Clinical medicine profile
Metformin
Biguanide antidiabetic
- Route
- ORAL
- Schedule
- POM
- ATC
- Not assigned
- PPB status
- registered
This profile needs source confirmation
A traceable source link is not attached to this profile. Confirm prescribing decisions against the current SmPC and Kenya STG/EML.
Safety essentials
The information most likely to change a prescribing or dispensing decision.
Contraindications
- Diabetic comma
- severe renal impairment
- hepatic impairment
- keto-acidosis
- cardiac failure
- excessive alcoholic intake
- pancreatitis
- severe infections and trauma
- pregnancy and lactation
- dehydration
- pre-desposition to lactic acidosis
- conditions associated with hypoxaemia
Precautions
- Discontinue 2-3 days before surgery
- conditions causing dehydration
- infections
- low calorie diet
- monitor vitamin B12 annually
- patients to be stabilized in hospital when combination therapy is used.
Dosing matrix
Population and organ-function guidance, shown together for faster comparison.
500mg TID or 850mg BD or 1gm OD [Max.:3g. daily in divided doses with or after meals]
From ~10 years if indicated: start 500 mg daily; max often 2 g/day — specialist/paediatric diabetes guidance.
Contraindicated if eGFR <30. Do not start if eGFR 30–45; if already on therapy review dose. Adjust per eGFR bands (local protocol).
- CrCl 45–120: Usual titration; monitor eGFR.
- CrCl 30–44: Do not initiate; if continuing, use reduced max dose and close monitoring.
- CrCl 0–29: Stop metformin — contraindicated.
Avoid in significant hepatic impairment (lactic acidosis risk).
Use, effects & interactions
Indications
- Non-Insulin Dependent Diabetes Mellitus (NIDDM) when dieting and sulphonylureas have failed to control diabetes, especially in over-weight patients (it is the drug of choice in these patients).
- Clinical selection for Metformin should follow culture results where relevant, Kenya STG/EML recommendations, and the current product SmPC.
- Class context: Biguanide antidiabetic.
- Confirm site-specific dose, duration and monitoring before prescribing.
Adverse effects
- Diarrhoea, nausea, abdominal discomfort, metallic taste.
- Serious: lactic acidosis (rare, high mortality if occurs).
Drug interactions
Open multi-drug checker ↗- First-line type 2 diabetes pharmacotherapy in most guidelines unless contraindicated.
- Educate on sick-day rules.
- Review eGFR at least annually or more if CKD.
Mechanism & disposition
A biguanide that acts by de-creasing gluconeogenesis and by increasing peripheral metabolism of glucose.
Read complete mechanism
A biguanide that acts by de-creasing gluconeogenesis and by increasing peripheral metabolism of glucose. Metformin decreases hepatic gluconeogenesis, improves peripheral insulin sensitivity, and reduces intestinal glucose absorption. Does not stimulate insulin secretion — low intrinsic hypoglycaemia risk alone.
Days for glycaemic effect
Continuous with chronic dosing
ORAL
saturable. Not metabolised; renally excreted unchanged. Accumulation in renal impairment drives lactic acidosis risk.
Pregnancy, lactation & diet
Increasingly used in GDM/PCOS pathways per specialist protocols; insulin remains standard in many settings.
Generally considered compatible.
Brands & loaded prices
| Brand | Manufacturer | Pack | Observed price |
|---|---|---|---|
| BETAFORM 500 TABLETS | BLISS GVS PHARMA LTD | Film-Coated Tablet | Unavailable |
| GENIMET 500 | STERLING LAB | Tablet | Unavailable |
| GENIMET 850 | STERLING LAB | Tablet | Unavailable |
| GLUCOMET | DAIMA BIASHARA / Wholesale Import | 500MG TABS 56`S | KES 418.17Daima Chemist price-list reference ↗ Source date not recorded · verify current price |
| GLUCOMET 500 TABS F/C 28`S | Not recorded | — | KES 118.25Daima Chemist price-list reference ↗ Source date not recorded · verify current price |
| GLUCOMET 850 TABS F/C 28`S | Not recorded | — | KES 221.45Daima Chemist price-list reference ↗ Source date not recorded · verify current price |
| GLUCOMET 1000 XR 30*S | Not recorded | — | UnavailableDaima Chemist price-list reference |
| GLUCOMET N TABS*28`S | Not recorded | — | KES 354.75Daima Chemist price-list reference ↗ Source date not recorded · verify current price |
| GLUCOPHAGE | DAIMA BIASHARA / Wholesale Import | 1000MG * 60`S | KES 384.85Daima Chemist price-list reference ↗ Source date not recorded · verify current price |
| GLUCOPHAGE XR | DAIMA BIASHARA / Wholesale Import | 1000MG TAB 60*S | KES 774.00daima_biashara_price_list |
| MEFTAN PLUS 4/2.5DT TABS 14*S | Not recorded | — | KES 362.18Daima Chemist price-list reference ↗ Source date not recorded · verify current price |
| MEFTAN PLUS 10 | Not recorded | 5MG TABS 28`S | UnavailableDaima Chemist price-list reference |
| MELMET 500 SR | Micro Labs Limited, India | Tablet | Unavailable |
| Metfil | FOURRTS (INDIA) Laboratories Private Limited | Tablet | Unavailable |
| Metformin Denk 500 | DENK PHARMA GMBH & CO. KG | Coated Tablet | Unavailable |
| Metformin Denk 850 | DENK PHARMA GMBH & CO. KG | Film-Coated Tablet | Unavailable |
| METFORMIN HYDROCHLORIDE TABLETS USP 500MG | VICTORIA HEALTHCARE LTD | Coated Tablet 500MG | Unavailable |
| Metmin 1000. | DAWA LIMITED | Film-Coated Tablet | Unavailable |
| METSAFE 500 ER | MSN Laboratories Private Limited | Film-Coated Tablet | Unavailable |
Sources & review state
Decision support only. Confirm patient-specific decisions against the current product SmPC, Kenya STG/EML, and professional judgement.