More serious side effects are rare. They include severe allergic reactions and a condition called lactic acidosis, a buildup of lactic acid in the bloodstream. The risk for this is higher among people with significant kidney disease, so doctors tend to avoid prescribing metformin for them.
Sulfonylureas or SFUs [DiaBeta, Glynase, or Micronase (glyburide or glibenclamide) Amaryl (glimepiride) Diabinese (chlorpropamide) Glucotrol (glipizide)] Usage: This is a good alternative to metformin and works well to lower blood sugar levels.
An effective substitute for Metformin is a compound known as berberine or berberine hydrochloride, which is obtained from many plant species, including goldenseal, barberry, Oregon grape, and turmeric.
Metformin should be avoided in patients with acute or unstable heart failure because of the increased risk of lactic acidosis. It also should be avoided in patients with hepatic impairment, according to the labeling. But this remains controversial in practice.
This medicine is not recommended in patients 80 years of age and older who have kidney problems.
There are some risks if you decide to stop taking metformin on your own. For example, your blood glucose levels may not be controlled. Over time, this can increase the risk of diabetes complications such as vision problems, nerve damage, and heart disease.
The use of metformin by non-diabetics stems from some evidence that metformin can decrease inflammation, protect against cardiovascular disease and cognitive impairment, minimize cancer risk and progression, and prolong life.
Official answer. Most experts consider metformin to be the safest medicine for type 2 diabetes because it has been used for many decades, is effective, affordable, and safe. Metformin is recommended as a first-line treatment for type 2 diabetes by the American Diabetes Association (ADA).
Ozempic and metformin help most people to lower their average blood sugar levels (as measured by an A1c blood test), and these effects are quite significant. Clinical trials have established that (at its maximum dose) metformin can help decrease A1c by 1.5%, while an average dose of Ozempic can decrease A1c by 1.4%.
Risks of stopping metformin
If you stop taking metformin abruptly, your health may suffer. You may experience side effects such as higher blood sugars, an increased A1c, and even weight gain. Over time, higher blood sugar levels can lead to diabetes complications, including: Retinopathy and blindness.
Generally, if you're prescribed metformin, you'll be on it long term. That could be many decades, unless you experience complications or changes to your health that require you to stop taking it.
As stated, metformin is contraindicated in patients with GFRs <30 mL/minute. Additionally, metformin is inappropriate for patients at risk of developing lactic acidosis from another cause, as this can lead to diagnostic ambiguity.
Physiologically, metformin acts directly or indirectly on the liver to lower glucose production, and acts on the gut to increase glucose utilisation, increase GLP-1 and alter the microbiome.
GLP-1 receptor agonists are another option if Metformin isn't working for you. These can either be taken orally or through an injection (either once a day or once weekly). They are proven to lower blood sugar levels and HbA1c levels, as well as protect against kidney disease and heart disease as well.
The current drug labeling strongly recommends against metformin use in some patients whose kidneys do not work normally because use of metformin in these patients can increase the risk of developing a serious and potentially deadly condition called lactic acidosis, in which too much lactic acid builds up in the blood.
Metformin has a black box warning for lactic acidosis — a condition where too much lactic acid builds up in the blood. It's a serious problem and can lead to death. If you experience these symptoms, seek medical attention right away.
Metformin alone (Glumetza®): At first, 500 mg once a day taken with the evening meal. Then, your doctor may increase your dose if needed until your blood sugar is controlled. However, the dose is usually not more than 2000 mg per day. Metformin with a sulfonylurea: Your doctor will determine the dose of each medicine.
If you eat a lot of sugar while taking Metformin, your body will have to work harder to keep your blood sugar levels within a healthy range, and the Metformin will not be as effective for weight loss. However, if it happens infrequently, you should not suffer too many negative side effects. The key is moderation.