Recall of metformin extended releaseIn May 2020, the
Food and Drug Administration (FDA)recommended that some makers of metformin extended release remove some of their tablets from the U.S. market. This is because an unacceptable level of a probable carcinogen (cancer-causing agent) was found in some extended-release metformin tablets. If you currently take this drug, call your healthcare provider. They will advise whether you should continue to take your medication or if you need a new prescription.
The most common medication worldwide for treating diabetes is metformin (Glumetza, Riomet, Glucophage, Fortamet). It can help control high blood sugar in people with type 2 diabetes. It’s available in tablet form or a clear liquid you take by mouth with meals.
If you’re taking metformin for the treatment of type 2 diabetes, it may be possible to stop. You may be able to manage your condition by making certain lifestyle changes, such as maintaining a healthy weight and getting more exercise.
Read on to learn more about metformin and whether it’s possible to stop taking it.
Before you stop taking metformin, talk to your doctor to see if this is the right step to take in managing your diabetes.
Metformin doesn’t treat the underlying cause of diabetes. It treats the symptoms of diabetes by lowering blood sugar, or glucose, by:
- decreasing liver production of glucose
- decreasing absorption of glucose from the gut
- improving insulin sensitivity in peripheral tissues, increasing tissue uptake and use of glucose
Metformin helps with other things in addition to improving blood sugar.
- lowering lipids, resulting in a decrease in blood triglyceride levels
- decreasing “bad” low-density lipoprotein (LDL) cholesterol
- increasing “good” high-density lipoprotein (HDL) cholesterol
- possibly reducing your appetite, which may result in modest weight loss
Because of its possible risks and side effects, metformin isn’t safe for everyone. It’s not recommended if you have a history of:
- substance use disorder
- liver disease
- severe kidney issues
- certain heart problems
If you’re currently taking metformin and have had some unpleasant side effects, you might be looking for alternative treatment options.
Most common side effects
The most common side effects are headaches and digestive issues that may include:
- abdominal cramps
- a metallic taste
- loss of appetite
Other side effects
In some cases, metformin leads to poor absorption of vitamin B-12. That can lead to a vitamin B-12 deficiency, though this only occurs after long-term use of the medication.
As a precaution, your doctor will check your B-12 levels every one to two years while you’re taking metformin.
Taking metformin might also lead to loss of appetite, which could cause a small amount of weight loss. But taking this medication won’t lead to weight gain.
There are also a few other side effects you may encounter, including hypoglycemia and lactic acidosis.
Hypoglycemia, or low blood sugar, might occur since metformin lowers blood sugar. It’s important to monitor your blood sugar regularly so your doctor can adjust your dosage based on your levels.
Hypoglycemia due to metformin is a rare side effect.
Low blood sugar is more likely to occur if you take metformin with other diabetes drugs or insulin.
Metformin can cause a life-threatening condition called lactic acidosis. People who have lactic acidosis have a buildup of a substance called lactic acid in their blood and shouldn’t take metformin.
This condition is very dangerous and often fatal. But this is a rare side effect and affects less than 1 in 100,000 people taking metformin.
Lactic acidosis is more likely to occur in people with kidney disease. Tell your doctor if you’ve ever had kidney problems.
Metformin can be an important part of an effective diabetes treatment plan. But reducing the dosage of metformin or stopping it altogether is safe in some cases if your diabetes is under control.
If you want to stop taking diabetes medications, talk with your doctor or healthcare provider about what steps you need to take to do so.
Everyone who has diabetes can benefit from changing certain lifestyle habits, even those taking medications.
Losing weight, eating better, and exercising are the best ways to help reduce blood glucose and A1C. If you can manage these through such lifestyle changes, you may be able to stop taking metformin or other diabetes drugs.
According to experts from the American Diabetes Association, you usually need to meet the following criteria before you can stop taking diabetes medications:
- Your A1C is less than 7 percent.
- Your fasting morning blood glucose under 130 milligrams per deciliter (mg/dL).
- Your blood glucose level at random or after a meal is below 180 mg/dL.
It’s risky to stop taking metformin if you don’t meet these criteria. And keep in mind that these criteria can change based on your age, overall health, and other factors. So, it’s important to talk with your doctor before changing your metformin plan.
Metformin may help prevent long-term health complications from type 2 diabetes. But you may be able to stop taking it if your doctor thinks you can maintain your blood sugar without it.
You may be able to successfully lower and manage your blood sugar without medication by making lifestyle changes such as the following:
- maintaining a healthy weight
- getting more exercise
- reducing your intake of carbohydrates
- modifying your diet to include low-glycemic carbohydrates
- stopping smoking tobacco in any form
- drinking less or no alcohol
It’s also important to get support. A registered dietitian, personal trainer, or peer group can improve your chances of sticking with these healthy habits.
Visit the American Diabetes Association for online and local support in your community.