Chronic
Type 2 Diabetes Treatment
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 understanding the particulars of dosage and timing, you may be a bit puzzled.
Taking Metformin at the right time and in the proper way can ensure you are maximizing the benefits of the medication, while minimizing any unpleasant side-effects.
Let’s review the ideal time of day or night to take the medication, as well as how to adapt to different dosages.
Metformin comes in two forms: standard and extended-release. The time at which you take the medication depends on the type of tablet you have been prescribed.
Because standard-release tablets metabolize at a much quicker rate than extended-release alternatives, you may need to take them 2 or 3 times daily, depending on the 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 a third dose, ask your doctor about the best time of day to take it, which would most often be with lunch.
Extended-release tablets take longer to metabolize (around 24 hours), and can maintain a steady level of medication in the blood stream. This means you will only need to take it once a day. One advantage of the extedned-release Metformin, is that it has less effect on the GI tract and may be better for patients who are prone to adverse reactions to medication.
It is important to take the extended-release tablet with your evening meal. Because the liver produces glucose overnight, people with diabetes can go to bed with normal blood sugar levels and wake up the next morning to find that they are quite high. 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 taking, always make sure that you take it with a glass of water, and never break, chew or crush the tablets.
While we now know that refraining from taking Metformin on an empty stomach is 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 time to acclimate 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 taken 2 or 3 times a day.
As an example, 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 significant side-effects, you can increase your dose to 500mg twice a day by taking an additional tablet with your breakfast. If needed, 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 such as 1000mg due to the lower risk of side-effects.
The maximum daily dose of Metformin should not exceed 2500mg for the standard release and 2000mg for the extended-release form. After a dose increase, if you do start to notice any significant side effects or if side effects persist for one or two weeks, reduce the dose back to the amount you were taking before.
Ultimately, you should always take the dosage prescribed by your doctor at the recommended time. Your doctor will tailor your dosage based on your past medical history, recent labs, and the severity of your condition.
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. You should never double the dose to make up for the one you have missed.
If you’re prone to forgetting about your medication, it may help to set an alarm or reminder on your phone to prompt you to take each dose on time.
You shoulld now be able 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.
Lastly, remember that following a diabetic diet, 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.
Reviewed by Dr Roy Kedem, MD
Information last reviewed 07/12/21
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