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Metformin Overdose

Survival Following A Metformin Overdose Of 63 G: A Case Report

Survival Following A Metformin Overdose Of 63 G: A Case Report

Survival Following a Metformin Overdose of 63 g: A Case Report Department of Clinical Pharmacology, Aarhus University Hospital, Aarhus Amtssygehus, DK8000 Aarhus C, Denmark Author for correspondence: Jrgen Rungby, Department of Endocrinology C, Aarhus University Hospital, Tage Hansensgade, DK8000 Aarhus C, Denmark (fax +45 8949 7659, Department of Clinical Pharmacology, Aarhus University Hospital, Aarhus Amtssygehus, DK8000 Aarhus C, Denmark Author for correspondence: Jrgen Rungby, Department of Endocrinology C, Aarhus University Hospital, Tage Hansensgade, DK8000 Aarhus C, Denmark (fax +45 8949 7659, Please review our Terms and Conditions of Use and check box below to share full-text version of article. I have read and accept the Wiley Online Library Terms and Conditions of Use. Use the link below to share a full-text version of this article with your friends and colleagues. Learn more. Metformin is a biguanide used in the treatment of type 2 diabetes mellitus. It lowers hepatic glucose production and peripheral insulin resistance. Hypoglycaemia is seen only after intake of toxic doses or in combination with other antidiabetic drugs or after prolonged fasting. As metformin is excreted by the kidneys, care must be taken in renal insufficiency or liver disease because of risk of lactic acidosis. Large overdoses of metformin can lead to lactic acidosis as well. Suicide with metformin is rare. Intake of 35 g of metformin has been shown to be lethal ( Teale et al. 1998 ). In the present paper we report on the treatment and outcome of a 70 year old man after ingestion of 63 g of metformin. Previously, survival after intake of up to 50 g has been described. A 70 year old man with type 2 diabetes mellitus who was being treated with metformin 850 mg twice daily and glimepiride Continue reading >>

Metformin Overdose

Metformin Overdose

Tweet Save As with any medication, it is possible to overdose on metformin. Some of the effects of a metformin overdose may include low blood sugar or lactic acidosis. Symptoms of low blood sugar include blurred vision, shakiness, and extreme hunger. Some symptoms of lactic acidosis can include an irregular heartbeat, trouble breathing, and feeling tired. There are some treatment options for a metformin overdose, including dialysis or using a sugar solution to increase blood sugar levels. Metformin Overdose: An Overview Metformin (Glucophage®) is a prescription medication that has been licensed to treat type 2 diabetes. As with all medicines, it is possible to take too much metformin. Effects of a metformin overdose will vary depending on a number of factors, including how much metformin was taken and whether it was taken with any other medicines, alcohol, and/or drugs. If you happen to overdose on metformin, seek medical attention immediately. Symptoms of a Metformin Overdose The effects of a metformin overdose may include: Possible symptoms of low blood sugar include: Sweating Shakiness Extreme hunger Dizziness Cold sweats Blurry vision. More severe low blood sugar symptoms include: Changes in behavior, such as irritability Loss of coordination Difficulty speaking Confusion Loss of consciousness Coma Lactic acidosis symptoms include: Feeling tired or weak Muscle pain Trouble breathing Abdominal pain (or stomach pain) Feeling cold Dizziness or lightheadedness A slow or irregular heartbeat Loss of life. Tweet Our free DiscountRx savings card can help you and your family save money on your prescriptions. This card is accepted at all major chain pharmacies, nationwide. Enter your name and email address to receive your free savings card. Treatment for a Metformin Overdose Continue reading >>

Fortamet Patient Information Including Side Effects

Fortamet Patient Information Including Side Effects

Brand Names: Fortamet, Glucophage, Glucophage XR, Glumetza, Riomet Generic Name: metformin (Pronunciation: met FOR min) What are the possible side effects of metformin (Fortamet, Glucophage, Glucophage XR, Glumetza, Riomet)? What is the most important information I should know about metformin (Fortamet, Glucophage, Glucophage XR, Glumetza, Riomet)? What should I discuss with my healthcare provider before taking metformin (Fortamet, Glucophage, Glucophage XR, Glumetza, Riomet)? What is metformin (Fortamet, Glucophage, Glucophage XR, Glumetza, Riomet)? Metformin is an oral diabetes medicine that helps control blood sugar levels. Metformin is for people with type 2 diabetes. Metformin is sometimes used in combination with insulin or other medications, but it is not for treating type 1 diabetes. Metformin may also be used for purposes not listed in this medication guide. What are the possible side effects of metformin (Fortamet, Glucophage, Glucophage XR, Glumetza, Riomet)? Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat. This medication may cause lactic acidosis (a build-up of lactic acid in the body, which can be fatal). Lactic acidosis can start slowly and get worse over time. Get emergency medical help if you have even mild symptoms of lactic acidosis, such as: muscle pain or weakness; numb or cold feeling in your arms and legs; trouble breathing; feeling dizzy, light-headed, tired, or very weak; stomach pain, nausea with vomiting; or slow or uneven heart rate. Call your doctor at once if you have any other serious side effect such as: feeling short of breath, even with mild exertion; swelling or rapid weight gain; or fever, chills, body aches, flu symptoms. Les Continue reading >>

Metformin Overdose: An Unusual Cause Of Severe Metabolic Acidosis Singh Y, Joshi Sc, Tayal I, Sharma N - Chrismed J Health Res

Metformin Overdose: An Unusual Cause Of Severe Metabolic Acidosis Singh Y, Joshi Sc, Tayal I, Sharma N - Chrismed J Health Res

Metformin is commonly used in the treatment of type 2 diabetes mellitus (DM). Severe lactic acidosis is a rare side effect of this drug. We present a 45-year-old man who deliberately took 30 g of metformin, presumably with suicidal intent. He had not eaten the previous night and presented with altered sensorium and recurrent seizures. He had profound metabolic acidosis at presentation with a pH of 7.06 and a low blood sugar of 44 mgs/dl. The patient was admitted in intensive care unit (ICU) with the suspicion of metformin-associated lactic acidosis. He developed irreversible renal failure, neurological deterioration and anemia. Despite of daily intensive hemodialysis and other supportive measures the patient expired 14 days later. Metformin overdose with renal failure and severe lactic acidosis have high mortality; hence, urgent medical consultation and treatment can be life saving in these patients. Keywords:Anemia, diabetes mellitus, metformin, metabolic acidosis, renal failure Singh Y, Joshi SC, Tayal I, Sharma N. Metformin overdose: An unusual cause of severe metabolic acidosis. CHRISMED J Health Res 2015;2:166-8 Singh Y, Joshi SC, Tayal I, Sharma N. Metformin overdose: An unusual cause of severe metabolic acidosis. CHRISMED J Health Res [serial online] 2015 [cited2018 Apr 1];2:166-8. Available from: Overdose with antidiabetic drugs often requires intensive care treatment and prolonged hospital stays. They can potentially contribute to increase in morbidity and mortality. [1] Metformin is considered a relatively safe oral hypoglycemic agent, although biguanides are well known to cause profound lactic acidosis. [2] However, there are only limited descriptions of metformin overdose in the literature despite its well-recognized potentially fatal side effect. [3] If ta Continue reading >>

Metformin Hcl

Metformin Hcl

Uses Metformin is used with a proper diet and exercise program and possibly with other medications to control high blood sugar. It is used in patients with type 2 diabetes. Controlling high blood sugar helps prevent kidney damage, blindness, nerve problems, loss of limbs, and sexual function problems. Proper control of diabetes may also lessen your risk of a heart attack or stroke. Metformin works by helping to restore your body's proper response to the insulin you naturally produce. It also decreases the amount of sugar that your liver makes and that your stomach/intestines absorb. How to use Metformin HCL Read the Patient Information Leaflet if available from your pharmacist before you start taking metformin and each time you get a refill. If you have any questions, consult your doctor or pharmacist. Take this medication by mouth as directed by your doctor, usually 1-3 times a day with meals. Drink plenty of fluids while taking this medication unless otherwise directed by your doctor. The dosage is based on your medical condition, response to treatment, and other medications you may be taking. Be sure to tell your doctor and pharmacist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products). To reduce your risk of side effects (such as upset stomach), your doctor may direct you to start this medication at a low dose and gradually increase your dose. Follow your doctor's instructions carefully. Take this medication regularly in order to get the most benefit from it. Remember to use it at the same times each day. If you are already taking another diabetes drug (such as chlorpropamide), follow your doctor's directions carefully for stopping/continuing the old drug and starting metformin. Check your blood sugar regularly a Continue reading >>

Hyperglycemia After Metformin Overdose: A Case Report Sabiha Sahina, D, Cigdem Binayb, Enver Simsekb, Ener Cagri Dinleyicia,

Hyperglycemia After Metformin Overdose: A Case Report Sabiha Sahina, D, Cigdem Binayb, Enver Simsekb, Ener Cagri Dinleyicia,

Articles © The authors | Journal compilation © Int J Clin Pediatr and Elmer Press Inc™ | www.theijcp.org This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited 44 Case Report Int J Clin Pediatr. 2016;5(3-4):44-46 ressElmer Kursat Bora Carmanc Abstract We present a case of a 16-year-old non-diabetic girl who ingested over 35 tablets (glucophage Merck 850 mg) of metformin in a sui- cide attempt. She presented to pediatric emergency department with severe lactic acidosis and a progressively increasing serum glucose level. She was in a coma state at the time of admission, Glasgow coma scale was 3/15 and arterial blood pressure was 106/45 mm Hg. Arterial blood gas (ABG) analysis indicated severe metabolic acido- sis (pH 6.7) with high anion gap -30.5, PCO2 13.2, HCO3 3.9, BE -30, lactate 14.54 mmol/L, blood glucose 497, amylase 531 IU/L, and uric acid 10.47 mg/dL. Serum ethanol, acetaminophen and salicylates were measured and found to be undetectable. Electrocardiographic monitoring demonstrated a narrow-complex sinus tachycardia. She was intubated, totally 2,000 cc/m2 fluid and NaHCO3 were given, and insulin infusion 0.1 units/kg was started for blood glucose of 497 mg/dL. But the patient suffered several cardiac arrests with pulse- less electrical activity and ultimately expired 25 h after the ingestion. The patient was transferred to pediatric intensive care unit (PICU) for high-volume continuous veno-venous hemofiltration (CVVH). Despite the supportive care in ICU, she died due to multiple organ failures after 48 h of hospitalization. Keywords: Continue reading >>

Metformin Litfl Life In The Fast Lane Medical Blog

Metformin Litfl Life In The Fast Lane Medical Blog

Metformin rarely causes hypoglycaemia but it can cause a profound lactic acidosis in overdose and in patients with renal failure. Used therapeutically to inhibit glucogenogenesis and stimulate peripheral glucose uptake, in toxic doses it causes a profound lactaemia. All the mechanisms are unclear but it is in part due to the inhibition of gluconeogenesis (which lactate is required). Therefore in healthy individuals there is some build up of lactate, this is normally excreted in the urine but at impaired renal function or an acute overdose there is excess lactate. It is not metabolised and excretion relies solely on renal excretion A lactic acidosis in the context of therapeutic metformin has a high mortality rate and an underlying cause (sepsis) needs to be managed Metformin overdose is usually benign but doses > 10 grams are concerning Lactic acidosis will occur in these individuals who are susceptible (renal, cardiac, respiratory failure) or in patients who have ingested co-ingestants or are on medications that impair cardiac and renal function Severe lactic acidosis usually manifests with non-specific symptoms several hours later but can progress to coma, shock and death Children: Unintentional ingestion of up to 1700mg is benign. Hypoglycaemia, if present can be managed with dextrose . Severe acidosis and hyperkalaemia may require the administration of sodium bicarbonate (1 2 mmol/kg). However, it is likely the patient is already hyperventilating to compensate for the metabolic acidosis, haemodialysis is the ultimate priority. If in a patient on therapeutic metformin, stop further administration and seek the underlying cause for their deterioration (sepsis, acute kidney injury) Screening: 12 lead ECG, BSL, Paracetamol level 50 grams of charcoal to the co-operative Continue reading >>

Metformin Overdose Symptoms And Treatment: What You Should Know

Metformin Overdose Symptoms And Treatment: What You Should Know

What is Metformin? It is a type of medication called a biguanide, which is used to treat people with type 2 diabetes. Type 2 diabetes is a chronic condition where the body cannot make enough insulin or use it properly. Most people with type 2 diabetes can control their blood sugar levels through regular exercise and healthy diet. In case this does not work, metformin is the first oral diabetes medication that is prescribed to people with type 2 diabetes. It can also be used together with insulin or other diabetes medication to reduce blood glucose levels when it is too high. Controlling high blood sugar is important because it prevents the risk of health complications such as loss of limbs, kidney damage and nerve problems. However, this medicine should not be used to treat type 1 diabetes, a condition where the body produces little or no insulin. This is because metformin works by helping the body respond better to the insulin it already makes. The drug works by reducing the amount of glucose that is produced by your liver and by decreasing insulin that is absorbed by the intestines. This helps to control blood glucose levels in people with type 2 diabetes. Dosage The dosage of metformin depends on your medical condition, response to treatment and kidney function. Do not change your dosage without your doctor’s permission. Your doctor may ask you to start at a lower dose, then gradually increase the dosage to reduce the risk of side effects like stomach upset. This medication is supposed to be taken by mouth, usually 1 to 3 times every day with meals. You should drink plenty of fluids as you take this medication unless directed otherwise by your healthcare provider. Metformin overdose symptoms and treatment Although not common, a metformin overdose can result in seri Continue reading >>

Lactic Acidosis Secondary To Metformin Overdose: A Case Report

Lactic Acidosis Secondary To Metformin Overdose: A Case Report

Timbrell et al.; licensee BioMed Central Ltd.2012 Metformin is a commonly used treatment modality in type 2 diabetes mellitus, with a well documented side effect of lactic acidosis. In the intensive care setting lactate and pH levels are regularly used as a useful predictor of poor prognosis. In this article we highlight how high lactate levels are not an accurate predictor of mortality in deliberate metformin overdose. We present the case of a 70-year-old Caucasian man who took a deliberate metformin overdose of unknown quantity. He had a profound lactic acidosis at presentation with a pH of 6.93 and a lactate level of more than 20mmol/L. These figures would normally correspond with a mortality of more than 80%; however, with appropriate management this patients condition improved. We provide evidence that the decision to treat severe lactic acidosis in deliberate metformin overdose should not be based on arterial lactate and pH levels, as would be the case in other overdoses. We also demonstrate that appropriate treatment with hemodiafiltration and 8.4% sodium bicarbonate, even in patients with a very high lactate and low pH, can be successful. MetforminLactate LevelLactic AcidosisArterial LactateCritical Care Patient Metformin is a biguanide typically used as a first line drug for the treatment of type 2 diabetes mellitus. Its chief modes of action are reduced absorption of glucose from the gastrointestinal tract, decreased hepatic gluconeogenesis and increased peripheral utilization of glucose[ 1 ]. All of these actions lower plasma levels of glucose. Commonly reported side effects are predominantly gastrointestinal and include: nausea, vomiting and abdominal pain. Lactic acidosis is a well-recognized consequence of toxicity and is often associated with concurrent Continue reading >>

Fatal Metformin Overdose Presenting With Progressive Hyperglycemia

Fatal Metformin Overdose Presenting With Progressive Hyperglycemia

Go to: CASE REPORT A 29-year-old man ingested metformin in a suicide attempt. The patient consumed the entire remaining contents of his father’s prescription metformin bottle that originally contained 100 tablets of 850 mg each. The father stated that the bottle had contained at least three-quarters of its original contents, putting the ingested dose between 64 and 85 grams. The patient also consumed ethanol, but denied any other co-ingestants. The parents discovered the overdose around 6:30 a.m., about 5 ½ hours post-ingestion, when the patient began complaining of vomiting, diarrhea, thirst, abdominal pain and bilateral leg pain. Paramedics were called, who found the patient to be agitated with a fingerstick glucose level of 180 mg/dL. The patient had a history of psychosis and depression, including prior suicide attempts by drug ingestion. He was not taking any prescribed medications, having discontinued olanzapine and sertraline several months earlier. The patient had no personal history of diabetes, despite the family history of type II diabetes in his father, who was taking no other anti-diabetic medications than metformin. The patient admitted to daily ethanol and tobacco use, but denied any current or past use of illicit drugs. He had no surgical history or known allergies. Vital signs on arrival to the Emergency Department (ED) were temperature of 35.2°C (rectal), pulse of 113 beats/min, blood pressure of 129/59 mmHg, respirations at 28 breaths/min with 100% saturation via pulse oximetry on room air. The patient was awake and oriented x4, but agitated and slightly confused (GCS=14). Pupils were equal and reactive at 4mm and the oral mucous membranes were dry. Other than tachycardia, the heart and lung exams were unremarkable. The abdomen was mildly tender t Continue reading >>

Fatal Metformin Intoxication With Markedly Elevated Blood And Liver Concentrations

Fatal Metformin Intoxication With Markedly Elevated Blood And Liver Concentrations

Fatal Metformin Intoxication with Markedly Elevated Blood and Liver Concentrations California Poison Control System, San Diego Division and Clinical Pharmacy, University of California San Francisco School of Pharmacy, 200 W. Arbor Dr., San Diego, CA 92103 Author to whom correspondence should be addressed. Email: [email protected] . Search for other works by this author on: San Diego County Medical Examiner's OfficeToxicology, 5555 Overland Ave., Suite 1411, San Diego, CA 92123 Search for other works by this author on: San Diego County Medical Examiner's OfficeToxicology, 5555 Overland Ave., Suite 1411, San Diego, CA 92123 Search for other works by this author on: San Diego County Medical Examiner's OfficeToxicology, 5555 Overland Ave., Suite 1411, San Diego, CA 92123 Search for other works by this author on: Journal of Analytical Toxicology, Volume 36, Issue 9, 1 November 2012, Pages 657659, F. Lee Cantrell, Craig L. Nelson, Ray D. Gary, Iain M. McIntyre; Fatal Metformin Intoxication with Markedly Elevated Blood and Liver Concentrations, Journal of Analytical Toxicology, Volume 36, Issue 9, 1 November 2012, Pages 657659, The highest postmortem metformin concentrations are recorded utilizing a sensitive and specific analytical procedure. The peripheral blood metformin concentration was 240 mg/L, the liver concentration was 240 mg/kg and the gastric concentration was 1,700 mg. Additionally, an antemortem blood sample collected shortly after admission revealed a metformin concentration of 210 mg/L. These data, revealing a liver to peripheral blood ratio of 1.0, provide additional support that metformin is not subject to postmortem redistribution. Intentional self-poisonings with metformin can result in death, despite multiple medical interventions. Since being appro Continue reading >>

Metformin (oral Route)

Metformin (oral Route)

Precautions Drug information provided by: Micromedex It is very important that your doctor check your progress at regular visits, especially during the first few weeks that you take this medicine. Blood and urine tests may be needed to check for unwanted effects. This medicine may interact with the dye used for an X-ray or CT scan. Your doctor should advise you to stop taking it before you have any medical exams or diagnostic tests that might cause less urine output than usual. You may be advised to start taking the medicine again 48 hours after the exams or tests if your kidney function is tested and found to be normal. Make sure any doctor or dentist who treats you knows that you are using this medicine. You may need to stop using this medicine several days before having surgery or medical tests. It is very important to carefully follow any instructions from your health care team about: Alcohol—Drinking alcohol may cause severe low blood sugar. Discuss this with your health care team. Other medicines—Do not take other medicines unless they have been discussed with your doctor. This especially includes nonprescription medicines such as aspirin, and medicines for appetite control, asthma, colds, cough, hay fever, or sinus problems. Counseling—Other family members need to learn how to prevent side effects or help with side effects if they occur. Also, patients with diabetes may need special counseling about diabetes medicine dosing changes that might occur with lifestyle changes, such as changes in exercise or diet. Counseling on birth control and pregnancy may be needed because of the problems that can occur in pregnancy for patients with diabetes. Travel—Keep a recent prescription and your medical history with you. Be prepared for an emergency as you would norm Continue reading >>

Fatal Metformin Overdose: Case Report And Postmortem Biochemistry Contribution

Fatal Metformin Overdose: Case Report And Postmortem Biochemistry Contribution

Abstract Metformin is an oral antihyperglycemic agent used in the management of type 2 diabetes mellitus. Lactic acidosis from metformin overdose is a rare complication of metformin therapy and occurs infrequently with therapeutic use. Fatal cases, both accidental and intentional, are extremely rare in clinical practice. Metformin is eliminated by the kidneys, and impaired renal function can result in an increased plasma concentration of the drug. In this report, we describe an autopsy case involving a 70-year-old woman suffering from diabetes mellitus and impaired renal function who received metformin treatment. Metformin concentrations in the peripheral blood collected during hospitalization and femoral blood collected during autopsy were 42 and 47.3 µg/ml, respectively. Lactic acidosis (29.10 mmol/l) was objectified during hospitalization. Furthermore, postmortem biochemistry allowed ketoacidosis to be diagnosed (blood β-hydroxybutyrate, 10,500 µmol/l). Death was attributed to lactic acidosis due to metformin intoxication. Increased plasma concentrations of the drug were attributed to severely impaired renal function. The case emphasizes the usefulness of performing exhaustive toxicology and postmortem biochemistry towards the more complete understanding of the pathophysiological mechanisms that may be involved in the death process. Discover the world's research 14+ million members 100+ million publications 700k+ research projects Join for free (500 mg at 8 a.m., 1,000 mg at 1 p.m., and 1,000 mg at 7 (500 mg at 8 a.m., 1,000 mg at 1 p.m., and 1,000 mg at 7 Tab l e 1 The results of biochemical antemortem and postmortem investigations Treatment Analyte and blood reference values Urea nitrogen Creatinine Lactate and pH K Na Cl BHB 65–105 mg/dl 5–6.6 % 8.1–17.9 Continue reading >>

Metformin Accidental Overdose

Metformin Accidental Overdose

Diabetes Forum The Global Diabetes Community Find support, ask questions and share your experiences. Join the community I have taken 2 x 500mg metformin by mistake what should I do? is it harmful? Shouldn't have too much impact. Can you take bs reading? I went too low on it once or twice as my doseage was too high. Had a hypo and ate tsp of honey which sorted it out. Do you do readings? If so, what's your normal reading? Keep an eye. A hypo is 4 or anything below. If you are worried make sure someone else around, tell them what you've done. You could ring 111. Happily it is not a very powerful drug and, in my opinion, it won't cause you problems. However if you have a meter then test and if you don't have a meter and go vague, slight headache and maybe a tremour then eat something sweet. @Scandichic suggests that if you are worried then call 111 and I think that's a good idea too. This is the dose that a lot of people on metformin take. It may give you a dodgy stomach if you are not used to that dose. Also depends what your levels are usually whether it may take you too low and you hypo. I have taken 2 x 500mg metformin by mistake what should I do? is it harmful? many thanks for those who took time to reply. 111 replied quite soon, but to actually speak to someone took much longer. it's the first time it's happened, won't be so worried next time! Glad you're ok! I got prescribed 3 but lost a substantial amount of weight. Kept feeling funny and asked doc who poo pooed it. Hubbie called 111 as kept drifting in and out of consciousness. Hospital set no met, doc said carry on. Chemist said load of crap and reduced it to 1. Now lost 4 stone and still on 1. Works well. If I stop, bs goes up a bit despite low carbing. And I am very low carb. So take 1. Hugsxxx Continue reading >>

Metformin

Metformin

Metformin, marketed under the trade name Glucophage among others, is the first-line medication for the treatment of type 2 diabetes,[4][5] particularly in people who are overweight.[6] It is also used in the treatment of polycystic ovary syndrome.[4] Limited evidence suggests metformin may prevent the cardiovascular disease and cancer complications of diabetes.[7][8] It is not associated with weight gain.[8] It is taken by mouth.[4] Metformin is generally well tolerated.[9] Common side effects include diarrhea, nausea and abdominal pain.[4] It has a low risk of causing low blood sugar.[4] High blood lactic acid level is a concern if the medication is prescribed inappropriately and in overly large doses.[10] It should not be used in those with significant liver disease or kidney problems.[4] While no clear harm comes from use during pregnancy, insulin is generally preferred for gestational diabetes.[4][11] Metformin is in the biguanide class.[4] It works by decreasing glucose production by the liver and increasing the insulin sensitivity of body tissues.[4] Metformin was discovered in 1922.[12] French physician Jean Sterne began study in humans in the 1950s.[12] It was introduced as a medication in France in 1957 and the United States in 1995.[4][13] It is on the World Health Organization's List of Essential Medicines, the most effective and safe medicines needed in a health system.[14] Metformin is believed to be the most widely used medication for diabetes which is taken by mouth.[12] It is available as a generic medication.[4] The wholesale price in the developed world is between 0.21 and 5.55 USD per month as of 2014.[15] In the United States, it costs 5 to 25 USD per month.[4] Medical uses[edit] Metformin is primarily used for type 2 diabetes, but is increasingly be Continue reading >>

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