Metformin is the most common first-line pill for type 2 diabetes. It lowers blood sugar mainly by cutting glucose production in the liver and improving how your body uses insulin. That makes it a go-to because it helps control levels without usually causing weight gain or low blood sugar on its own.
Doctors also use metformin off-label for conditions like polycystic ovary syndrome (PCOS) and sometimes for prediabetes to slow progression. If you’re starting metformin, expect your clinician to discuss goals: A1C targets, lifestyle changes, and how metformin fits into your overall plan.
Typical starting doses are 500 mg once or twice a day or 850 mg once daily. Many people move to 1000 mg twice daily if needed. There’s an extended‑release (XR) version taken once a day to reduce stomach upset. Your prescriber will usually raise the dose slowly over weeks to help your gut adjust.
Take metformin with food to cut nausea and diarrhea. Do not crush or split XR tablets. If you miss a dose, take it when you remember unless it’s close to your next dose—don’t double up.
Common side effects are stomach upset, gas, and diarrhea—these often ease after a few weeks or after switching to XR. Long-term use can lower vitamin B12, so ask your clinician about periodic B12 checks if you’ve been on metformin for years.
Serious problems are rare but include lactic acidosis, a buildup of acid that can be dangerous. That risk is very low if your kidneys are healthy. Your provider will check kidney function (eGFR) before starting and during treatment. Stop metformin and seek care if you get severe muscle pain, trouble breathing, dizziness, or unusual drowsiness.
Avoid heavy alcohol use while on metformin. Also, tell health providers you take metformin before any CT scan with contrast—many doctors pause metformin around that time until kidney function is rechecked.
If metformin isn’t enough or causes unacceptable side effects, there are other options: SGLT2 inhibitors (like empagliflozin), GLP-1 receptor agonists (like semaglutide), DPP‑4 inhibitors, sulfonylureas, and insulin. Each has pros and cons—some help with weight loss, others reduce heart or kidney risk. Talk with your clinician about what fits your health needs and budget.
Practical tips: take metformin at the same time every day, pair it with meals to reduce nausea, keep up with lab checks (A1C, kidney tests, B12), and carry a list of your meds when you travel. If you plan pregnancy or surgery, mention metformin—your care team may change your plan briefly.
Want more details or alternatives? Browse related articles on this site to compare options, side effects, and costs so you can discuss clear choices with your provider.
Recent research has uncovered that Metformin, a diabetes medication, significantly increases the production of an 'anti-hunger' molecule, lac-phe, leading to reduced appetite and significant weight loss. This discovery opens new avenues for obesity treatment, showcasing Metformin's potential beyond diabetes management.
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