Glucophage: Effective First-Line Type 2 Diabetes Management
Glucophage
| Product dosage: 1000mg | |||
|---|---|---|---|
| Package (num) | Per pill | Price | Buy |
| 90 | $0.56 | $50.00 (0%) | 🛒 Add to cart |
| 180 | $0.38 | $100.00 $69.00 (31%) | 🛒 Add to cart |
| 270 | $0.32 | $150.00 $86.00 (43%) | 🛒 Add to cart |
| 360 | $0.27
Best per pill | $200.00 $97.00 (52%) | 🛒 Add to cart |
| Product dosage: 500mg | |||
|---|---|---|---|
| Package (num) | Per pill | Price | Buy |
| 90 | $0.46 | $41.00 (0%) | 🛒 Add to cart |
| 180 | $0.30 | $82.00 $54.00 (34%) | 🛒 Add to cart |
| 270 | $0.24 | $123.00 $64.00 (48%) | 🛒 Add to cart |
| 360 | $0.21
Best per pill | $164.00 $74.00 (55%) | 🛒 Add to cart |
| Product dosage: 850mg | |||
|---|---|---|---|
| Package (num) | Per pill | Price | Buy |
| 90 | $0.53 | $48.00 (0%) | 🛒 Add to cart |
| 180 | $0.33 | $96.00 $60.00 (38%) | 🛒 Add to cart |
| 270 | $0.27 | $144.00 $72.00 (50%) | 🛒 Add to cart |
| 360 | $0.24
Best per pill | $192.00 $85.00 (56%) | 🛒 Add to cart |
Glucophage, with the active ingredient metformin hydrochloride, is a foundational oral antihyperglycemic agent widely prescribed for the management of type 2 diabetes mellitus. As a biguanide class medication, it primarily works by decreasing hepatic glucose production and improving insulin sensitivity in peripheral tissues, thereby reducing both fasting and postprandial blood glucose levels. Its well-established efficacy, favorable safety profile, and potential cardiovascular benefits make it a first-line therapeutic choice in clinical guidelines worldwide. This medication is typically integrated into a comprehensive treatment plan that includes dietary modifications, physical activity, and regular glucose monitoring.
Features
- Active Ingredient: Metformin hydrochloride
- Available Formulations: Immediate-release tablets (500 mg, 850 mg, 1000 mg) and extended-release tablets (500 mg, 750 mg, 1000 mg)
- Mechanism of Action: Reduces hepatic gluconeogenesis, enhances peripheral glucose uptake and utilization, and decreases intestinal absorption of glucose
- Prescription Status: Available by prescription only
- Bioavailability: Approximately 50–60% under fasting conditions
- Half-life: Approximately 6.2 hours for immediate-release; extended-release offers prolonged absorption
- Metabolism: Not metabolized; eliminated unchanged in urine
- Onset of Action: Blood glucose-lowering effects typically observed within 48 hours; full therapeutic effect may take up to 2 weeks
Benefits
- Significantly lowers both fasting and postprandial blood glucose levels without stimulating insulin secretion
- Associated with weight neutrality or modest weight loss, unlike many other antidiabetic agents
- Demonstrates a low risk of hypoglycemia when used as monotherapy
- May improve lipid profile by reducing triglycerides and LDL cholesterol
- Shown in long-term studies to potentially reduce cardiovascular events and mortality in type 2 diabetes patients
- Cost-effective compared to many newer antidiabetic medications
Common use
Glucophage is primarily indicated as an adjunct to diet and exercise to improve glycemic control in adults and pediatric patients 10 years and older with type 2 diabetes mellitus. It is frequently used as initial monotherapy following diagnosis and may be combined with other oral antidiabetic agents or insulin when additional glycemic control is required. Off-label uses include polycystic ovary syndrome (PCOS) management, prediabetes intervention, and weight management in certain clinical scenarios, though these applications require careful medical supervision.
Dosage and direction
The usual starting dose for adults is 500 mg twice daily or 850 mg once daily with meals, with gradual titration to minimize gastrointestinal side effects. The maintenance dose typically ranges from 1500 mg to 2000 mg daily divided into 2-3 doses, with a maximum recommended daily dose of 2550 mg for immediate-release and 2000 mg for extended-release formulations. Extended-release tablets should be taken once daily with the evening meal. Dosage adjustments are necessary for patients with renal impairment, with contraindication in those with eGFR below 30 mL/min/1.73m². Pediatric dosing (ages 10-16) starts at 500 mg twice daily, with maximum dose of 2000 mg daily.
Precautions
Renal function must be assessed before initiation and regularly during treatment due to the risk of lactic acidosis, a rare but serious complication. Temporary discontinuation is recommended during situations predisposing to renal impairment, including dehydration, severe infection, hypoxic states, and administration of iodinated contrast materials. Vitamin B12 levels should be monitored periodically, as long-term use may decrease absorption. Use with caution in elderly patients, those with hepatic impairment, or patients consuming alcohol excessively. Patients should be advised about the importance of regular blood glucose monitoring and recognition of hypoglycemia symptoms when used with other antidiabetic agents.
Contraindications
Glucophage is contraindicated in patients with severe renal impairment (eGFR <30 mL/min/1.73m²) or renal disease, metabolic acidosis (including diabetic ketoacidosis), acute or chronic disease which may cause tissue hypoxia (e.g., cardiac or respiratory failure, recent myocardial infarction, shock), history of lactic acidosis, hypersensitivity to metformin or any component of the formulation, and acute alcohol intoxication. It should be temporarily discontinued for 48 hours before and after procedures requiring intravascular iodinated contrast materials.
Possible side effect
Common gastrointestinal side effects include diarrhea, nausea, vomiting, abdominal discomfort, flatulence, and indigestion, which often diminish with continued use. These occur in up to 30% of patients, particularly during initial therapy. Less frequently reported effects include metallic taste, decreased vitamin B12 absorption (with potential for deficiency after long-term use), and mild skin reactions. Lactic acidosis, though rare (<0.01 cases per 1000 patient-years), represents the most serious potential adverse effect and requires immediate medical attention if symptoms such as hyperventilation, myalgia, malaise, or unusual somnolence occur.
Drug interaction
Cationic drugs that are eliminated by renal tubular secretion (such as cimetidine, ranitidine, amiloride, digoxin, morphine, procainamide, quinidine, quinine, trimethoprim, and vancomycin) may increase metformin plasma levels through competition for renal tubular transport systems. Alcohol potentiates metformin’s effect on lactate metabolism and increases the risk of lactic acidosis. Glucocorticoids, diuretics, phenothiazines, thyroid products, estrogens, oral contraceptives, phenytoin, nicotinic acid, sympathomimetics, calcium channel blockers, and isoniazid may reduce hypoglycemic effectiveness. Conversely, hypoglycemic effects may be enhanced when co-administered with sulfonylureas, insulin, ACE inhibitors, disopyramide, fibrates, fluoxetine, MAO inhibitors, propoxyphene, salicylates, or NSAIDs.
Missed dose
If a dose is missed, it should be taken as soon as remembered unless it is almost time for the next scheduled dose. In that case, skip the missed dose and resume the regular dosing schedule. Do not double the dose to make up for a missed one. Patients should be educated that consistent dosing is important for maintaining stable blood glucose control but that occasional missed doses are unlikely to cause significant hyperglycemia if promptly addressed.
Overdose
Metformin overdose, particularly doses exceeding 10 grams, may lead to lactic acidosis, which is a medical emergency characterized by elevated blood lactate levels, metabolic acidosis, hypothermia, hypotension, and resistant bradyarrhythmias. Hypoglycemia has been reported but is uncommon with metformin monotherapy. Treatment is primarily supportive and includes immediate gastric lavage if ingestion is recent, correction of acidosis with intravenous sodium bicarbonate, and hemodialysis to correct acidosis and remove accumulated metformin (which has excellent dialyzability). Blood glucose should be monitored and treated if hypoglycemia occurs.
Storage
Store at controlled room temperature (20°C to 25°C or 68°F to 77°F) with excursions permitted between 15°C to 30°C (59°F to 86°F). Keep in the original container with the lid tightly closed to protect from moisture. Keep out of reach of children and pets. Do not use if the blister pack or bottle seal has been broken or if tablets show signs of deterioration. Do not flush medications down the toilet or pour into drains unless instructed to do so; proper disposal through medication take-back programs is recommended.
Disclaimer
This information is provided for educational purposes only and does not constitute medical advice. Individual patient needs may vary, and only a qualified healthcare professional can determine appropriate treatment based on specific medical history, current condition, and other factors. Patients should not initiate, discontinue, or change dosage of Glucophage without consulting their physician. The manufacturer and distributor are not liable for any outcomes resulting from the use or misuse of this information.
Reviews
Clinical studies consistently demonstrate Glucophage’s efficacy in reducing HbA1c by 1-2% when used as monotherapy. The UK Prospective Diabetes Study (UKPDS) showed significant cardiovascular risk reduction with metformin therapy. Many clinicians report excellent patient tolerance with appropriate dose titration, though gastrointestinal side effects remain a common reason for discontinuation in approximately 5% of patients. Patient satisfaction surveys indicate appreciation for its weight-neutral effects and minimal hypoglycemia risk compared to other antidiabetic agents. Long-term real-world evidence supports its position as a cornerstone therapy in type 2 diabetes management protocols.