Metformin is a first-line medication for the treatment of type 2 diabetes. It is also used in the treatment of polycystic ovary syndrome. It is not associated with weight gain. 

Metformin is a biguanide antihyperglycemic agent. It works by decreasing glucose production by the liver and increasing the insulin sensitivity of body tissues

Today, metformin has garnered a new reputation as a possible anti-aging pill that influences a host of metabolic and cellular processes closely associated with the development of age-related conditions.

Indications for use

  • Type 2 diabetes: the American Diabetes Association and the American College of Physicians each recommend metformin as a first-line agent to treat type 2 diabetes. It is as effective as repaglinide and more effective than all other oral diabetes mellitus type 2 drugs.
  • Polycystic ovarian syndrome: in those with polycystic ovarian syndrome (PCOS), tentative evidence shows that metformin use increases the rate of live births. This includes in those who have not been able to get pregnant with clomiphene. Metformin does not appear to change the risk of miscarriage. A number of other benefits have also been found both during pregnancy and in nonpregnant people with PCOS. 
  • Diabetes mellitus and pregnancy: a review of metformin use during pregnancy compared to insulin alone found good short-term safety for both the mother and baby. Several observational studies and randomized, controlled trials found metformin to be as effective and safe as insulin for the management of gestational diabetes.
  • Weight change: metformin is typically associated with weight loss. Metformin appears to be safe and effective in counteracting the weight gain caused by the antipsychotic medications olanzapine and clozapine.
  • Use with insulin: metformin may reduce the insulin requirement in type 1 diabetes, albeit with an increased risk of hypoglycemia.
  • Anti-aging properties: as shown by the latest studies, metformin also demonstrates anti-aging properties in tested organisms.

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Dosage and administration

Orally. Without chewing

Adults: The initial dose is 500 mg or 850 mg 2-3 times a day after or during meals. To reduce side effects from the gastrointestinal tract, the daily dose should be divided into 2-3 doses.

The maximum dose is 3000 mg per day, divided into three doses.

Combination with insulin: To achieve better blood glucose control, metformin and insulin can be used as a combination therapy. The usual dose is one tablet 2-3 times a day. The dose of insulin is selected based on the concentration of glucose in the blood.

Children: in children over 10 years old, Metformin can be used both in monotherapy and in combination with insulin. The usual starting dose is 500 mg or 850 mg 1 time per day after or during meals.

The maximum daily dose is 2000 mg, divided into 2-3 doses.

Elderly patients: due to a possible decrease in renal function, the dose of metformin must be selected under regular monitoring of renal function indicators.

The duration of treatment is determined by the doctor.


  • Hypersensitivity
  • diabetic ketoacidosis, diabetic precoma, coma;
  • renal failure or impaired renal function;
  • acute conditions with a risk of developing renal dysfunction: dehydration (with diarrhea, vomiting), severe infectious diseases, shock;
  • clinically expressed acute or chronic diseases that can lead to the development of tissue hypoxia (including heart or respiratory failure, acute myocardial infarction);
  • extensive surgery and trauma when insulin therapy is indicated;
  • liver failure, impaired liver function;
  • chronic alcoholism, acute alcohol poisoning;
  • pregnancy;
  • lactic acidosis;
  • use for less than 48 hours before and within 48 hours after conducting radioisotope or x-ray studies with the introduction of iodine-containing contrast medium;
  • adherence to a low-calorie diet (less than 1000 kcal / day);
  • age below 10 years.

With caution: Use in people over 60 years who perform heavy physical work, which is associated with an increased risk of developing lactic acidosis; lactation.

Side effects

  • lactic acidosis.
  • taste violation.
  • nausea, vomiting, diarrhea, abdominal pain and lack of appetite. 
  • skin reactions such as erythema, pruritus, rash.
  • impaired liver function and hepatitis; after the abolition of metformin, these undesirable effects completely disappear.