Prescription Clinical MonographBiguanide (Antihyperglycemic Agent)

Verified Evidence Sources: openFDA & NLM MedlinePlus

Metformin

Metformin activates AMP-activated protein kinase (AMPK), decreasing hepatic gluconeogenesis and intestinal glucose absorption while improving peripheral insulin sensitivity.

Generic Active Chemical: Metformin

Brand Formulations:FortametGlucophage¶GlumetzaRiomet¶Trijardy (as a combination product containing Empagliflozin, Linagliptin, Metformin)Actoplus Met (containing Metformin, Pioglitazone)Avandamet (containing Metformin, Rosiglitazone)¶Invokamet (containing Canagliflozin, Metformin)Janumet (containing Metformin, Sitagliptin)Jentadueto (containing Linagliptin, Metformin)Kazano (containing Alogliptin, Metformin)Kombiglyze XR (containing Metformin, Saxagliptin)¶Metaglip (containing Glipizide, Metformin)¶Prandimet (containing Metformin, Repaglinide)¶Qternmet XR (containing Dapagliflozin, Metformin, Saxagliptin), Segluromet (containing Ertugliflozin, Metformin)¶Synjardy (containing Empagliflozin, Metformin)Xigduo XR (containing Dapagliflozin, Metformin)Zituvimet (containing Metformin, Sitagliptin)

Quick Jump:Kitchen Foods (1)Drug Red Flags (0)Supplements & Herbs (0)Nutrient Depletion (1)Administration Timing (2)Pairwise Combos (2)

Kitchen Food, Drink & Dietary Conflicts

Biochemical interactions with common foods, beverages & cooking ingredients

1 Flagged Foods

Official Patient Dietary Instruction (NLM MedlinePlus)

Be sure to follow all exercise and dietary recommendations made by your doctor or dietitian. It is important to eat a healthful diet.

HIGH

Alcoholic Beverages (Beer, Wine, Spirits)

NutriDive Kitchen Food Biochemical Ontology & openFDA

Bioactive Compound:Ethanol

Biological Target:GABA-A Receptors, Hepatic CYP2E1 & Gluconeogenesis

Clinical Mechanism:

Multiplies respiratory depression and profound sedation with opioids and sedatives; blocks hepatic lactate uptake with metformin (lactic acidosis); triggers acute disulfiram-like vomiting and tachycardia with metronidazole; and accelerates dose-dumping in extended-release capsules.

Patient Actionable Rule:Completely abstain from alcohol while taking metronidazole, cephalosporins, prescription sedatives, or empty-stomach metformin.

Prescription & OTC Drug Interactions (DDI)

Documented pharmacological conflicts & contraindicated co-prescriptions

0 Warning Classes

No major contraindicated drug classes listed in the basic monograph. Always provide your complete medication list to your prescribing physician.

Dietary Supplements, Herbs & Minerals (DNI)

Interactions with over-the-counter vitamins, minerals, and herbal preparations

0 Monitored

No acute supplement or herb contraindications identified. Notify your healthcare provider of any multi-vitamins or botanicals you take daily.

Drug-Induced Nutrient Depletion & Nutritional Defense

Micronutrient depletions caused by pharmacological pathways & recommended replenishment

1 Depletion Pathways

Vitamin B12 (Cobalamin) & Folate

American Diabetes Association (ADA) Standards of Care

Depletion Pathway: Metformin impairs calcium-dependent membrane action in the terminal ileum, decreasing the uptake of the intrinsic factor-vitamin B12 complex in up to 30% of long-term users.

Nutritional Defense Protocol:Annual serum vitamin B12 monitoring; supplement with 1,000 mcg sublingual methylcobalamin if levels drop below 400 pg/mL.

Chronotherapy & Meal Administration Protocols

Optimal absorption, meal-timing rules & GI tolerability protocols

2 Protocols

MEALMealtime Administration

The solution is usually taken with meals one or two times a day.

Rationale: Food enhances bioavailability, prevents gastric mucosal irritation, or stabilizes peak-to-trough pharmacokinetic variations.

MEALMealtime Administration

The regular tablet is usually taken with meals two or three times a day.

Rationale: Food enhances bioavailability, prevents gastric mucosal irritation, or stabilizes peak-to-trough pharmacokinetic variations.

Frequently Researched Drug-Substance Combinations

Explore pairwise interaction dossiers and laboratory safety analyses

CRITICAL→

Metformin and Alcohol

Pairwise Clinical Analysis & Safety Rating

CRITICAL→

Metformin and Vitamin-b12

Pairwise Clinical Analysis & Safety Rating

Multi-Substance Interactive Radar

Taking Metformin alongside daily coffee, supplements, or other medications?

Add all your daily medications, foods (Dairy, Spinach, Coffee, Grapefruit), and botanicals (Ashwagandha, Curcumin, Melatonin) into the SafeStack interactive engine to run full multi-way synergy collision analysis in real time.

Launch SafeStack Radar with Metformin→

Authoritative Clinical Evidence & Regulatory Sources

Data on this clinical monograph is compiled from the U.S. National Library of Medicine (MedlinePlus), openFDA Structured Product Labeling (SPL Section 7 Drug Interactions), the NIH Office of Dietary Supplements (ODS), and Krause and Mahan's Food & Nutrition Care Process.

View Original NLM MedlinePlus Monograph·Clinical & Legal Disclaimers