See also Warning section.
Before taking this medication, tell your doctor or pharmacist if you are allergic to Metfor-acis; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.
Before using this medication, tell your doctor or pharmacist your medical history, especially of: severe breathing problems (such as obstructive lung disease, severe asthma), blood problems (such as anemia, vitamin B12 deficiency), kidney disease, liver disease.
Before having surgery or any X-ray/scanning procedure using iodinated contrast, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products). You may need to stop this medication for a short time for the surgery/procedure. Ask your doctor or dentist for instructions before your surgery/procedure.
You may experience blurred vision, dizziness, or drowsiness due to extremely low or high blood sugar. Do not drive, use machinery, or do any activity that requires alertness or clear vision until you are sure you can perform such activities safely.
Limit alcohol while using this medication because it can increase your risk of lactic acidosis and developing low blood sugar.
High fever, "water pills" (diuretics such as hydrochlorothiazide), too much sweating, diarrhea, or vomiting may cause loss of too much body water (dehydration) and increase your risk of lactic acidosis. Stop taking this medication and tell your doctor right away if you have prolonged diarrhea or vomiting. Be sure to drink enough fluids to prevent dehydration unless your doctor directs you otherwise.
It may be harder to control your blood sugar when your body is stressed (such as due to fever, infection, injury, or surgery). Consult your doctor because increased stress may require a change in your treatment plan, medications, or blood sugar testing.
Older adults may be at greater risk for side effects such as low blood sugar or lactic acidosis.
During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor. Your doctor may direct you to use insulin instead of this product during your pregnancy. Follow your doctor's instructions carefully.
Metfor-acis can cause changes in the menstrual cycle (promote ovulation) and increase the risk of becoming pregnant. Consult your doctor or pharmacist about the use of reliable birth control while using this medication.
Metfor-acis passes into breast milk in small amounts. Consult your doctor before breast-feeding.
Vitamin B-12 deficiencies
Vitamin B-12 is an essential nutrient that is key to cardiovascular and neurological health, as well as being vital for healthy red blood cells.
Metfor-acis may reduce vitamin B-12 absorption in some people. Alcohol can also interfere with B-12 absorption by causing inflammation in the stomach.
Vitamin B-12 deficiency is a rare side effect of using Metfor-acis. However, some research suggests that the risk may be much higher, with 10 to 30 percent of people who take Metfor-acis for long-term type 2 diabetes experiencing reduced circulating B-12 levels.
While the symptoms of deficiency may be subtle and slow to progress, significant B-12 deficiency can pose serious health risks. If a person suspects they may have a B-12 deficiency, they should seek medical advice.
The warning signs and complications of vitamin B-12 deficiencies include:
- numbness or tingling in the hands and feet
- impaired memory
- inability to concentrate
Supplements or diet change can reverse most B-12 deficiencies and reduce any symptoms. Vitamin B-12 is present in high levels in foods such as beef, eggs, dairy products, and shellfish.
People with diabetes using Metfor-acis should discuss B-12 screening options with their doctor.
Switching from Metfor-acis immediate-release to Metfor-acis extended-release
- Patients receiving Metfor-acis HCl may be switched to Metfor-acis extended-release at the same total daily dose, up to 2,000 mg/day
6. How to cope with s >
What to do about:
- feeling sick - take Metfor-acis with food to reduce the chances of feeling sick. It may also help to slowly increase your dose over several weeks. Ask a pharmacist or your doctor for advice.
- being sick (vomiting) or diarrhoea - drink lots of fluids, such as water or squash, to avoid dehydration. Take small, frequent sips if you're being sick. Speak to a pharmacist if you have signs of dehydration, such as peeing less than usual or having dark, strong-smelling pee. Do not take any other medicines to treat diarrhoea or vomiting without speaking to a pharmacist or doctor.
- stomach pain - try to rest and relax. It can help to eat and drink slowly and have smaller and more frequent meals. Putting a heat pad or covered hot water bottle on your stomach may also help. If you're in a lot of pain, speak to your pharmacist or doctor.
- loss of appetite - eat when you'd usually expect to be hungry. If it helps, eat smaller meals more often than usual.
- a metallic taste in the mouth - if you find that Metfor-acis is giving you a metallic taste in the mouth, try chewing sugar-free gum
Why is this medication prescribed?
Metfor-acis is used alone or with other medications, including insulin, to treat type 2 diabetes (condition in which the body does not use insulin normally and, therefore, cannot control the amount of sugar in the blood). Metfor-acis is in a class of drugs called biguanides. Metfor-acis helps to control the amount of glucose (sugar) in your blood. It decreases the amount of glucose you absorb from your food and the amount of glucose made by your liver. Metfor-acis also increases your body's response to insulin, a natural substance that controls the amount of glucose in the blood. Metfor-acis is not used to treat type 1 diabetes (condition in which the body does not produce insulin and therefore cannot control the amount of sugar in the blood).
Over time, people who have diabetes and high blood sugar can develop serious or life-threatening complications, including heart disease, stroke, kidney problems, nerve damage, and eye problems. Taking medication(s), making lifestyle changes (e.g., diet, exercise, quitting smoking), and regularly checking your blood sugar may help to manage your diabetes and improve your health. This therapy may also decrease your chances of having a heart attack, stroke, or other diabetes-related complications such as kidney failure, nerve damage (numb, cold legs or feet; decreased sexual ability in men and women), eye problems, including changes or loss of vision, or gum disease. Your doctor and other healthcare providers will talk to you about the best way to manage your diabetes.
COMMON BRAND(S): Glucophage
GENERIC NAME(S): Metfor-acis
Rarely, too much Metfor-acis can build up in the body and cause a serious (sometimes fatal) condition called lactic acidosis. Lactic acidosis is more likely if you are an older adult, if you have kidney or liver disease, dehydration, heart failure, heavy alcohol use, if you have surgery, if you have X-ray or scanning procedures that use iodinated contrast, or if you are using certain drugs. For some conditions, your doctor may tell you to stop taking this medication for a short time. Ask your doctor or pharmacist for more details.
Stop taking this medication and get medical help right away if you have any symptoms of lactic acidosis, such as unusual tiredness, dizziness, severe drowsiness, chills, blue/cold skin, muscle pain, fast/difficult breathing, slow/irregular heartbeat, or stomach pain with nausea/vomiting/diarrhea.
Metfor-acis is used with a proper diet and exercise program and possibly with other medications to control high blood sugar. It is used in patients with type 2 diabetes. Controlling high blood sugar helps prevent kidney damage, blindness, nerve problems, loss of limbs, and sexual function problems. Proper control of diabetes may also lessen your risk of a heart attack or stroke. Metfor-acis works by helping to restore your body's proper response to the insulin you naturally produce. It also decreases the amount of sugar that your liver makes and that your stomach/intestines absorb.
1) Lactic Acidosis
Lactic acidosis is a condition in which lactic acid builds up in the body, altering pH balance and potentially leading to complications .
Because Metfor-acis reduces the breakdown of lactate to glucose, the drug may induce lactic acidosis if it accumulates significantly. Metfor-acis’s exact mechanism of action in doing so is unknown. More frequently, the combination of this drug and an underlying health condition may trigger lactic acidosis .
Patients with the following conditions have an increased risk of lactic acidosis induced by Metfor-acis:
- Recent surgery
- Kidney or liver damage
- History of heart disease
- Respiratory failure
- Excessive alcohol consumption or dehydration
Also, elderly patients are especially at risk for developing lactic acidosis .
Symptoms of lactic acidosis include :
- Muscle aches
- Shortness of breath
- Nausea and vomiting
- Diarrhea and Stomach pain
- Irregular or slow heartbeat
- Cold , blue skin
What else should I know about Metfor-acis?
- Metfor-acis is available as
- Tablets: 500, 850, and 1000 mg
- Tablets (extended release): 500, 750, and 1000 mg.
- Solution: 100 mg/ ml
- Metfor-acis should be stored at room temperature between 20 C to 25 C (68 F to 77 F).
- Metormin is available in generic versions of immediate release and extended release formulations.
- You need a prescription from your doctor to obtain Metfor-acis.
- Glucophage XR
4) Oral Contraceptives
Although the combination of oral contraceptives and Metfor-acis has not been documented to cause any harm, a study on 41 women showed that oral contraceptives decrease Metfor-acis’s insulin-sensitizing effects .
Hepatic (liver) impairment: Avoid use; risk of lactic acidosis.
- Obtain eGFR before starting Metfor-acis
- eGFR less than 30 mL/min/1.73 m²: Contraindicated
- eGFR 30-45 mL/min/1.73 m²: Not recommended to initiate treatment
- Monitor eGFR at least annually or more often for those at risk for renal impairment (e.g., elderly)
- If eGFR falls below 45mL/min/1.73 m² while taking Metfor-acis, health risks and benefits of continuing therapy should be evaluated
- If eGFR falls below 30 mL/min/1.73 m²: while taking Metfor-acis, discontinue the drug
Orphan designation for treatment of pediatric polycystic ovary syndrome
What should I avoid while taking Metfor-acis?
Avoid drinking alcohol. It lowers blood sugar and may increase your risk of lactic acidosis.