Eat metformin everyday, these problems cannot know! Do not be careless, suggest collection learning!

First, the contraindications and side effects of metformin.

Before taking any drug, it is important to know the indications, contraindications and possible side effects. To date, metformin remains the first-line oral hypoglycemic agent for the treatment of type 2 diabetes, recommended by almost all guidelines, but not everyone.

1. Contraindication: Metformin is clinically contraindicated in patients with severe renal insufficiency and any form of acidosis, congestive heart failure, hypoxemia, and liver disease.

2. Side effects: The most common are gastrointestinal adverse reactions, such as diarrhea, stomach bloating, nausea, vomiting, indigestion, etc., which mostly occur in the early stage of medication and can be tolerated by most patients. In addition, metformin will block the absorption of vitamin B12, rarely induce anemia, long-term use of appropriate vitamin B12 supplement is recommended.

Secondly, about the medication of metformin.

1. Dosage: Pay attention to individual medication. It is recommended to start with a small dose and gradually increase to a normal dose. The general minimum recommended dose is 500mg/ day, the best effective dose is 2000mg/ day; The maximum recommended dose is 2550mg/ day.

2. Medication: Metformin common tablets and sustained release tablets can be taken after meals or during meals to avoid gastrointestinal irritation. Enteric-coated tablets or enteric-coated capsules are recommended to be taken 15-30 minutes before meals. Take it once a day, preferably after dinner, as a whole tablet. Remember to drink alcohol when taking medicine; The liver and kidney function should be monitored regularly in patients over 65 years of age. Patients with renal insufficiency need to estimate the level of glomerular filtration rate (eGFR) to adjust the dose.

3. Drug compatibility: Metformin can be used in combination with any other hypoglycemic drugs with minimal drug interaction. Because metformin is mainly excreted through the kidney, when combined with digoxin, quinidine, cimetidine, ranitidine, trimethoprimidine, aminoglycoside antibiotics and other cationic drugs secreted through the renal tubules, attention should be paid to monitoring blood glucose; When combined with anticholinergic drugs, pyrimidine, ethambutol, verapamil, furosemide and other drugs, blood glucose should be monitored.

In addition, iodized contrast media may cause metformin accumulation and increase the risk of lactic acidosis. It should be noted that metformin should be stopped before or during the angiography examination and should be checked again 48 hours after the examination. Normal medication can be resumed if renal function does not deteriorate. It is usually recommended to stop the drug for 3 days before and after the examination.

Finally, cognitive misconceptions about metformin.

1. Hepatorenal toxicity: Metformin is not metabolized by the liver, and is mainly excreted by the kidney in prototype form. Its clearance is rapid, and about 90% can be cleared within 12-24h. However, for those with impaired liver and kidney function, it is recommended to stop taking the drug when serum aminotransferase exceeds 3 times the normal upper limit, in order to prevent the liver from reducing the metabolic ability of lactic acid, resulting in lactic acid accumulation; It is recommended to adjust the dose according to the eGFR value. If eGFR≥60 is normal, the dosage should be reduced between 45 and 60, < You need to stop at 45.

2. Weight loss effect: Metformin does have a certain weight loss effect on obese diabetic patients, but it is not a weight-loss drug and has no clear weight loss effect on obese patients.

3. Applicable people: Metformin is mainly used in the treatment of type 2 diabetes, but it can also be used in patients with type 1 diabetes. The combination of metformin can reduce insulin dosage by 10%, thus reducing the side effects caused by insulin use.

Thanks for reading and good health