CI: CKD

• CrCL/eGFR < 60 → Caution
• CrCL/eGFR < 30 → CI
• !AKI - Acute Kidney Injury (can cause metformin to accumulate)

Effects

Lower blood glucose (expect 1-2% drop in A1C) → increase insulin sensitivity

Side effects:

• GI side-effects
  • metallic taste
  • N/V - Nausea/vomitting(20%)
  • Abdominal Pain
  • Diarrhea
  • Lead to B12 malabsoprtion → Vitamin B12 (Cobalamin) Deficiency → Megaloblastic Anemia
• Type B: Non-tissue hypoperfusion

MOA:

• Decrease glycogenolysis and gluconeogenesis at the liver
• Increase insulin-mediated glucose uptake at the tissues

Admin:

• 250 mg BID

Pro: Cheap