet or
½ of 1000 mg tablet
750 mg = one 750 mg tablet
850 mg = one 850 mg tablet
AND BEYOND
1000 mg = two 500 mg tablets or
one 1000 mg tablet

Will My Dose Change?

 Metformin takes several weeks, once you have reached your target dose, to have the greatest effect on your
blood sugar.

 If your blood sugar is still high 2 or 3 weeks after you reach your target dose, you may need to have your dose
increased or may need to start additional diabetes medications. Your doctor will discuss any changes with
you. You should not change the dose without talking with your doctor first.
revised 1-06
Page 2 of 2

Source: http://boulderendo.com/pdffiles/metformin.pdf