Metformin is a first-line treatment for type 2 diabetes, and has some surprising dental implications. Here are some things you may not have known about Metformin:
Generic Name: Metformin Hydrochloride
Brand Name(s): Fortamet, Glumetza, Riomet
Pronunciation: met FOR min
About this drug:
Metformin is used to control blood sugar levels in patients with type 2 diabetes, in combination with diet and exercise.
It can also occasionally be used to treat Polycystic Ovary Syndrome (PCOS), prediabetes, gestational diabetes, and weight gain from antipsychotic medications.
Metformin is not used to treat type 1 diabetes.
Dentistry-related tidbits:
Metformin may cause a metallic taste in the mouth.
Metformin may cause a vitamin B12 deficiency, a side effect of which is glossitis (inflammation of the tongue).
Quinolone antibiotics and steroids can decrease Metformin’s antidiabetic efficacy, so advise patients to check their blood sugar if you plan on prescribing these drugs.
Cephalexin, Ketoconazole, and Trimethoprim are three commonly prescribed medications that can increase the risk of lactic acidosis in patients taking Metformin.
Make sure to check for potential interactions before prescribing using a tool like Rx Check.
Epinephrine can increase the risk of hyperglycemia in patients taking Metformin.
Withholding of food and fluids during surgical or other procedures may increase the risk of volume depletion, hypotension, and renal impairment. Speak with the patient's physician for this medication to be temporarily stopped while patients have restricted food and fluid intake or will need to be NPO before surgery.
Fun facts:
Researchers are investigating Metformin’s potential in lowering risk of breast, colon, and prostate cancer, lowering risk for dementia and stroke, and slowing aging.
Metformin has a surprisingly ancient history, extending back centuries where the use of the herb Galega officinalis (a.k.a. goat’s rue, French lilac, Italian fitch, Spanish sainfoin, or professor weed) was common in medieval Europe. In the early 20th century, the plant was found to be rich in guanidine, which was later reported to reduce blood glucose in animals in 1918. In the years following, several guanidine-based drugs were developed but soon fell out of favor due to their potential toxicities and as insulin also came on the scene. Metformin was rediscovered in the 1950s by French researcher Jean Sterne, but it took several decades before being approved by the U.S. FDA. Its more favorable safety profile compared to other biguanide agents eventually propelled it to its current front-line status in the treatment of diabetes.
Today, Metformin is the #3 most commonly prescribed drug in the U.S., with over 92 million prescriptions written in 2020.
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