When should we take metformin?

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ValH

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Hi everyone.
I'm feeling very confused about when it is best to take our metformin.
I know it's best to take
A) at the same time each day
B) with or after meals
C) with a glass of water
D) start gradually & increase the dose over time to monitor any side effects.

But since being diagnosed, my dose has been changed several times.

Started on 2 x 500mg standard release, taken 1 with breakfast and 1 with evening meal

Then GP increased to 3,
with 2 at breakfast, 1 at evening meal.

Then GP increase to 4,
with 2 at breakfast, 2 at evening meal.

I raised my concerns as my Hba1c was only 51, stable, not overweight and I exercise regularly.

As a trial, they have now reduced back to 3 x 500mg, with a retest in 3 months.

So I have been researching when is it best to take, and l'm now feeling very confused. Personally l don't (usually) have any tummy side effects.

Some advice suggests take ALL at night.
As l am on 3 tablets, is it best to take 2xam/1xpm or
1xam/2×pm?

If l tend to have sugar binges at night, should l take 2 or all 3 at night?

If l tend to have carbs during the day, should l take 2 or all 3 in the morning?

Whichever l choose is best overall, l know that l should stick to this and not vary it because of the day I've had.

Would be very interested to know what everyone else has been advised by their GPs

Thank you
 
It's spaced out during the day to keep it at a 'steady state' in the system, I believe. It's taken with meals to prevent the side effects.

It doesn't really work 'immediately', just can increase insulin sensitivity (When insulin is present) and may do some things in the liver to hold back glucose release (Which is overactive in T2s, but this does change during the day based on the circadian rhythmn) and might affect how carbs are digested.

So 'binging on sugar' and then taking Metformin won't help, unlike someone injecting insulin or taking a drug that stimulates the pancreas to release more insulin.
 
I did the increasing 1 tablet a week till taking 4. Four days later saw hcp, prearranged and metformin reduced to 2 and an
SGLT2 taken. I started to have a slightly dodgy tummy when increased 3 to 4 whereas at first it bunged me up. I took it erratically because it affected my appetite. Sometimes I didn't feel like breakfast and sometimes didn't feel like supper. I therefore now take 1 at first meal I eat and second at second meal. I do sometimes have three meals. I was advised when it went down to 2 to take at breakfast and lunch. I don't know if the advice is because I'm retired. I started 1 in evening one in morning then two in evening etc. Until my medication changed I had toyed with taking them all in the evening g as I had read a post on the forum where someone did this. Mine like yours are slow release it wouldn't work for ordinary ones.
I don't know when is best and know most pharmacists will say take at same time. I haven't had breakfast today. I'm going to have an early lunch as have an appointment just after one then will take second with supper.

I take the SGLT2 every day with lots of water and take it at 7.30. I was advised to take it in the morning.

I look forward to reading the replies.
 
I take one in the morning with breakfast, washed down by coffee, and one with my evening meal washed down by a glass of red wine!
 
Vonny said:
I take one in the morning with breakfast, washed down by coffee, and one with my evening meal washed down by a glass of red wine!
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I take my morning Metformin with a spoonful of yoghurt and my evening one with cream or something similar ,it goes down better than with wager
 
Like you I was confused about when to take the metformin I was prescribed. I am on slow release tablets. Patient information leaflet said take in the evening with or after food. Doctor said take 1 x 500mg with breakfast then increased to 1x 500mg after evening meal as well. Changed again to 2 at breakfast plus 2 with evening meal till I received 1000mg dose. Find taking it twice daily working well. Digestive upsets only lasted a couple of days with each dosage change and were quite mild. Long term I hope to be able to reduce medication
 
Morning metformin at 6.45 approx with Gliclazide and some food (usually small amounts of tomato, cheese and chicken). Brekkers at 8am or so. Metformin again with evening meal at 7pm.
 
It is if they are slow release that people can take them all at once. Otherwise you could take 1 with breakfast and 2 with dinner as taking with a substantial meal is supposed to minimise stomach issues. It works away in the background rather than acting directly on food.
Personally I think metformin is over kill if your HbA1C is only 51mmol/mol and GPs should allow a period of life style change before prescribing medication.
if that doesn't work them the meds are an option.
 
Sorry to hear you’ve been getting mixed messages about the best times to take your Metformin @ValH

Starting on low doses, then gradually increasing is often an attempt to allow the body to adjust and to reduce the possibility of side effects I think. Similarly, the recommendation to take with a reasonably substantial meal. Research seems to suggest that there’s a minimum effective dose for Metformin, so try not to worry that your tablets were incrementally increased.

As others have said, Metformin doesn’t work directly on the meal that follows the dose. It’s a medication that gradually builds up in the system, and works ‘in the background’ by reducing insulin resistance, and glucose output from the liver.

Taking them regularly at times that suit you will help to keep your system ‘topped up’. 🙂
 
silver minion said:
Like you I was confused about when to take the metformin I was prescribed. I am on slow release tablets. Patient information leaflet said take in the evening with or after food. Doctor said take 1 x 500mg with breakfast then increased to 1x 500mg after evening meal as well. Changed again to 2 at breakfast plus 2 with evening meal till I received 1000mg dose. Find taking it twice daily working well. Digestive upsets only lasted a couple of days with each dosage change and were quite mild. Long term I hope to be able to reduce medication
Click to expand...
I was told the same as you - DN told me nothing - did research and it seems Metformin SR releases over about 12 hours so by taking twice a day the effect is spread out - I assume for some people having a bigger effect at night is preferable so once a day is better. .
 
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