Pharm 101: Metformin

Class

Biguanide


Pharmacodynamics
  • Euglycaemic agent
  • Reduces hepatic gluconeogenesis by activating enzyme AMPK
  • Does not require functioning pancreatic beta cell for its action

Pharmacokinetics
  • Well absorbed
  • Not protein bound
  • Not metabolised
  • Half-life 1.5-3 hours
  • Excreted by kidney as unchanged compound

Clinical uses
  • Diabetes mellitus

Adverse effects
  • GI upset in 20%, limits compliance with drug
  • HAGMA (lactic acidosis), especially in patients with coexistent renal failure, alcoholism, chronic cardiopulmonary disease
    • Contraindicated if eGFR < 30 ml/min
  • Decreased B12 absorption

Further reading

References

Pharm 101 700

Pharmacology 101

Top 200 drugs

MBBS (UWA) CCPU Emergency Medicine Advanced Trainee based in Melbourne, Australia. Co-author of the LITFL ECG Library. Likes Ultrasound, Echo, ECGs, and anything and everything with caffeine. Part of the 2021 ANZCEN Clinician Educator Incubator Programme | @rob_buttner | ECG Library |

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