Metformin Compounded

Metformin is an anti-diabetic medication and is generally the preferred initial pharmacologic agent for the treatment of diabetes mellitus 2. It is also used for antipsychotic-induced weight gain, polycystic ovary syndrome (PCOS), gestational diabetes mellitus, and other conditions. Here at CareFirst Specialty Pharmacy, we have the facility capable of compounding metformin into different dosage forms such as creams and capsules to best fit your needs.

Pronunciation:

(met FOR min)

Other Names:

Brand Names (U.S.): Fortamet, Glucophage, Glucophage XR, Glumetza, Riomet, and Riomet ER

Drug Class:

Antidiabetic Agent and Biguanide

Mechanism of Action:

Metformin decreases hepatic glucose production (gluconeogenesis), decreases intestinal absorption of glucose, and improves insulin sensitivity (increases peripheral glucose uptake and utilization).

Drug Interactions:

Do not take with the following medications: Alcohol (Ethyl)

Consider therapy modification with the following medications: Cimetidine, Dolutegravir, Iodinated Contrast Agents, Patiromer, Ranolazine, Risdiplam, and Tafenoquine

Adverse Effects:

Common side effects you might experience: stomach pain or diarrhea, gas, upset stomach or throwing up, heartburn, feeling tired or weak, and headache

Tell your doctor if you begin to have any of these symptoms following metformin administration:

• Signs of an allergic reaction like a rash, hives, itching, trouble breathing, wheezing, tightness in chest and/or throat.
• Very bad stomach pain; it is common to have stomach problems such as upset stomach, throwing up, or diarrhea when starting medication. If stomach problems persist or occur later on during therapy contact your doctor right away.
• Low blood sugar can happen, which is noted by signs of dizziness, headache, feeling sleepy or weak, shaking, fast heartbeat, confusion, hunger, or sweating.

Administration:

Use this drug as ordered by your prescriber.

Dosing:

Contact your healthcare provider for specific dosing instructions.

Pregnancy:

Metformin does cross the placenta. It is best to speak to your healthcare provider to see if the benefits outweigh the risks of using metformin while pregnant.

Breastfeeding:

Metformin is present in breast milk. The relative infant dose (RID) of metformin has been noted to be ~1.08%. RID is considered acceptable when RID is <10% and when RID is >25% breastfeeding should generally be avoided. The decision to breastfeed while taking metformin should consider the following: risk of infant exposure, the benefits of breastfeeding to the infant, and benefits of treatment to the mother. Based on limited information, metformin is considered relatively compatible with breastfeeding.

Children/Pediatrics:

For children ≥10 years of age, metformin is relatively safe to use; however, dosing is subject to change based on age and weight.

References:

• Metformin [Lexi-Drugs]. Lexi-Comp. Wolters Kluwer Health, Inc. http://online.lexi.com. Updated September 23 rd , 2020. Accessed September 25, 2020.
• American Diabetes Association (ADA). Standards of medical care in diabetes–2020. Diabetes Care. 2020;43(suppl 1):S1- S212. https://care.diabetesjournals.org/content/43/Supplement_1. Accessed January 22, 2020.
• Glucophage ® [package insert]. Princeton, NJ. Bristol-Myers Squibb Company.