Metformin is a prescription medicine used to improve blood sugar levels in people with type 2 diabetes.

Type 2 diabetes is a disease in which your body doesn’t use the hormone insulin effectively, so it can’t control the amount of sugar in your blood.

Metformin is in a class of medications called biguanides. It works by lowering the amount of sugar you absorb from food and the amount of sugar your liver makes. Additionally, it increases your body’s response to insulin.

The medication was approved by the U.S. Food and Drug Administration (FDA) in 1995.

warnings

What is the most important information I should know about Metformin (Metformin (Eqv-Fortamet))?

You should not use metformin if you are allergic to it, or if you have:

severe kidney disease; or
metabolic acidosis or diabetic ketoacidosis (call your doctor for treatment).

If you need to have surgery or any type of x-ray or CT scan using a dye that is injected into your veins, you may need to temporarily stop taking metformin. Be sure your caregivers know ahead of time that you are using this medication.

Tell your doctor if you have ever had:

kidney disease (your kidney function may need to be checked before you take this medicine);
high ketone levels in your blood or urine;
heart disease, congestive heart failure;
liver disease; or
if you also use insulin, or other oral diabetes medications.

You may develop lactic acidosis, a dangerous build-up of lactic acid in your blood. This may be more likely if you have other medical conditions, a severe infection, chronic alcoholism, or if you are 65 or older. Ask your doctor about your risk.

Follow your doctor's instructions about using this medicine if you are pregnant or you become pregnant. Controlling diabetes is very important during pregnancy, and having high blood sugar may cause complications in both the mother and the baby.

Metformin may stimulate ovulation in a premenopausal woman and may increase the risk of unintended pregnancy. Talk to your doctor about your risk.

You should not breastfeed while using this medicine.

Metformin should not be given to a child younger than 10 years old. Some forms of metformin are not approved for use by anyone younger than 18 years old.

Side Effects

What are the side effects of Metformin (Metformin (Eqv-Fortamet))?

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Some people using metformin develop lactic acidosis, which can be fatal. Get emergency medical help if you have even mild symptoms such as:

unusual muscle pain;
feeling cold;
trouble breathing;
feeling dizzy, light-headed, tired, or very weak;
stomach pain, vomiting; or
slow or irregular heart rate.

Common side effects may include:

low blood sugar;
nausea, upset stomach; or
diarrhea.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Pregnancy & Breastfeeding

Can I take Metformin (Metformin (Eqv-Fortamet)) if I’m pregnant or breastfeeding?

Metformin may stimulate ovulation in a premenopausal woman and may increase the risk of unintended pregnancy. Talk to your doctor about your risk.

You should not breastfeed while using this medicine.

Dosage Guidelines & Tips

How to take Metformin (Metformin (Eqv-Fortamet))?

Use Metformin (Metformin (Eqv-Fortamet)) exactly as directed on the label, or as prescribed by your doctor. Do not use in larger or smaller amounts or for longer than recommended.

Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose. Use the medicine exactly as directed.

Take metformin with a meal, unless your doctor tells you otherwise. Some forms of metformin are taken only once daily with the evening meal. Follow your doctor's instructions.

Do not crush, chew, or break an extended-release tablet. Swallow it whole.

Measure liquid medicine carefully. Use the dosing syringe provided, or use a medicine dose-measuring device (not a kitchen spoon).

Shake the oral suspension (liquid) before you measure a dose. Use the dosing syringe provided, or use a medicine dose-measuring device (not a kitchen spoon).

Some tablets are made with a shell that is not absorbed or melted in the body. Part of this shell may appear in your stool. This is normal and will not make the medicine less effective.

You may have low blood sugar (hypoglycemia) and feel very hungry, dizzy, irritable, confused, anxious, or shaky. To quickly treat hypoglycemia, eat or drink a fast-acting source of sugar (fruit juice, hard candy, crackers, raisins, or non-diet soda).

Your doctor may prescribe a glucagon injection kit in case you have severe hypoglycemia. Be sure your family or close friends know how to give you this injection in an emergency.

Blood sugar levels can be affected by stress, illness, surgery, exercise, alcohol use, or skipping meals. Ask your doctor before changing your dose or medication schedule.

Metformin is only part of a complete treatment program that may also include diet, exercise, weight control, blood sugar testing, and special medical care. Follow your doctor's instructions very closely.

Store at room temperature away from moisture, heat, and light.

Your doctor may have you take extra vitamin B12 while you are taking metformin. Take only the amount of vitamin B12 that your doctor has prescribed.

What should I do if I missed a dose of Metformin (Metformin (Eqv-Fortamet))?

Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

Additional Dosage Information

The dosage depends on your medical condition, the formulation you use, your age, and other factors.

Your doctor may start you on a lower dose of metformin and gradually increase it over a few weeks. This will help you avoid unwanted side effects and let your physician monitor your progress.

Typically, patients see the most significant changes in their blood sugar levels when they get to a dose of at least 1,000 milligrams (mg) a day.

Your doctor may recommend a lower dose if you have other medical issues or if you are elderly or malnourished.