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Home / Drugs / Starting with M / Metformin

Metformin is a biguanide antihyperglycemic agent used for treating non-insulin-dependent diabetes mellitus (NIDDM). It improves glycemic control by decreasing hepatic glucose production, decreasing glucose absorption and increasing insulin-mediated glucose uptake. Metformin is the only oral antihyperglycemic agent that is not associated with weight gain. Metformin may induce weight loss and is the drug of choice for obese NIDDM patients. When used alone, metformin does not cause hypoglycemia; however, it may potentiate the hypoglycemic effects of sulfonylureas and insulin. Its main side effects are dyspepsia, nausea and diarrhea. Dose titration and/or use of smaller divided doses may decrease side effects. Metformin should be avoided in those with severely compromised renal function (creatinine clearance < 30 ml/min), acute/decompensated heart failure, severe liver disease and for 48 hours after the use of iodinated contrast dyes due to the risk of lactic acidosis. Lower doses should be used in the elderly and those with decreased renal function. Metformin decreases fasting plasma glucose, postprandial blood glucose and glycosolated hemoglobin (HbA1c) levels, which are reflective of the last 8-10 weeks of glucose control. Metformin may also have a positive effect on lipid levels.
Glucophage XR
Sandoz Metformin
ManufacturersRanbaxy pharmaceuticals inc
Andrx labs llc
Bristol myers squibb co
Depomed inc
Actavis elizabeth llc
Amneal pharmaceuticals ny llc
Apotex inc etobicoke site
Barr laboratories inc
Impax laboratories inc
Ivax pharmaceuticals inc sub teva pharmaceuticals usa
Mutual pharmaceutical co inc
Mylan pharmaceuticals inc
Neurosci inc
Nostrum pharmaceuticals inc
Ranbaxy laboratories ltd
Sandoz inc
Sun pharmaceutical industries ltd
Teva pharmaceuticals usa inc
Torrent pharma inc
Torrent pharmaceuticals ltd
Watson laboratories inc
Watson laboratories inc florida
Zydus pharmaceuticals usa inc
Bristol myers squibb co pharmaceutical research institute
Alphapharm party ltd
Alvogen inc
Apotex inc
Aurobindo pharma ltd
Caraco pharmaceutical laboratories ltd
Dr reddys laboratories inc
Genpharm inc
Glenmark generics ltd
Granules india ltd
Indicus pharma llc
Ipca laboratories ltd
Mutual pharmacal co
Provident pharmaceutical inc
Watson laboratories
PackagersActavis Group
Advanced Pharmaceutical Services Inc.
Alphapharm Party Ltd.
Amerisource Health Services Corp.
Amkas Laboratories Inc.
Amneal Pharmaceuticals
Apotex Inc.
Apotheca Inc.
AQ Pharmaceuticals Inc.
A-S Medication Solutions LLC
Aurobindo Pharma Ltd.
Aurolife Pharma LLC
Barr Pharmaceuticals
Biovail Pharmaceuticals
Bristol-Myers Squibb Co.
Bryant Ranch Prepack
Cadila Healthcare Ltd.
Caraco Pharmaceutical Labs
Cardinal Health
Caremark LLC
Cobalt Pharmaceuticals Inc.
Comprehensive Consultant Services Inc.
Corepharma LLC
Coupler Enterprises Inc.
Depomed Inc.
Dept Health Central Pharmacy
DHHS Program Support Center Supply Service Center
Direct Dispensing Inc.
Dispensing Solutions
Diversified Healthcare Services Inc.
Doctor Reddys Laboratories Ltd.
DSM Corp.
Emcure Pharmaceuticals Ltd.
Eon Labs
Glenmark Generics Ltd.
Golden State Medical Supply Inc.
Greenstone LLC
Heartland Repack Services LLC
Heritage Pharmaceuticals
Indicus Pharma LLC
Ivax Pharmaceuticals
Kaiser Foundation Hospital
Lake Erie Medical and Surgical Supply
Legacy Pharmaceuticals Packaging LLC
Liberty Pharmaceuticals
Lipha Pharmaceuticals Ltd.
Major Pharmaceuticals
Mallinckrodt Inc.
Mckesson Corp.
Medisca Inc.
Medvantx Inc.
Merck KGaA
Murfreesboro Pharmaceutical Nursing Supply
Mutual Pharmaceutical Co.
Neurosci Inc.
Novopharm Ltd.
Nucare Pharmaceuticals Inc.
Ohm Laboratories Inc.
Palmetto Pharmaceuticals Inc.
Par Pharmaceuticals
Patheon Inc.
PD-Rx Pharmaceuticals Inc.
Physicians Total Care Inc.
Preferred Pharmaceuticals Inc.
Prepackage Specialists
Prepak Systems Inc.
Provident Pharmaceuticals LLC
Ranbaxy Laboratories
Rebel Distributors Corp.
Remedy Repack
Resource Optimization and Innovation LLC
Sciele Pharma Inc.
Solco Healthcare US LLC
Southwood Pharmaceuticals
Stat Rx Usa
Stat Scripts LLC
Sun Pharmaceutical Industries Ltd.
Takeda Pharmaceutical Co. Ltd.
Teva Pharmaceutical Industries Ltd.
Torpharm Inc.
Torrent Pharmaceuticals
Tya Pharmaceuticals
UDL Laboratories
USV Ltd.
Va Cmop Dallas
Vangard Labs Inc.
Watson Pharmaceuticals
Zydus Pharmaceuticals
SynonymsMetformin HCL
metformin hydrochloride


For use as an adjunct to diet and exercise in adult patients (18 years and older) with NIDDM. May also be used for the management of metabolic and reproductive abnormalities associated with polycystic ovary syndrome (PCOS).


Metformin is an oral antihyperglycemic agent that improves glucose tolerance in patients with NIDDM, lowering both basal and postprandial plasma glucose. Metformin is not chemically or pharmacologically related to any other class of oral antihyperglycemic agents. Unlike sulfonylureas, metformin does not produce hypoglycemia in either patients with NIDDM or healthy subjects and does not cause hyperinsulinemia. Metformin does not affect insulin secretion.

mechanism of action

Metformin's mechanisms of action differ from other classes of oral antihyperglycemic agents. Metformin decreases blood glucose levels by decreasing hepatic glucose production, decreasing intestinal absorption of glucose, and improving insulin sensitivity by increasing peripheral glucose uptake and utilization. These effects are mediated by the initial activation by metformin of AMP-activated protein kinase (AMPK), a liver enzyme that plays an important role in insulin signaling, whole body energy balance, and the metabolism of glucose and fats. Activation of AMPK is required for metformin's inhibitory effect on the production of glucose by liver cells. Increased peripheral utilization of glucose may be due to improved insulin binding to insulin receptors. Metformin administration also increases AMPK activity in skeletal muscle. AMPK is known to cause GLUT4 deployment to the plasma membrane, resulting in insulin-independent glucose uptake. The rare side effect, lactic acidosis, is thought to be caused by decreased liver uptake of serum lactate, one of the substrates of gluconeogenesis. In those with healthy renal function, the slight excess is simply cleared. However, those with severe renal impairment may accumulate clinically significant serum lactic acid levels. Other conditions that may precipitate lactic acidosis include severe hepatic disease and acute/decompensated heart failure.


Acute oral toxicity (LD50): 350 mg/kg [Rabbit]. It would be expected that adverse reactions of a more intense character including epigastric discomfort, nausea, and vomiting followed by diarrhea, drowsiness, weakness, dizziness, malaise and headache might be seen.


Metformin is not metabolized.


Absorbed over 6 hours, bioavailability is 50 to 60% under fasting conditions. Administration with food decreases and delays absorption. Some evidence indicates that the level of absorption is not dose-related, suggesting that absorption occurs through a saturable process. Limited data from animal and human cell cultures indicate that absorption occurs through a passive, non-saturable process, possibly involving a paracellular route. Peak action occurs 3 hours after oral administration.

half life

6.2 hours. Duration of action is 8-12 hours.

route of elimination

Intravenous single-dose studies in normal subjects demonstrate that metformin is excreted unchanged in the urine and does not undergo hepatic metabolism (no metabolites have been identified in humans) nor biliary excretion. Approximately 90% of the drug is eliminated in 24 hours in those with healthy renal function. Renal clearance of metformin is approximately 3.5 times that of creatinine clearance, indicating the tubular secretion is the primary mode of metformin elimination.

drug interactions

Cimetidine: Cimetidine may increase the therapeutic and adverse effects of metformin by increasing its serum concentration. Consider alternate therapy.

Glucosamine: Possible hyperglycemia

Somatropin recombinant: Somatropin may antagonize the hypoglycemic effect of metformin. Monitor for changes in fasting and postprandial blood sugars.