Metformin
Pronunciation: met-FOR-min.
- Generic name
- metformin hydrochloride
- Drug class
- Biguanide (oral antidiabetic)
- Form
- Tablet or extended-release tablet (500 mg, 850 mg, 1000 mg)
- Route
- Oral
- Legal status
- Prescription-only
Availability and supply rules vary by country
Trade names by country: United States · United Kingdom · Canada · Australia · India · Nepal · New Zealand · China
Australia: Diabex / Diabex XR, Diaformin / Diaformin Alphapharm XR, Metex XR, Formet, Metformin Sandoz, APO-Metformin XR / Apotex-Metformin · Full directory
Boxed warning: Risk of lactic acidosis
Metformin can rarely cause a serious buildup of lactic acid in the blood (lactic acidosis), which has been fatal in some reported cases. The risk is higher in people with kidney problems, liver problems, heart failure, dehydration, excess alcohol use, or certain other conditions, and in people over 65. Symptoms can be subtle at first -- feeling generally unwell, muscle pain, breathing difficulty, unusual sleepiness, or stomach pain. If lactic acidosis is suspected, seek emergency hospital treatment immediately; metformin will be stopped by the treating team as part of that care. (1)
What metformin hydrochloride is and how it works
Metformin is a prescription-only oral medicine used to help control blood sugar in type 2 diabetes. It is usually the first medicine tried for type 2 diabetes and is often combined with other diabetes medicines. (1)
Take metformin exactly as your prescriber directs, with meals, to reduce stomach upset. Your prescriber will check your kidney function before starting and periodically afterward, since this affects your dose and safety.
Mechanism of action: how metformin hydrochloride works
Metformin decreases hepatic glucose production, decreases intestinal glucose absorption, and improves insulin sensitivity by increasing peripheral glucose uptake and utilisation. (1)
What metformin hydrochloride is used for
Type 2 diabetes
Used together with diet and exercise to improve blood sugar control in adults and children aged 10 and older with type 2 diabetes. (1)
Before taking metformin hydrochloride
Do not take / not appropriate for
- Do not take metformin if you have severe kidney problems (eGFR below 30). (all countries) (1)
- Do not take metformin if you have diabetic ketoacidosis or any other acute or chronic metabolic acidosis. (all countries) (1)
- Do not take metformin if you have had a serious allergic reaction to it. (all countries) (1)
Tell your clinician about
- Any kidney or liver problems.
- Heart failure or any condition causing low oxygen levels in the body.
- How much alcohol you drink.
- Any upcoming surgery or imaging tests that use injected contrast dye.
- Pregnancy, plans for pregnancy, or breastfeeding.
How to take metformin hydrochloride
- Take metformin with meals to reduce stomach upset.
- Swallow extended-release tablets whole -- do not split, crush, or chew them.
- Your prescriber will start you on a low dose and increase it gradually over several weeks.
- Before any surgery or imaging test using injected contrast dye, your prescriber may tell you to stop metformin temporarily -- follow their specific instructions.
Procedures and treatment changes
Tell the treating team before surgery, procedures, or any medicine change. Do not alter treatment without the responsible clinician. (1) (2) (3) (4) (5)
Missed dose
Take your next dose at the regular scheduled time. Do not take an extra dose to make up for a missed one.
Overdose
Seek urgent medical attention or contact your prescriber immediately if too much metformin has been taken. (1)
Side effects
Side effects and their urgency vary; report severe, persistent, or concerning symptoms.
Diarrhoea, nausea, and vomiting are common, especially when starting treatment.
What to notice: Diarrhoea, nausea, and vomiting are common, especially when starting treatment.
What to do: Discuss persistent or troublesome symptoms with the treating clinician or pharmacist. (1)
Gas, weakness, indigestion, stomach discomfort, and headache.
What to notice: Gas, weakness, indigestion, stomach discomfort, and headache.
What to do: Discuss persistent or troublesome symptoms with the treating clinician or pharmacist. (1)
Serious warnings
Signs of lactic acidosis — boxed_warning
Symptoms: Feeling generally unwell, muscle pain, difficulty breathing, unusual tiredness or sleepiness, low body temperature, slow or irregular heartbeat, or stomach pain.
Action: Seek urgent medical attention immediately if this is suspected -- the treating team will stop metformin as part of hospital care. (1)
Signs of vitamin B12 deficiency — high caution
Symptoms: Unusual tiredness, numbness or tingling in the hands or feet, or memory problems.
Action: Tell your prescriber -- long-term metformin use can lower vitamin B12 levels, which are checked periodically. (1)
Interactions
- Certain medicines that reduce metformin clearance (such as ranolazine, vandetanib, dolutegravir, and cimetidine) can increase metformin levels -- tell your prescriber about all other medicines you take. (1)
- Drinking alcohol, especially in excess, increases the risk of lactic acidosis with metformin. (1)
- Taking metformin with insulin or a sulfonylurea increases the risk of low blood sugar -- your prescriber may adjust those doses. (1)
- Medicines that treat glaucoma or altitude sickness (carbonic anhydrase inhibitors) can increase the risk of lactic acidosis if combined with metformin. (1)
Pregnancy, breastfeeding, kidney/liver function, age
Pregnancy
There is limited data on metformin use in pregnancy, not enough to determine whether it increases the risk of birth defects. Animal studies did not show harmful effects on the developing baby. Discuss with your prescriber if you are pregnant or planning pregnancy. (1) (2) (3) (4) (5)
Breastfeeding
Metformin passes into breast milk in small amounts. Discuss with your prescriber. (1) (2) (3) (4) (5)
Children
Approved for children aged 10 and older with type 2 diabetes, at a lower maximum dose than adults. (1) (2) (3) (4) (5)
Elderly
People over 65 have a higher risk of lactic acidosis -- kidney function should be checked more often. (1) (2) (3) (4) (5)
Hepatic_impairment
Liver impairment increases the risk of lactic acidosis -- tell your prescriber about any liver problems. (1) (2) (3) (4) (5)
Renal_impairment
Contraindicated if eGFR is below 30; not recommended to start if eGFR is 30-45; kidney function should be checked before starting and periodically during treatment. (1) (2) (3) (4) (5)
Source_ids
Monitoring
Before starting
- Kidney function (eGFR)
- Liver function if relevant
- Vitamin B12 level (baseline useful for long-term monitoring)
During treatment
- Periodic kidney function checks.
- Vitamin B12 levels checked annually.
- Blood sugar (HbA1c) monitoring to assess response.
Storage
Store at room temperature, away from moisture and heat. Keep out of the reach of children.
Professional information
Clinician-facing context only, sourced from the current US FDA prescribing information; verify against the current full label before prescribing.
United States
Indication: Type 2 diabetes
Dose summary: Adults: start 500mg BID or 850mg once daily with meals; titrate by 500mg/week or 850mg/2 weeks; max 2,550mg/day divided. Children 10+: start 500mg BID; max 2,000mg/day divided. Contraindicated eGFR <30; do not initiate 30-45. Stop at/before iodinated contrast procedures, may resume 48h later if renal function stable.
Renal context: Contraindicated below eGFR 30 mL/min/1.73m2; not recommended to initiate at eGFR 30-45; assess eGFR before starting and periodically. (1)
Hepatic guidance
Hepatic impairment is a risk factor for lactic acidosis; use with caution and closer monitoring.
Overdose note
Hemodialysis is effective at removing metformin and correcting lactic acidosis in overdose; manage supportively and seek urgent guidance. (1)
Frequently asked questions
Is metformin available in the US, UK, Europe, Canada, and Australia?
Yes -- metformin is one of the most widely available medicines in the world. The US prescribing information is published on DailyMed, multiple UK marketing authorisations are listed on the electronic medicines compendium, Health Canada's Drug Product Database lists many metformin products, and Australia's TGA lists multiple ARTG registrations. Its use for diabetes was first reported in 1957, it was introduced in the USA in 1995, and it has become the most prescribed glucose-lowering medicine worldwide. New Zealand-specific confirmation was not found in this research but availability there is highly likely given its global ubiquity. (1) (2) (4) (5) (3)
Why do I need to stop metformin before a scan with contrast dye?
Contrast dye used in some imaging tests can temporarily affect kidney function, and metformin relies on the kidneys to be cleared from the body. Stopping it around the time of the procedure reduces the risk of lactic acidosis; your prescriber will tell you exactly when to stop and restart. (1)
What are the warning signs of lactic acidosis with metformin?
Lactic acidosis is rare but serious, and can be fatal. Warning signs include unusual muscle pain, difficulty breathing, unusual tiredness, stomach pain with nausea or vomiting, feeling cold, dizziness, or a slow or irregular heartbeat. Seek emergency medical care immediately if these occur, especially if you also have kidney problems or another risk factor your prescriber has discussed with you -- do not decide on your own whether to keep taking metformin, let the treating team make that call once you're being seen. (1)
What is the mechanism of action of metformin hydrochloride?
Metformin decreases hepatic glucose production, decreases intestinal glucose absorption, and improves insulin sensitivity by increasing peripheral glucose uptake and utilisation. (1)
What is the generic name of Metformin?
The generic name is metformin hydrochloride. (1)
What class of drug is metformin hydrochloride?
Metformin is classed as: Biguanide (oral antidiabetic). (1)
References
- METFORMIN HYDROCHLORIDE tablets -- full prescribing informationU.S. Food and Drug Administration / DailyMed (NIH), full prescribing information · United States · accessed 2026-07-29 · source 1
- Metformin: historical overviewBailey CJ, 'Metformin: historical overview', Diabetologia 2017;60:1566-1576 (PubMed-indexed peer-reviewed review) · Global · accessed 2026-08-17 · source 2
- Multiple metformin products -- ARTG registrationsTherapeutic Goods Administration (TGA), Australia · Australia · accessed 2026-07-29 · source 3
- Metformin -- UK marketing authorisations and SmPCselectronic medicines compendium (emc), United Kingdom · United Kingdom · accessed 2026-08-17 · source 4
- Metformin hydrochloride -- Drug Product Database active ingredient listingHealth Canada Drug Product Database · Canada · accessed 2026-08-17 · source 5
Brand names by country
Single-ingredient metformin hydrochloride names are shown separately by country. Product availability, strengths, and supply rules can change; combination products are not included here.
Priority countries
United States
- Glumetza500 mg, 1000 mg · santarus, inc.
- Riomet500 mg/5mL · sun pharmaceutical industries, inc.
United Kingdom
- Glucophage / Glucophage SR500 mg, 850 mg (IR), 500 mg, 750 mg, 850 mg, 1000 mg (SR) · Merck
- Sukkarto SR500 mg, 750 mg, 1000 mg · Morningside Healthcare Ltd
- Metabet SR500 mg, 1000 mg · Morningside Healthcare Ltd
- Bolamyn SR500 mg, 1000 mg · Teva UK Limited
- Diagemet XL500 mg
Canada
- GLUCOPHAGE
- GLYCON
- GLUMETZA
- METFORMIN FC
- ECL-METFORMIN
- SANDOZ METFORMIN FC
- JAMP-METFORMIN BLACKBERRY
Australia
- Diabex / Diabex XR500 mg, 850 mg, 1000 mg (IR), 500 mg, 750 mg, 1000 mg (XR) · Alphapharm Pty Ltd (Viatris)
- Diaformin / Diaformin Alphapharm XR500 mg (IR), 500 mg, 1000 mg (XR) · Alphapharm Pty Ltd (IR); Strides Pharma Science Pty Ltd (XR ARTG records)
- Metex XR500 mg, 750 mg, 1000 mg · Arrotex Pharmaceuticals Pty Ltd
- Formet250 mg, 500 mg, 850 mg, 1000 mg
- Metformin Sandoz500 mg · Sandoz
- APO-Metformin XR / Apotex-Metformin500 mg · Apotex Pty Ltd / Arrotex
India
- Glycomet500 mg · USV Private Limited
- Glyciphage500 mg · Franco-Indian Pharmaceuticals Pvt Ltd
- Okamet500 mg · Cipla Ltd
- Gluformin500 mg · Abbott Healthcare Private Limited
- Obimet500 mg · Corona Remedies Pvt Ltd
- MelmetMicro Labs Ltd
- MetsmallDr Reddy's Laboratories Ltd
- MetadozeEris Lifesciences Limited
- GluconormLupin Ltd
- X MetGlenmark Pharmaceuticals Ltd
Nepal
- Metfor500 mg · Quest Pharmaceuticals (P.) Ltd.
- Formet500 mg · Lomus Pharmaceutical Pvt. Ltd.
- Bigomet500 mg, 850 mg, 1 g · Aristo Pharmaceuticals Ltd.
- Formin SR500 mg, 850 mg, 1000 mg · Nepal Pharmaceuticals Pvt. Ltd.
- GlycometUSV Ltd. (Indian import)
New Zealand
- Metformin (Apotex)500 mg, 850 mg, 1000 mg · Apotex NZ Ltd
- Metformin Viatris500 mg, 850 mg, 1000 mg · Viatris Ltd (formerly Mylan; data sheet formerly 'Metformin Mylan')
- Indoco Metformin500 mg, 850 mg · Miro Healthcare Ltd, Auckland (sponsor named in section 8 of the data sheet)
China
- Glucophage0.5 g · 中美上海施贵宝制药有限公司 (Sino-American Shanghai Squibb, as shown on source)
- Meidikang深圳市中联制药有限公司 (as shown on source)
- Taibailisted as domestic single-ingredient metformin brand in a top-10 brand ranking
- Yuedaninglisted as single-ingredient 盐酸二甲双胍 brand in a top-10 brand ranking
- Bukelisted as single-ingredient metformin brand in a top-10 brand ranking
View brands in additional countries.
Pakistan
Glucophage, Neodipar, Neophage, Glucoformin, Glumet, Diabimin, Comet
Bangladesh
Comet, Informet, Nobesit, Bigmet, Metfo, Daomin, Metform, Glucomet, Oramet, Glunor
Indonesia
Glucophage, Glumin XR, Gludepatic 500, Eraphage, Forbetes, Nevox XR, Glufor
Nigeria
Glucophage / Glucophage XR, Diamet / Diamet SR, Panfor SR 500, Biophage, Avrophage, Glyformin, Glucoform, Glylow / Glylow SR, Sealmet 1000, Betaform 500
Brazil
Glifage, Glifage XR, Formyn, Diglixx, Glicomet, Glicefor, Meglize
Russia
Glucophage / Glucophage Long, Siofor / Siofor Long, Formetin / Formetin Long, Merifatin, Metformin Sanofi, Metformin Renewal
Mexico
Glucophage, Dimefor / Dimefor XR, Dabex XR, Predial / Predial Plus, Ficonax, Pharmafet / Pharmafet Lb
European Union
Metformin (generic) (2)