Metformin 1000 mg is a widely prescribed oral medication used primarily for managing type 2 diabetes mellitus. It is also employed in the treatment of polycystic ovary syndrome (PCOS) and is sometimes used off-label for conditions such as gestational diabetes and metabolic syndrome.

What Is Metformin 1000 mg?

Metformin belongs to the biguanide class of medications. It works by:

• Reducing glucose production in the liver.
• Decreasing glucose absorption in the intestines.
• Increasing insulin sensitivity, allowing for better utilization of glucose by muscle and fat cells.

These mechanisms help lower blood sugar levels without causing significant hypoglycemia (low blood sugar) .

Dosage and Administration

• Starting Dose: Typically, treatment begins with 500 mg to 850 mg once or twice daily, taken with meals to reduce gastrointestinal side effects.
• Maintenance Dose: The dose may be gradually increased based on individual response, up to a maximum of 2,000 mg to 2,500 mg per day, divided into two or three doses .
• Extended-Release Formulations: For extended-release versions, the usual starting dose is 500 mg to 1,000 mg once daily with the evening meal, with potential increases based on tolerance and blood sugar levels.

Always follow your healthcare provider’s instructions regarding dosage and administration.

Side Effects

Common Side Effects:

• Gastrointestinal issues: Nausea, vomiting, diarrhea, stomach pain, and loss of appetite. These are usually temporary and can be minimized by taking the medication with food .

Serious Side Effects:

• Lactic acidosis: A rare but serious condition characterized by symptoms such as muscle pain, difficulty breathing, stomach discomfort, dizziness, and feeling cold. This condition requires immediate medical attention .
• Vitamin B12 deficiency: Long-term use of metformin may lead to decreased vitamin B12 levels, potentially causing fatigue and anemia.

Precautions and Contraindications

• Kidney Function: Metformin is contraindicated in individuals with severe renal impairment (e.g., eGFR below 30 mL/min/1.73 m²) due to the increased risk of lactic acidosis .
• Liver Disease: Use with caution in patients with liver disease, as it may increase the risk of lactic acidosis.
• Alcohol Consumption: Excessive alcohol intake can increase the risk of lactic acidosis and should be avoided.
• Surgical Procedures: Metformin should be temporarily discontinued before major surgeries or procedures involving contrast dyes and resumed only when kidney function is stable .

Monitoring and Lifestyle Considerations

• Blood Sugar Levels: Regular monitoring of blood glucose levels is essential to assess the effectiveness of metformin and make necessary adjustments.
• Vitamin B12 Levels: Long-term use may require periodic monitoring of vitamin B12 levels to prevent deficiency.
• Diet and Exercise: Adhering to a balanced diet and regular physical activity can enhance the effectiveness of metformin in controlling blood sugar levels.

1. What is Metformin 1000 mg used for?

Metformin 1000 mg is primarily used to manage type 2 diabetes mellitus by helping to control blood sugar levels. It may also be used in the treatment of polycystic ovary syndrome (PCOS) and is sometimes used off-label for conditions like gestational diabetes and metabolic syndrome.

2. How does Metformin 1000 mg work?

Metformin works by:

• Decreasing glucose production in the liver.
• Reducing glucose absorption from the intestines.
• Increasing insulin sensitivity, allowing for better utilization of glucose by muscle and fat cells.

These actions help lower blood sugar levels without causing significant hypoglycemia (low blood sugar).

3. What is the usual dosage of Metformin 1000 mg?

• Starting Dose: Typically, Metformin is started at 500 mg to 850 mg once or twice a day with meals to reduce gastrointestinal side effects.
• Maintenance Dose: The dose can be increased gradually based on individual response, up to a maximum of 2,000 mg to 2,500 mg per day, divided into two or three doses.
• Extended-Release Forms: For extended-release formulations, the usual starting dose is 500 mg to 1,000 mg once daily, usually with the evening meal.

Always follow your healthcare provider’s instructions for dosage.

4. What are the common side effects of Metformin 1000 mg?

Common side effects include:

• Nausea
• Diarrhea
• Stomach pain
• Loss of appetite

These side effects are usually temporary and can be minimized by taking Metformin with meals.

5. What are the serious side effects of Metformin 1000 mg?

Serious side effects may include:

• Lactic acidosis: A rare but severe condition characterized by symptoms such as muscle pain, difficulty breathing, stomach discomfort, dizziness, and feeling cold.
• Vitamin B12 deficiency: Long-term use of Metformin can reduce vitamin B12 levels, leading to fatigue and anemia.

Seek immediate medical attention if you experience any of these symptoms.