Metformin

Question 1

Question

Answer 1

Answer

Question 2

Q1: What is metformin primarily used for in adults?

Answer 2

Treatment of type 2 diabetes mellitus.

Question 3

Q2: Is metformin licensed for treating polycystic ovary syndrome in adults?

Answer 3

A2: No, it’s not licensed for this indication.

Question 4

Q3: Can metformin be used in children aged 8-9 years for type 2 diabetes?

Answer 4

A3: Yes, it may be used, but it’s not licensed for this age group.

Question 5

Is metformin safe for use during pregnancy?

Answer 5

YES it can be used during pregnancy and the periconception period if clinically indicated.

Question 6

B12 levels in metformin-treated patients?

Answer 6

A5: Monitor vitamin B12 levels in patients at risk and treat deficiency as per guidelines.

Question 7

Q6: What are the contraindications for metformin use?

Answer 7

• Acute metabolic acidosis,
• lactic acidosis
• Diabetic ketoacidosis.

Question 8

Q7: What cautions should be taken when using metformin?

Answer 8

• cautious in chronic stable heart failure,
• with drugs impairing renal function,
• during dehydration,
• in conditions causing tissue hypoxia.

Question 9

Q8: When should metformin be avoided in adults with renal impairment?

Answer 9

(eGFR) is less than
30 mL

Question 10

Q9: Can metformin be used during breastfeeding in women with pre-existing diabetes?

Answer 10

Yes, it may be used during breastfeeding.

Question 11

Q10: What dose adjustment should be considered for metformin in children with moderate renal impairment?

Answer 11

A10: Consider dose reduction.

Question 12

Q11: How often should renal function be monitored in patients taking metformin?

Answer 12

• Before treatment
• annually, or
• More frequent in Pt with renal impairment
• or deteriation

Question 13

Q12: What’s the maximum daily dose for metformin immediate-release medicines in adults with Type 2 diabetes mellitus?

Answer 13

2000 mg

Question 14

Q13: What advice should patients and their carers receive regarding the risk of lactic acidosis?

Answer 14

A13: They should be informed of the risk and told to seek immediate medical attention if specific symptoms occur.

Question 15

Q14: What is the primary drug action of metformin hydrochloride?

Answer 15

• Metformin decreases gluconeogenesis
• and increases peripheral utilization of glucose,
• it’s effective only in the presence of endogenous insulin
• and some functioning pancreatic islet cells.

Question 16

Q15: What are some common side effects associated with metformin use?

Answer 16

• abdominal pain,
• decreased appetite,
• N&V&D gastrointestinal disorders,
• altered taste,
• vitamin B12 deficiency,

Question 17

Q16: What are some rare or very rare side effects associated with metformin use?

Answer 17

• hepatitis and lactic acidosis
• (which requires discontinuation of the medication).
• skin reactions can occur rarely.

Question 18

Q17: How are gastrointestinal side effects of metformin typically experienced during treatment?

Answer 18

• during treatment initiation and usually resolve spontaneously.
• Slowly increasing the dose may improve tolerability.

Question 19

Q18: When should patients and their carers seek immediate medical attention regarding metformin use?

Answer 19

seek immediate medical attention if
experience symptoms such as

• dyspnea,
• muscle cramps,
• abdominal pain,
• hypothermia, or asthenia,

as these could be signs of lactic acidosis, a rare but serious side effect.