As seen in Table 2, 40 patients (53.3%) had GI side effects with persistent use of metformin tablet for 7.8 years in average (range, 1–30 years), including epigastric and abdominal pain, nausea, vomiting, diarrhea, and bloating.
GI AEs typically encountered with metformin therapy include diarrhoea, nausea, flatulence, indigestion, vomiting and abdominal discomfort, with diarrhoea and nausea being the most common.
Common Side Effects of Metformin
Stomach trouble is the most common metformin side effect. About 25% of people have problems like: Bloating. Gas.
Metformin has a number of actions within the gut. It increases intestinal glucose uptake and lactate production, increases GLP-1 concentrations and the bile acid pool within the intestine, and alters the microbiome.
Take metformin with food to reduce the chances of feeling sick. It may also help to slowly increase your dose over several weeks. Ask a pharmacist or your doctor for advice. Take small, frequent sips of water or squash to avoid dehydration.
Metformin may have an adverse effect on renal function in patients with type 2 DM and moderate CKD.
Non-symptomatic gastritis is linked with metformin-related gastrointestinal side effects in patients with type 2 diabetes, a study finds. Gastritis occurs when the stomach lining becomes inflamed, which can cause stomach pain, vomiting and bloating following eating.
Metformin can be a bit tough on the digestive tract, especially when first starting it. In one study, over half the people taking metformin experienced a gastrointestinal (GI) side effect — an issue with the stomach or digestive tract. The most common metformin side effects include: Diarrhea.
Conclusion: In conclusion, the present study proposes the benefit of combining probiotics with metformin in the treatment of patients with T2D or prediabetes in terms of improved glycemic control and treatment adherence rather than correction of dyslipidemia or weight reduction.
It may start lowering your blood sugar within the first week. But it may cause stomach problems like nausea and diarrhea. These uncomfortable symptoms usually stop within a few weeks of starting metformin. Taking it with meals (preferably the largest meal or meals of the day) can help you limit these side effects.
As much as possible, avoid white bread, white rice, white pasta, candy, soda, desserts, and snacks like chips or crackers. Eating foods that can spike your blood sugar will not necessarily make the metformin not work, however, it will increase the burden it has to work against.
Common metformin alternatives are SGLT-2 Inhibitors (Invokana, Farxiga, Jardiance, and Steglatro), GLP – 1 Receptor Agonists ( Bydureon, Byetta, Ozempic, Adlyxin, Rybelsus, Trulicity, and Victoza), Sulfonylureas or SFUs { DiaBeta, Glynase, or Micronase (glyburide or glibenclamide) Amaryl (glimepiride) Diabinese ( ...
Medication or Supplement Use
The popular diabetes medication Metformin could make IBS symptoms worse for some people with PCOS. Metformin works to block carbohydrates from raising blood glucose and insulin levels. In doing so, metformin can cause diarrhea and nausea.
GLP-1 receptor agonists are another option if Metformin isn't working for you. These can either be taken orally or through an injection (either once a day or once weekly). They are proven to lower blood sugar levels and HbA1c levels, as well as protect against kidney disease and heart disease as well.
A rare side effect of metformin is its association with acute pancreatitis due to overuse or renal failure [4].
Clinically apparent liver injury from metformin is very rare, fewer than a dozen cases having been described in the literature despite widespread use of this agent for several decades. The liver injury usually appears after 1 to 8 weeks, typically with symptoms of weakness and fatigue followed by jaundice.
Dosage and strength
The maximum daily dose is 2,000mg a day. This can be taken as four 500mg tablets a day. Liquid metformin should be taken in 5ml doses of 500mg, 850mg or 1,000mg.
More serious side effects are rare. They include severe allergic reactions and a condition called lactic acidosis, a buildup of lactic acid in the bloodstream. The risk for this is higher among people with significant kidney disease, so doctors tend to avoid prescribing metformin for them.
Declining renal function prohibits many medications for fear of potential side effects from lower renal clearance. As such, it is recommended that metformin should be discontinued when the eGFR falls to 30 ml/minute/1.73 m2 or below [3], in anticipation of a higher risk of lactic acidosis.
Under certain conditions, too much metformin can cause lactic acidosis. The symptoms of lactic acidosis are severe and quick to appear, and usually occur when other health problems not related to the medicine are present and are very severe, such as a heart attack or kidney failure.
Is it safe to have coffee while consuming Metformin? Caffeine gets broken down by the body to remove it. Metformin may reduce how rapidly the body breaks down caffeine. Metformin when consumed in combination with caffeine can enhance the effects and side effects of caffeine.
Common side effects of metformin can include dizziness, irregular heartbeat, feeling cold, tiredness, and more.
Symptoms of lactic acidosis are nonspecific and may include anorexia, nausea, vomiting, abdominal pain, lethargy, hyperventilation, and hypotension [11]. Five of our patients (71%) complained of diarrhea, which can be an adverse effect of metformin and can aggravate hypovolemia.