Metformin — what it does and how to use it safely

Metformin is the most common first-line pill for type 2 diabetes. It lowers blood sugar by helping your body respond to insulin and by reducing how much sugar your liver makes. People like it because it often helps control glucose without causing major weight gain.

How metformin works and who should take it

Doctors usually start metformin when lifestyle changes (diet, exercise) aren’t enough. It’s used for type 2 diabetes and sometimes for PCOS or prediabetes. Typical starting doses are low and go up over weeks so your stomach can adjust. Your provider will choose the dose based on your blood sugar and kidney function.

Before starting, you should get an A1C test to see average blood sugar and a kidney check (eGFR). Metformin isn’t recommended if your eGFR is very low — talk to your doctor about what’s safe for you.

Side effects, monitoring, and real alternatives

Most side effects are stomach-related: nausea, diarrhea, gas. They often ease after a few weeks. Tips to reduce these: take the pill with food, start on a low dose, or switch to an extended-release form. Serious but rare risk: lactic acidosis. That’s why kidney checks matter and why doctors stop metformin before some procedures or if you have severe dehydration.

Monitoring is simple: A1C every 3 months until stable, then less often. Kidney function should be checked at least once a year or more if you’re older or have other health issues. Tell your doctor about any new symptoms, especially unusual tiredness, muscle pain, or trouble breathing.

If metformin doesn’t fit your needs, there are other options. Some commonly used alternatives include:

• Januvia (sitagliptin) — easy to take, modest blood sugar drop.
• Precose (acarbose) — works on carbs at meals, may cause gas.
• Victoza (liraglutide) and Ozempic (semaglutide) — injectable drugs that lower A1C and often help with weight loss.
• Invokana (canagliflozin) — a pill that helps pass sugar in urine and can lower blood pressure, but it has specific side effects to watch for.

Each option has pros and cons. For example, GLP-1 drugs (Victoza, Ozempic) can help weight and heart health but cost more and are injections. SGLT2 drugs (Invokana) help kidneys and heart for some people but raise UTI risk. Talk with your clinician about which fits your goals and health history.

Buying meds online? Use caution. Only buy from pharmacies you can verify, and keep a valid prescription. Cheap sites that don’t require a script are risky. Our site reviews pharmacy options and offers tips to help you find legitimate Canadian or local sources.

If you have questions about dosing, interactions, or switching meds, ask your healthcare team. Small changes—timing, dose form, or adding lifestyle steps—often make a big difference in how well metformin works for you.