Metformin ke Side Effects
Metformin ke sabse common side effects gastrointestinal hain - jaise diarrhea, nausea, vomiting, aur pet mein discomfort - lekin long-term use se vitamin B12 deficiency bhi ho sakti hai jo peripheral neuropathy ko aur bhi badtar kar sakti hai. 1, 2
Common Gastrointestinal Side Effects
- Diarrhea, nausea, vomiting, pet mein dard, aur flatulence metformin ke primary adverse effects hain jo type 2 diabetes ke patients mein bahut common hain 3, 2
- Ye GI side effects lagbhag 51-52% patients mein dekhe gaye hain Indian population studies mein 4
- Kuch patients (lagbhag 3%) ko metallic taste bhi ho sakta hai jab medicine shuru karte hain, lekin ye thode time ke liye hi rehta hai 2
- Appetite mein kami bhi ho sakti hai, jo especially older adults ke liye problematic hai 3
Serious but Rare Side Effect: Lactic Acidosis
- Lactic acidosis ek rare lekin serious condition hai jisme blood mein acid build-up ho jata hai aur ye jaan-leva ho sakta hai 2
- Lactic acidosis ke symptoms hain: haath-pair thande hona, chakkar aana, slow ya irregular heartbeat, bahut weakness, saans lene mein takleef, neend aana, pet dard, nausea ya vomiting 2
- Agar ye symptoms dikhein to turant doctor ko call karein - ye medical emergency hai 2
Long-term Side Effect: Vitamin B12 Deficiency
- Long-term metformin use se vitamin B12 deficiency ho sakti hai jo anemia ya peripheral neuropathy ko badtar kar sakti hai 1
- American Diabetes Association strongly recommend karta hai ki metformin users mein periodic vitamin B12 testing honi chahiye, especially un patients mein jo anemia ya peripheral neuropathy se suffer kar rahe hain 1
- Ye deficiency neuropathy ke symptoms ko aur bhi badtar bana sakti hai 3
GI Side Effects Ko Kam Karne Ke Tarike
- Low dose se shuru karein (500 mg once ya twice daily) aur gradually maximum effective dose (2 g/day) tak badhayein 1
- Khane ke saath medicine lein - isse GI side effects kam ho sakte hain 1, 2
- Extended-release formulation (Glucophage XR) use karein - ye immediate-release se better tolerated hoti hai 3, 5
- Agar persistent GI side effects hain to dose reduction ya discontinuation consider karein 3
Important Precautions
- Nausea, vomiting, ya dehydration hone par medicine temporarily band kar dein 1, 2
- Zyada alcohol na piyein - ye lactic acidosis ka risk badha sakta hai 2
- Metformin akele se hypoglycemia (low blood sugar) rarely hota hai, lekin agar aap kam khate hain, alcohol lete hain, ya doosri blood sugar lowering medicines lete hain to ho sakta hai 2
Chronic Diarrhea Ka Dhyan Rakhein
- Kuch patients mein chronic diarrhea saalon tak chal sakta hai aur isko galti se irritable bowel syndrome samajh liya jata hai 6
- Agar diabetic patient mein chronic diarrhea hai aur koi aur obvious cause nahi hai, to metformin ko suspect karein 6
- Metformin discontinue karne se GI symptoms mein significant improvement ho sakta hai 6