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Glucophage (Metformin Hydrochloride)
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Glucophage, also known as metformin, is a diabetes medication that helps reduce insulin resistance, glucose production, and glucose absorption. Glucophage is typically prescribed to patients with type 2 diabetes.
People with type 2 diabetes become resistant to insulin over time. Insulin is usually released by the body when blood glucose levels are high. It prompts cells to absorb sugar from the blood and either convert it to energy or store it for later. However, in people with type 2 diabetes, cells no longer absorb sugar when the body releases insulin. The resulting high blood sugar can cause problems with the kidneys, eyes, nerves, immune system, sexual organs, and more.
The body transforms carbohydrates, including sugar, to glucose in the stomach during the digestive process. The liver also produces glucose using carbohydrates from the intestines. Glucophage reduces the amount of glucose made by the liver, which decreases the amount of glucose in the blood. Research also suggests that Glucophage impacts digestion in the gut, possibly changing how carbohydrate particles reach the liver.
Glucophage Precautions and Warnings
Don’t use Glucophage if you’re allergic to metformin or any of the medication’s inactive ingredients. Diabetes treatment typically requires a holistic plan that includes lifestyle changes. Follow all your doctor’s recommendations to see the best results from Glucophage.
Glucophage can cause complications during surgeries. It can also complicate procedures like X-rays or other scans that use iodinated contrast. Tell your doctor about all your medications before any of these procedures.
Fasting before surgery, dental work, lab tests, or religious/cultural reasons can cause dangerously low blood sugar when you’re taking Glucophage. Ask your medical providers if you should temporarily stop taking Glucophage before such procedures.
Your doctor will test your blood sugar, kidney function, liver function, and other metrics while you take Glucophage.
Your doctor needs to know your complete medical history before you start Glucophage. Tell your medical team about all your current and previous medical concerns, especially the following conditions:
- Breathing problems
- Blood conditions
- Kidney disease
- Liver disease
- Congestive heart failure
- Heart attack
- Sepsis
Side Effects of Glucophage
Since Glucophage changes how your body makes and stores glucose, the medication impacts your energy levels and blood sugar. Glucophage can cause lactic acidosis or low blood sugar which have wide-ranging side effects including dizziness, drowsiness, and blurred vision.
Dehydration
Glucophage can cause dehydration. Older patients are especially likely to develop dehydration but it can happen at any age. This side effect can be worse under the following conditions:
- High fever
- Taking “water pills” or diuretics
- Excessive sweating
- Vomiting
- Diarrhea
- Drinking alcohol
B12 Deficiency
Glucophage can cause B12 deficiency or pernicious anemia, which can lead to irreversible neurological damage. Pernicious anemia symptoms include:
- Anemia (low iron levels)
- Depression
- Ringing in the ears
- Stroke
Hyperglycemia
If your Glucophage treatment isn’t enough to manage your blood sugar, you may still develop dangerously high blood sugar. Get medical attention immediately if you notice signs of hyperglycemia, such as:
- Confusion
- Seizures
- Losing consciousness, fainting, or passing out
- Dry mouth
- Vomiting
- Sweet-smelling breath
Drug Interactions of Glucophage
Glucophage can interact with other medications, especially those that also impact how your body metabolizes carbohydrates, sugar, and glucose. Combining Glucophage with other diabetes treatments can cause your blood sugar to drop dangerously. Patients who also take beta-blockers may not experience the rapid heartbeat that often occurs during low blood sugar. Other symptoms of hypoglycemia like hunger, sweating, and dizziness should still be noticeable.
Glucophage frequently interacts with the following types of medicines:
- Diabetes treatments
- Beta-blockers
- Diuretics
- Calcium-channel blockers
- Heart medications (such as Eliquis or Xarelto)
- Ulcer or acid reflux medication
- Some cancer and HIV treatments
- Carbonic anhydrase inhibitors
- Corticosteroids
- Some antipsychotics
- Thyroid medication (such as Synthroid)
- Estrogen
- Oral contraceptives
- Seizure medications
- Niacin or vitamin B3
- Tuberculosis treatments
Strengths and Dosages of Glucophage
Glucophage is available in 500mg, 850mg, and 1000mg tablets. Patients are usually started on a relatively low dose. Patients who tolerate Glucophage increase this dose over time until they reach the standard maintenance dose.
| Patient Age | Type of tablet | Initial Dose | Maintenance Dose |
| Adult | Immediate release | 500mg twice a day | 2000mg daily, divided into multiple doses |
| Adult | Immediate release | 850mg once a day | 2000mg daily, divided into multiple doses |
| Adult | Extended release | 500-1000mg once a day | 2000mg daily |
| Pediatric (ages 10-17) | Immediate release | 500mg twice a day | 2000mg daily |
Alternatives to Glucophage
Glucophage is the standard first-line treatment for type 2 diabetes. However, there are alternatives for patients who can’t tolerate Glucophage, such as:
- Fortamet
- Glumetza
- Riomet
- Riomet ER
Glucophage FAQs
What is the difference between Glucophage and Glucophage XR?
Glucophage XR is an extended-release tablet. It contains the same active ingredient, metformin, as Glucophage. The tablet simply takes longer to dissolve than the original Glucophage tablet.
What is Glucophage used for?
Glucophage is a type 2 diabetes treatment that lowers blood glucose levels. It may also be used as a treatment for weight loss and polycystic ovarian syndrome (PCOS).
How does Glucophage work?
Glucophage impacts how the liver produces glucose. It prevents liver cells from making as much glucose as they would otherwise produce. This reduces the overall amount of glucose in the body which reduces the amount of glucose in the blood. The pancreas doesn’t release as much insulin since blood glucose is lower. Since insulin levels are lower, body cells may not be over-exposed to insulin. This reduces insulin resistance.
What is the difference between metformin and Glucophage?
Metformin is the generic version of brand-name Glucophage. Metformin is the active ingredient in Glucophage. Both of these medicines have the same effect on insulin resistance, glucose levels, and glucose metabolism. Metformin and other generic drugs often cost less than name-brand medications so metformin may be more affordable. The two formulations may contain different inactive ingredients or have a different appearance but their mechanism of action is the same.
How long does it take for Glucophage to work?
It generally takes two to three months to see the best results from Glucophage. Some patients start to see results in the first week of treatment. Most patients take Glucophage as a long-term medication or until their type 2 diabetes symptoms resolve.
When should I take Glucophage?
Take Glucophage as directed by your doctor. Many prescriptions instruct patients to take Glucophage two or three times a day, at the same times every day. Follow your dosing instructions for the best results.
How much weight loss is possible with Glucophage?
Studies have shown that diabetic patients can lose between 5 and 20 pounds while taking Glucophage. Overweight and obese patients without diabetes have lost up to 27 pounds while taking Glucophage.
What happens when you stop taking Glucophage?
Glucophage is an ongoing maintenance treatment. If you stop taking Glucophage, your liver will start making its standard amount of glucose. Patients with active type 2 diabetes will experience high blood sugar, insulin resistance, and other symptoms.
Some patients need to stop taking Glucophage because of serious side effects or kidney problems. Other patients stop taking Glucophage when they can manage their blood sugar through diet and other lifestyle changes. You shouldn’t stop taking Glucophage for any reason without talking to your doctor first.
How does Glucophage work for PCOS?
Just as Glucophage can manage insulin resistance in type 2 diabetes, it can also manage the insulin resistance that causes polycystic ovarian syndrome (PCOS) in patients who are not obese. Glucophage treatment increases ovulation, reduces ovarian hyperstimulation during in vitro fertilization, and may reduce acne, hirsutism, and other hyperandrogenism symptoms.
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IMPORTANT NOTE: The information provided here is for educational purposes only and is not intended to serve as medical advice, diagnosis, or treatment recommendations. It should not be taken as an endorsement of any specific medication or treatment. Individual health conditions and responses to treatment can vary greatly; therefore, this information should not be seen as a guarantee of safety, suitability, or effectiveness for any particular individual. Always consult with a healthcare professional for personalized medical advice and before making any decisions regarding your health or treatment plans.
