Glucophage

Glucophage is a brand name for metformin, an oral antidiabetic medication in the biguanide class. It is used to improve glycemic control in people with type 2 diabetes, typically as first-line therapy either alone or in combination with other antidiabetic agents. Metformin helps lower blood glucose by reducing hepatic glucose production, increasing insulin sensitivity in muscle and fat tissue, and modestly decreasing glucose absorption from the gut. Because it does not stimulate insulin secretion, metformin is less likely to cause hypoglycemia when used without other glucose-lowering drugs.

Glucophage is available in immediate-release tablets and extended-release formulations. Dosing usually starts at 500 mg once or twice daily with meals, with gradual titration to minimize gastrointestinal side effects. The usual maximum daily dose ranges from 2000 to 2550 mg, depending on the preparation and regional guidelines. The extended-release form is often taken once daily with the evening meal. Common adverse effects include gastrointestinal symptoms such as diarrhea, nausea, and abdominal discomfort, which often improve with slower titration or a switch to extended-release therapy.

Contraindications include significant renal impairment (eGFR below approximately 30 mL/min/1.73 m2), acute or chronic metabolic acidosis, and hypersensitivity to metformin. Cautions include liver disease, excessive alcohol use, heart failure, and conditions predisposing to hypoxia, as these can increase the risk of lactic acidosis, a rare but serious complication. Patients should monitor kidney function periodically, and metformin may need to be paused around certain procedures involving iodinated contrast media.

Long-term use has been associated with vitamin B12 deficiency in some patients. Metformin use during pregnancy should be discussed with a clinician, as insulin is often preferred for diabetes management in pregnancy.