Which groups of patients should not take metformin and why?

Metformin should be avoided in patients with acute or unstable heart failure because of the increased risk of lactic acidosis. It also should be avoided in patients with hepatic impairment, according to the labeling.

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Which patient should not be taking metformin?

This medicine is not recommended in patients 80 years of age and older who have kidney problems.

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Why can some people not take metformin?

Taking metformin can cause vitamin B12 deficiency if you take it for a long time. This can make you feel very tired, breathless and faint, so your doctor may check the vitamin B12 level in your blood. If your vitamin B12 levels become too low, vitamin B12 supplements will help.

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What is a contraindication for metformin in a person with type 2 diabetes?

Metformin is contraindicated in patients with creatinine clearance below 15ml/min. Impaired hepatic function may significantly limit the ability to clear lactate. Metformin should be avoided in patients with severe hepatic insufficiency (see Contraindications) and used with caution in patients with milder disease.

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Why is metformin contraindicated in patients with severe infection and or renal impairment?

Because metformin is cleared by the kidneys, it may accumulate when renal function decreases, with the potential for exposure-dependent toxicity that could precipitate lactate accumulation.

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What To Avoid When Taking Metformin | Drug Interactions | Pharmacology

27 related questions found

What is the risk of using metformin in patients with liver or renal impairment?

Metformin is primarily excreted unchanged by the kidney, and renal impairment may cause the accumulation of metformin leading to an elevated metformin concentration, and this has been proposed to lead to lactic acidosis [5].

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Why is metformin contraindicated in the hospital?

Metformin does have an associated risk of lactic acidosis, as well as a few frequently cited contraindications, most notably glomerular filtration rate (GFR) <30 mL/minute, hemodynamic instability, and need for contrast imaging [1].

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Should metformin be used in every patient with type 2 diabetes?

Metformin is the cornerstone of diabetes therapy and should be considered in all patients with type 2 diabetes. Both the American Diabetes Association (ADA) and the American Association of Clinical Endocrinologists (AACE)1,2 recommend it as first-line treatment for type 2 diabetes.

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Why is metformin contraindicated in hypertension?

Metformin had no significant effect on ambulatory blood pressure. Thus, metformin has, if any, only a minor clinically insignificant effect on blood pressure in nondiabetic hypertensives. The study does not support the hypothesis that circulating insulin is a major regulator of blood pressure in hypertension.

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Why metformin Cannot be used in type 1 diabetes?

Because the pancreas of a person with type 1 diabetes cannot produce insulin, these medications are not effective – and therefore, metformin combination drugs would not have a benefit for a person with type 1 diabetes.

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What natural remedy can replace metformin?

An effective substitute for Metformin is a compound known as berberine or berberine hydrochloride, which is obtained from many plant species, including goldenseal, barberry, Oregon grape, and turmeric.

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Why is metformin not recommended for people over 60?

However, elderly patients are more likely to have age-related kidney problems, which may require caution in patients receiving metformin. This medicine is not recommended in patients 80 years of age and older who have kidney problems.

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Can I take metformin if I have high blood pressure?

Giugliano et al. have reported that metformin may decrease blood pressure and increase insulin sensitivity in obese, non-diabetic, hypertensive women.

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Can you take metformin if you have heart problems?

It is estimated that 20-25% of patients taking metformin have heart failure. Metformin has been shown to have favorable effects on the course of heart failure in experimental models.

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Can people with high blood pressure take metformin?

Abstract. Abstract—Metformin, an antihyperglycemic agent used for treatment of type 2 diabetes mellitus, lowers blood pressure in humans and experimental animals. We recently demonstrated that short-term administration of metformin may lower blood pressure by reducing sympathetic neural outflow.

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What exactly does metformin do to your body?

Metformin lowers your blood sugar levels by improving the way your body handles insulin. It's usually prescribed for diabetes when diet and exercise alone have not been enough to control your blood sugar levels.

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Can type 2 diabetes be controlled without metformin?

You can treat type 2 diabetes without medication by focusing on: Eating a healthy, balanced diet. Losing weight to achieve a BMI in the healthy range. Living an active life.

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What should your blood sugar be when on metformin?

What should your blood sugar be when on metformin? Once metformin has started to work, it should help keep your blood glucose levels in the normal range. This means fasting glucose of 100 mg/dL or lower and post-meal levels of 140 mg/dL or lower.

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What are the symptoms of liver damage from metformin?

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.

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What is the black box warning on metformin?

Metformin has a black box warning for lactic acidosis — a condition where too much lactic acid builds up in the blood. It's a serious problem and can lead to death. If you experience these symptoms, seek medical attention right away.

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Does metformin damage other organs?

Metformin is often a first-choice treatment for Type 2 diabetes. It's not known to be harmful to your kidneys or other organs. But if you have kidney problems, there's a greater risk of a serious condition called lactic acidosis. Your healthcare provider should watch your kidney function while you're taking metformin.

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What age should you stop taking metformin?

The recommendations advise clinicians to consider discontinuing metformin in people aged 80 and older, those with gastrointestinal complaints during the last year, and/or those with Glomerular Filtration Rate (GFR) ≤60 ml/min.

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When do you no longer need metformin?

A doctor will often use certain criteria to determine whether it is safe for an individual to stop taking metformin. These criteria include: having a fasting or pre-meal blood glucose level of 80–130 milligrams per deciliter (mg/dL) having a random or after-meal blood glucose level of under 180 mg/dL.

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