What To Avoid When Taking Metformin | Drug Interactions | Pharmacology
JJ Medicine・10 minutes read
Metformin is a vital medication for conditions like type 2 diabetes, but has side effects like hypoglycemia and lactic acidosis, with interactions with alcohol, grapefruit, and other medications like diuretics, ACE inhibitors, and antidepressants being crucial to consider for patient safety. Supplementation with vitamin B12 is necessary to prevent deficiency symptoms like neurological issues, highlighting the importance of monitoring and managing potential risks associated with metformin use.
Insights
- Alcohol consumption and grapefruit intake can heighten the risk of lactic acidosis and hypoglycemia in metformin users, emphasizing the need for caution with these substances.
- Interactions with various medications like diuretics, antibiotics, ACE inhibitors, and antidepressants can significantly impact metformin's efficacy and side effects, necessitating careful monitoring and potential adjustments in treatment plans.
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Recent questions
What are the side effects of metformin?
Side effects of metformin include hypoglycemia, headaches, diarrhea, and lactic acidosis, with increased risk for patients with liver, kidney, or heart disease, recent heart attack, or previous allergic reactions to metformin.
How does alcohol consumption affect metformin users?
Alcohol consumption, especially excessive, can increase the risk of lactic acidosis and hypoglycemia for metformin users, while grapefruit consumption may also heighten side effects due to liver enzyme inhibition.
What medications can interact with metformin?
Certain medications like contrast media, chest pain meds, anti-malarial drugs, and monoamine oxidase inhibitors can interact with metformin, affecting its levels and effects.
How can vitamin B12 deficiency be prevented with metformin use?
Cimetidine, an H2 blocker for heartburn, can also increase metformin effects, while supplementation with vitamin B12 is crucial to prevent deficiency caused by long-term metformin use.
How do diuretics interact with metformin?
Diuretics like furosemide, carbonic anhydrase inhibitors, and antibiotics can increase the risk of lactic acidosis when used with metformin.
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Summary
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Metformin: Effects, Interactions, and Deficiencies
- Metformin is a medication used to lower blood glucose levels by inhibiting gluconeogenesis, glucose uptake, and increasing insulin sensitivity, crucial for conditions like type 2 diabetes and polycystic ovary syndrome.
- Side effects of metformin include hypoglycemia, headaches, diarrhea, and lactic acidosis, with increased risk for patients with liver, kidney, or heart disease, recent heart attack, or previous allergic reactions to metformin.
- Alcohol consumption, especially excessive, can increase the risk of lactic acidosis and hypoglycemia for metformin users, while grapefruit consumption may also heighten side effects due to liver enzyme inhibition.
- Certain medications like contrast media (iodinated media, ioversol, metrizimide), chest pain meds (renolazine), anti-malarial drugs (tefenoquin), and monoamine oxidase inhibitors (selegiline) can interact with metformin, affecting its levels and effects.
- Diuretics like furosemide, carbonic anhydrase inhibitors (topiramate, methazolamide), and antibiotics (fluoroquinolones, macrolides, trimethoprim, cephalexin) can also increase the risk of lactic acidosis when used with metformin.
- ACE inhibitors (ramipril, lisinopril, captopril) and certain antidepressants (SSRIs, bupropion) can enhance metformin effects, potentially leading to hypoglycemia or other side effects.
- Cimetidine, an H2 blocker for heartburn, can also increase metformin effects, while supplementation with vitamin B12 is crucial to prevent deficiency caused by long-term metformin use.
- Vitamin B12 deficiency symptoms from metformin use can include neurological issues like paresthesias, proprioception problems, and depression, emphasizing the importance of B12 supplementation to mitigate risks.
