Metformiinin

Metformiinin is an oral antidiabetic medication belonging to the biguanide class. In many languages the name corresponds to metformin, the drug used to improve glycemic control in adults with type 2 diabetes. It is also prescribed for polycystic ovary syndrome (PCOS) and, in some guidelines, for prediabetes to slow progression. It is commonly used as first‑line therapy, either alone or in combination with other agents.

Metformiinin works mainly by reducing hepatic glucose production and by improving insulin sensitivity in muscle and adipose tissue. It also lowers intestinal glucose absorption modestly. Unlike some diabetes drugs, it does not stimulate insulin secretion, which contributes to a relatively low risk of hypoglycemia when used alone.

Pharmacokinetics and administration: metformiinin is absorbed from the gut and is excreted unchanged by the kidneys; it is not significantly metabolized in the body. Dosing is tailored to the formulation and renal function. A typical starting regimen is 500 mg once or twice daily with meals, titrated to about 1,500–2,000 mg per day (up to 2,000–2,500 mg with extended‑release preparations) as tolerated.

Safety and cautions: common side effects include gastrointestinal symptoms such as diarrhea, nausea, and abdominal discomfort, usually transient. The most serious but rare risk is lactic acidosis, which is more likely with renal impairment, hepatic disease, hypoxia, or excessive alcohol use. Metformiinin is contraindicated in severe renal impairment, metabolic acidosis, and certain acute conditions; radiographic contrast studies may require temporarily withholding the drug.