Guide To The Side Effects Of Metformin

Metformin is a prescription medication used to manage type 2 diabetes. The medication works by decreasing the amount of glucose the liver makes and reducing the amount of glucose absorbed from the patient's diet. Additionally, metformin promotes increased insulin sensitivity, enabling the body to respond to and use insulin more effectively. This medicine is taken by mouth, and it is available as a liquid, immediate-release tablet, and extended-release tablet. Patients using liquid metformin generally take it once or twice per day at mealtimes, and the immediate-release tablet is normally taken on the same schedule. Individuals who take the extended-release form are typically advised to take it once per day with their evening meal. Doctors start patients on a low dose of this medication, gradually increasing the dose over one to two weeks. Patients are asked to monitor their blood glucose frequently during this period so the doctor will know how well metformin is working. Patients should continue to take their medication even if they feel well, and they should not stop taking metformin without talking to their physician first.

Some of the major side effects of metformin are discussed below.

Nausea And Vomiting

Nausea and vomiting are very common side effects associated with metformin, and they occur in an estimated twenty-five percent of patients taking this medication. Nausea is a feeling of unease in the stomach, and it may occur before vomiting. Some patients feel nausea more in the back of the throat or the chest. While uncomfortable, it is not painful. Patients may be able to reduce nausea by avoiding strong odors and getting fresh air. Keeping a food diary could be beneficial in identifying potential dietary triggers if patients have had nausea for an extended period. Eating small meals every few hours is often recommended for patients who feel nauseous, and it is important to avoid eating any food that has not been properly refrigerated or is spoiled. Most cases of nausea resolve on their own within a maximum of twenty-four hours.

Vomiting is an involuntary, forceful release of stomach contents through the mouth or nose. It is the stomach's attempt to rid itself of an irritant. If vomiting occurs, patients should make a note of how many episodes they have, and seek medical help immediately if the vomit contains blood or if it appears brown or black. Green vomit could indicate the presence of bile, and this should be mentioned to the patient's physician urgently. To treat vomiting at home, it can be helpful to have bland foods such as toast or crackers, and sipping water, flat ginger ale, and fruit juices could prevent dehydration. Some patients like to consume foods and drinks with ginger to reduce both nausea and vomiting. A doctor should be consulted if vomiting lasts more than twenty-four to forty-eight hours or if it prevents the patient from keeping down liquids.

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Diarrhea Or Constipation

Patients may experience stool changes such as diarrhea or constipation while taking metformin. Diarrhea affects around fifty-three percent of patients on metformin, and constipation is less common. Diarrhea occurs when the patient has loose, watery stools three or more times in twenty-four hours, and stomach cramps may be present. To reduce diarrhea, it may help to consume low-fiber foods and avoid dairy products and high-fat foods. Most cases of diarrhea related to metformin use are self-limiting and resolve without treatment; however, patients may wish to use an over-the-counter medication such as loperamide or bismuth subsalicylate to treat diarrhea at home. A physician should be consulted if diarrhea persists or if black stools occur as these may be a sign of a more serious condition.

Constipation develops if patients have stools that are dry, hard, or difficult to pass, and most doctors define constipation as having fewer than three bowel movements per week. Patients with constipation could experience pain during bowel movements, and there may be a constant sensation of fullness in the rectum. To treat constipation, doctors recommend that individuals increase their dietary fiber intake, and it may be necessary to take over-the-counter laxatives. Severe constipation may require an enema, and surgery is necessary if untreated constipation leads to a bowel blockage. Patients who take metformin should check with their doctor about whether they need to take fiber supplements or other medicines to prevent constipation.

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Lactic Acidosis

Lactic acidosis is a rare and potentially life-threatening potential side effect of metformin. The condition develops when there is an excessive amount of lactate in the blood, and it is also triggered by a low blood pH. Lactic acidosis is fatal in roughly fifty percent of cases, and metformin users who have liver or kidney issues such as liver failure, cirrhosis, or kidney failure are at an increased risk of this side effect. Congestive heart failure patients taking metformin face an elevated risk as well, and individuals who struggle with alcohol misuse face a higher likelihood of developing it. Symptoms of lactic acidosis include abdominal pain, a slow or irregular heartbeat, persistent nausea, and shortness of breath. Patients may notice they feel cold all the time, and the hands and feet could turn blue. Muscle pain, weakness, and fatigue may be present. Although lactic acidosis is rare, patients should let their doctor know immediately if they experience any of these symptoms. The primary treatment method for this condition is to discontinue metformin, and patients may need to be hospitalized to receive intravenous fluids and breathing support.

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Gas

Patients taking metformin often report an increase in gas (flatulence). To help manage this side effect, doctors suggest that patients consider making dietary modifications. It is particularly beneficial to avoid spicy foods since these tend to excite digestive acids and may cause gas to be expelled throughout the digestive system. Yogurt containing probiotics or active cultures may help to regulate digestion, and some individuals choose to add active probiotic supplements to their diets for this purpose. Reducing intake of fats is suggested to prevent the patient's rate of digestion from slowing. High-fat meals are digested slowly, and this allows gas to build up in the empty spaces of the digestive system. Over-the-counter medicines such as simethicone can help reduce gas, and ginger is beneficial for some patients. If gas is bothersome or persistent, the patient should speak to their doctor about prescription adjustments that could reduce this side effect.

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Stomach Pain

Stomach pain with metformin is most likely to occur in female patients who are at least sixty years old. It typically develops during the first six months of taking metformin, and those who have high blood pressure are at an increased risk for this side effect. Using acetylsalicylic acid and metformin together raises the likelihood of experiencing stomach pain as well. Patients with stomach pain might notice bloating and indigestion too. To reduce the risk of these symptoms, doctors suggest taking metformin with meals, and they may be able to prescribe an extended-release version of the medication or adjust the dose to make side effects more tolerable. Patients should always let their doctor know if stomach pain lasts more than a few days, and emergency medical care should be obtained if the stomach is swollen or tender to the touch. Stomach pain accompanied by fever, bloody stools, or persistent nausea and vomiting also warrants emergency care.