Metformin

Drug Class

Biguanide

Mechanism of Action (MOA)

↓ hepatic gluconeogenesis and ↑ peripheral insulin sensitivity (does not stimulate insulin secretion).

Black Box Warning

Lactic acidosis — risk rises with renal or hepatic impairment, age ≥65, iodinated contrast, hypoxic states, alcohol.

Clinical Notes

First-line for type 2 DM; weight-neutral, no hypoglycemia as monotherapy. GI upset, lowers vitamin B12. Hold for iodinated contrast.

Source

FDA label

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