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Metformin Med Card

Metformin Med Card

Generic Name: Metformin

Brand Names: Glucophage, Glumetza, Fortamet

Class: Biguanide; Antidiabetic agent

Actions

  • Decreases hepatic glucose production

  • Decreases intestinal absorption of glucose

  • Improves insulin sensitivity by increasing peripheral glucose uptake and utilization

Indications

  • Type 2 Diabetes Mellitus (T2DM)

  • May be used with diet and exercise or with other antidiabetic agents

Contraindications

  • Renal impairment (eGFR < 30 mL/min/1.73 m²)

  • Metabolic acidosis, including diabetic ketoacidosis

  • Severe hepatic dysfunction

  • Recent history of lactic acidosis

Caution

  • Use cautiously in patients with hepatic disease, CHF, or alcohol abuse

  • Risk of lactic acidosis increases with age and dehydration

  • Discontinue before iodinated contrast procedures and resume after renal function is re-evaluated

Adverse Effects

  • GI disturbances (nausea, vomiting, diarrhea)

  • Metallic taste

  • Vitamin B12 deficiency (long-term use)

  • Rare but serious: Lactic acidosis

Drug-Drug Interactions

  • Iodinated contrast dyes → increased risk of lactic acidosis

  • Alcohol → increases risk of lactic acidosis

  • Cimetidine, ranolazine, and other drugs that impair renal function

  • Other hypoglycemic agents → risk of hypoglycemia when combined

Assess

  • Monitor blood glucose levels regularly

  • Check renal function (BUN, creatinine, eGFR) before starting and periodically

  • Monitor for signs of lactic acidosis (hyperventilation, myalgia, malaise)

Teach

  • Take with meals to reduce GI side effects

  • Do not drink alcohol while taking this medication

  • Report symptoms of lactic acidosis: muscle pain, fatigue, difficulty breathing

  • Notify provider before imaging studies with contrast

  • Importance of routine labs and follow-up