Guide To The Side Effects Of Metformin

January 22, 2023

Metformin is a prescription medication that works by decreasing the amount of glucose the liver makes. It also reduces the amount absorbed from the patient's diet. Additionally, this medication promotes increased insulin sensitivity. Metformin is available as a liquid, immediate-release tablet, and extended-release tablet. Patients taking metformin in an immediate-release tablet or as a liquid do so once or twice daily at mealtimes. Individuals who take the extended-release form are typically advised to take it once per day with dinner. Doctors start patients on a low dose, gradually increasing it over one to two weeks. Patients are asked to monitor their blood glucose frequently during this period. Patients must continue taking metformin even if they feel well. Ultimately, they should not stop taking it without talking to their doctor first.

Metformin is a strong diabetes medication. It is a common option for the treatment of type 2 diabetes. As mentioned, patients must maintain blood sugar monitoring on this medication. This often means using blood sugar test strips. Many patients may still need an insulin pen to help manage their condition. Although metformin is an effective diabetes treatment, it has quite a few potential side effects. Patients must understand the common ones so they know what to watch for when they take this medication.

Nausea And Vomiting

Nausea and vomiting are two very common side effects associated with metformin. 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 happen before vomiting. Some patients feel nausea more in the back of their throat or their 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 helps identify 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. It is essential to avoid eating any food that has not been properly refrigerated or is spoiled. Most cases of nausea resolve on their own within 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 note how many episodes they have. They need to seek medical help immediately if the vomit contains blood or if it appears brown or black. Green vomit could indicate the presence of bile. Patients need to mention this to their doctor quickly. Eating bland foods, such as toast or crackers, helps relieve vomiting. Beverages that help include water, flat ginger ale, and certain fruit juices. The beverages also prevent dehydration. Some patients like to consume foods and drinks with ginger to reduce both nausea and vomiting. Individuals should contact their doctor if vomiting lasts more than twenty-four to forty-eight hours or if it prevents them from keeping down liquids.

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. Constipation is not as common. Diarrhea occurs when the patient has loose, watery stools three or more times in twenty-four hours, and stomach cramps may be present. Consuming low-fiber foods and avoiding dairy products and high-fat foods helps reduce diarrhea. 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. Patients need to consult their doctor if diarrhea persists or if black stools occur. These may be signs of a more serious condition.

Constipation develops if patients have stools that are dry, hard, or difficult to pass. Most doctors define constipation as having fewer than three bowel movements per week. Patients with constipation often experience pain during bowel movements. They may have a constant sensation of fullness in their rectum. Doctors recommend that individuals increase their dietary fiber intake to treat constipation. It may be necessary to take over-the-counter laxatives. Severe constipation may require an enema. 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.

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. A low blood pH also triggers it. Lactic acidosis is fatal in roughly fifty percent of cases. 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 are at an elevated risk as well. Individuals who struggle with alcohol misuse also have 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 their 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 is to discontinue metformin. Patients may need to be hospitalized to receive intravenous fluids and breathing support.

Gas

Patients taking metformin often report an increase in gas (flatulence). Doctors suggest that patients consider making dietary modifications to manage this side effect. 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 regulate digestion. Some individuals choose to add active probiotic supplements to their diets for this purpose.

Reducing fat intake is suggested to prevent the patient's digestion from slowing. High-fat meals are digested slowly, which allows gas to build up in the empty spaces of the digestive system. Over-the-counter medicines such as simethicone can help reduce gas. Ginger is beneficial for some patients. If gas is bothersome or persistent, the patient should speak to their doctor about prescription adjustments.

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. 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.

Doctors suggest taking metformin with meals to reduce the risk of these symptoms. They may 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. They need to obtain emergency medical care if their stomach is swollen or tender to the touch. Stomach pain accompanied by fever, bloody stools, or persistent nausea and vomiting also warrants emergency care.

Heartburn

Heartburn is another common side effect of taking metformin. This refers to a burning sensation in the chest, typically behind the individual's breastbone. Individuals who deal with this side effect often report that their heartburn worsens after eating, taking a dose of the medication, lying down, or bending over. Although heartburn is uncomfortable, it is usually harmless. In addition, heartburn typically disappears as the patient's body starts to adjust to metformin. However, patients may want to talk to their doctor if their heartburn persists for longer than a couple of weeks or worsens.

Weight Loss

Patients who take metformin for diabetes often experience weight loss as a side effect. In many cases, this side effect is the result of others. Specifically, individuals on metformin are more likely to deal with weight loss if they are also experiencing nausea and vomiting. The reason for this is that nausea and vomiting both reduce an individual's appetite. Thus, when patients on metformin eat less food, they are not consuming as many calories. The fewer calories they consume, the more weight they will lose. Of course, patients may experience weight loss on metformin for other reasons. However, the good news is that in most cases, once their body adjusts to metformin, this side effect will disappear.

Metallic Taste In Mouth

Many individuals who take metformin experience an unpleasant and unusual metallic taste in their mouth. There are a few reasons behind this side effect. First, metformin can alter the patient's taste bud receptors in their brain. The alteration from metformin triggers the metallic taste. In addition, when patients have any of this medication left in their saliva, the metallic taste can be prolonged. However, patients can rest easy since this side effect is typically harmless. In addition, many individuals report that it often goes away when they continue to take metformin as prescribed. Of course, should this side effect worsen or persist, patients may want to contact their doctor for advice.

Anemia

Some patients who take metformin may find that it decreases vitamin B12 in their body. Unfortunately, this can result in anemia as a side effect. Thankfully, anemia from metformin is rare. However, not getting enough calcium or vitamin B12 through diet can increase this risk significantly. Symptoms of anemia include feeling lightheaded, dizziness, as well as frequent fatigue. While patients can relieve this side effect by stopping metformin, they should not do so unless their doctor has recommended it. In many cases, doctors will recommend that patients try taking vitamin B12 supplements first. This can help relieve anemia as a side effect fairly often.

Fever And Chills

In rare cases, patients will experience a fever and chills as side effects of metformin. A fever refers to a body temperature of 100.4 degrees Fahrenheit or higher. Patients have a high fever when their temperature is at least 103.1 degrees Fahrenheit. Chills, on the other hand, refer to an individual feeling extremely cold even when their body temperature dictates otherwise. Patients with chills often shiver and deal with clammy skin at the same time. Patients need to talk to their doctor immediately if they deal with either a fever or chills on metformin. This is particularly vital for chills, which can be a warning sign of lactic acidosis, another rare and severe side effect of this medication.

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