What are metformin and metformin ER?
Metformin, metformin ER, and their equivalent brands are all used to improve blood sugar in those with type 2 diabetes. Metformin is the immediate-release version, whereas metformin ER is the extended-release version that dissolves in the gut over a longer period of time.
Both metformin and metformin ER decrease how much sugar the liver makes and increase the body’s overall sensitivity to insulin, which lowers blood sugar levels overall.
You must have a prescription from your doctor to fill any of these drugs. In order to avoid any confusion or extra time spent at the pharmacy, make sure your doctor notes what brand name you are taking if you are filling for metformin ER.
Brand names for metformin
- Glucophage
Brand names for metformin ER
- Glucophage XR
- Glumetza
- Fortamet
How are metformin and metformin ER administered?
Forms and strengths
Metformin, metformin ER, and their brands come in different forms and strengths, and because they dissolve in the body at different speeds, they are prescribed differently. Extended-release tablets are made specifically to allow for slower dissolving, so they should NOT be cut, crushed or chewed. Immediate-release tablets, on the other hand, are okay to break apart.
Immediate-release tablets
- Metformin: 500 mg, 800, 1000 mg
- Glucophage: 500 mg, 850 mg, 1000 mg
Extended-release tablets
- Metformin ER: 500 mg, 1000 mg
- Glucophage XR: 500 mg, 750 mg
- Glumetza: 500 mg
- Fortamet: 500 mg, 1000 mg
Dosing
Depending on how much metformin is prescribed, some patients may take metformin twice a day. Metformin ER could be an option here to cut dosing down to only one time per day.
Typical starting doses
- Metformin and Glucophage: 500 mg twice a day, or 850 mg once a day
- Metformin ER, Glucophage XR and Glumetza: 500 mg once a day with an evening meal
- Fortamet: 1000 mg once a day with an evening meal
Maximum recommended daily doses*
- Metformin and Glucophage: 2550 mg
- Metformin ER, Glucophage XR and Glumetza: 2000 mg
- Fortamet: 2500 mg
How effective are metformin and metformin ER?
People with diabetes typically measure their A1c levels to see their average blood sugar over the last three months. Doctors usually recommend that diabetics reach a target A1c of less than 7%. In a review of studies looking at anti-diabetes medications, doses of up to 1,500 mg per day of either metformin and metformin ER were shown to lower hemoglobin A1c levels by roughly 1% after three months of therapy. This effect lasted for at least 10 months.
What are the most common side effects of metformin and metformin ER?
Metformin and metformin ER have similar side effects. Their most common side effects include diarrhea, nausea, vomiting, gas, lack of energy, indigestion, stomach discomfort and headache.
Both medications may also lower vitamin B12 levels. Patients at a higher risk for B12 deficiency (like vegetarians, older adults and people with diseases of the gut) are urged to have their B12 levels measured every two to three years if they are taking metformin or metformin ER.
Metformin and metformin ER are safe for most people’s kidneys. However, patients with advanced kidney disease should take these medications with caution due to the potential for buildup of the medication in the body and lactic acidosis.
Results from clinical studies conflict on how common side effects are with metformin versus metformin ER. Some show that both drugs cause side effects with the same frequency. Others show that patients who took metformin ER experienced fewer side effects than those who took metformin.
How much do metformin and metformin ER cost?
Since metformin and metformin ER are generic drugs, they are affordable—both cost around $30 for a 30-day supply.
Here’s a chart to sum it all up.
Glucophage XR: 500 mg, 750 mg
Glumetza: 500 mg
Fortamet: 1000 mg once a day with an evening meal
Fortamet: 2500 mg
*Maximum recommended doses are based on drug label information published by the National Institutes of Health at dailymed.nlm.nih.gov.
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