What is the best time of day to take Metformin?

We’re delving into the ideal time of day or night to take the drug as well as how to adapt to different dosages.

So, you’ve been prescribed Metformin by your doctor to help keep your type 2 diabetes or polycystic ovaries syndrome (PCOS) in check,  However, when it comes to hashing out the particulars of dosage and timing, you may be left a little puzzled. Thankfully, you’ve come to the right place.

Taking Metformin at the right times and in the proper way can ensure it is working as it should and also help reduce any unpleasant side-effects.

So let’s delve into the ideal time of day or night to take the drug as well as how to adapt to different dosages.

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When should I be taking Metformin?

Metformin comes in two forms: standard or extended-release. The time at which you take the medication depends on the type of tablet you have been prescribed.

Because standard-release tablets circulate in the body at a much quicker rate than its extended-release alternative, your doctor may have told you that you need to take it several times throughout the day, typically 2 or 3 times, depending on your dosage.

It is recommended that you take the standard-release Metformin with the first and last meal of the day in order to minimize the risk of gastrointestinal (GI) side-effects, such as stomach pain, diarrhea or vomiting. If you’re taking the third dose, ask your doctor about the best time of day to take it – this will most likely be with your lunch.

On the other hand, as the name suggests, extended-release tablets take longer to be absorbed by the body (around 24 hours), meaning you usually only need to take it once a day. The good thing about the slower release version is that it has less effect on the GI tract, and is ideal for those that are prone to adverse effects.

It’s important that you take this tablet form with your evening meal in order for it to do its job effectively. Because the liver produces glucose overnight, it’s typically the case with many diabetics that they go to bed with normal blood sugar levels and wake up the next morning to find that their levels have shot up.  All thanks to the liver being up all night producing sugar. So, by taking Metformin with your final meal, you can slow down or stop this process overnight, thereby stabilizing your glucose levels.

No matter the type of Metformin you’re on, always make sure that you take it with a glass of water alongside your meal and never break, chew or crush the tablets.

 

How can I minimize the side-effects of Metformin?

While we now know that refraining from taking Metformin on an empty stomach is super important, your dosage also plays a key role in diminishing the possibility of side-effects.

When it comes to standard-release tablets, it’s usually best to start off small and then gradually increase your dose, in order to give your body plenty of time to adjust to the medication.  Therefore, it’s best to build up your dosage over several weeks until you reach the final prescribed dose, which is typically 2 or 3 times a day.

For instance, you could start by taking 500mg of Metformin once a day with your evening meal; after a couple of weeks, if you haven’t experienced any adverse reactions or side-effects, you can increase your dose to 500mg twice a day, taking the additional amount with your breakfast. Wait another week or two before adding the final 500mg dose to your regimen at lunchtime.

If you’re taking the extended-release tablets, it’s usually okay to start off on a higher dose of 1000mg that can subsequently be increased because of the lower risk of side-effects associated with this version of the drug.

Keep in mind that the maximum daily dose of Metformin should not exceed 2500mg for the standard release and 2000mg for the extended form. After a dose increase, if you do start to notice any significant side-effects that don’t disappear after a week or two, then reduce the dose back down to the amount you were taking before.

The above are simply average doses of the medication that are to be followed as a guideline. Ultimately, you should always take the dosage prescribed by your doctor, who will tailor your dosage based on your past medical history, and the severity of your condition.

 

What if I miss a dose?

If you miss a dose of Metformin, there’s no need to fret, just take it as soon as you remember. However, if it’s almost time for your next prescribed dose, then it is best to skip your missed dose altogether and resume your regular dosing schedule – never double dose to make up for the one you have missed.

If you’re prone to forgetting to take your medication, it may help to set an alarm or reminder on your phone to prompt you to take each dose on time.

There you have it; you’re now in the know on how to start taking Metformin properly to get the best results and avoid any possible side-effects. If you still have any doubts about your dosage, you can always refer to the patient information leaflet or better still, get in touch with your doctor.

And remember, following a special meal plan devised by your doctor, making sure that you’re getting plenty of exercises each day, and testing your blood sugar regularly is just as important as medication, for controlling your diabetes and living healthy.

 

References

  1. Abraham the Pharmacist (2018) How to take Metformin| How to start taking Metformin| How to Reduce Metformin Side Effects [Online Video] Available at https://www.youtube.com/watch?v=rc4ukEnN0OA Accessed: 29th August 2020
  2. Drugs.com 2020, Metformin Extended Release Tablets, viewed 29th August 2020, https://www.drugs.com/pro/Metformin-extended-release-tablets.html
  3. NHS 2019, Metformin, viewed 29th August 2020, https://www.nhs.uk/medicines/Metformin/

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