ELMMB logo
Facebook logo Twitter logo
Menu Biguanides Biguanides

              GREEN      Metformin tablets 500mg, 850mg   
                                   >     Review metformin dose when serum creatinine >130 micromol/litre or eGFR <45 ml/min/1.73 m2.
                                   >     Stop metformin if serum creatinine >150 micromol/litre or eGFR <30 ml/min/1.73 m2.
                                   >     Prescribe metformin with caution in those at risk of sudden deterioration of kidney function, or at risk of a 
                                          decline of eGFR to <45 ml/min/1.73 m2.
              Metformin  is recommended for reduction in the risk or delay of the onset of type 2 diabetes mellitus in adult, overweight 
              patients with impaired glucose tolerance and/or impaired fasting glucose, and/or increased HbA1c who are:
                                  >      at high risk for developing overt type 2 diabetes mellitus AND 
                                  >      still progressing towards type 2 diabetes mellitus despite implementation of intensive lifestyle change for 3 
                                          to 6 months OR
                                  >      are unable to participate in an intensive lifestyle-change programme.
              GREEN    Metformin tablets (standard release)
                              *Second line treatment to intensive lifestyle-intervention
            Metformin Oral Solution SF  
               Use restricted to those with swallowing difficulties/enteral tube feeding 
               GREEN      Metformin 500mg/5ml oral solution SF   
            Metformin Sustained Release (SR) Tablets 
              In patients in whom slow dose titration does not reduce GI adverse effects, metformin sustained release tablets should be 
              used ONLY where intolerance to the immediate release preparation had been clearly documented and where it prevents 
              continuation of metformin therapy.  A review of the evidence on the use of sustained release metformin preparations did 
              not find that their use in unselected patients reduced gastro-intestinal side effects.
              Metformin sustained release tablets are supported purely as an attempt to ensure the largest number of patients are able 
              to stay on metformin therapy, hopefully delaying progression to other new drugs which often have a reduced evidence 
              base and/oradditional safety concerns.  
              GREEN     Metformin sustained release (SR), tablets 500mg, 750mg, 1000mg    

All material in this section is aimed at health care professionals, but is information currently held in the public domain, members of the  
public seeking advice on medicine-related matters are advised to speak with their GP, pharmacist, nurse or contact NHS111 Service. 
  Email: info.elmmb@nhs.net
 Copyright© 2016-2020 East Lancashire Medicines Management Board. 
 All rights reserved.  Disclaimer/Terms and conditions