Metformin is in a class of drugs called biguanides. Metformin helps to control the amount of glucose (sugar) in the blood. It decreases the amount of glucose you absorb from your food and the amount of glucose made by your liver. It’s commonly prescribed to help with the treatment of Type-2 diabetes.
Key Takeaways
Immediate-release and extended-release tablets may have total differing milligram amounts that can be consumed per day.
The maximum milligram dose of immediate-release tablets that can be taken is 2550mg. Check the per tablet milligram dosage to determine what that means for the number of total immediate-release tablets that can be consumed per day.
The maximum milligram dose of extended-release tablets that can be taken is 2000mg. Check the per tablet milligram dosage to determine what means for the number of total extended-release tablets that can be consumed per day.
Metformin and Maximum Daily Dosages
Oral metformin should generally not exceed anything over 2000mg per day. Patients may either want to select higher dose tablets or consume more tablets per day for a variety of reasons. Some of those reasons might include to improve current HbA1c levels (82.6%), to control fasting plasma glucose (51.5%), low risk of hypoglycemia (32.9%), and cost (31.7%).
However, consuming larger quantities of low-dose metformin may actually not decrease your overall cost.
Adult Dose of Metformin With Type-2 Diabetes
Immediate-release tablets:
Initial dose: 500 mg orally twice a day or 850 mg orally once a day
Dose titration: Increase in 500 mg increments weekly or 850 mg every 2 weeks as tolerated
Maintenance dose: 2000 mg/day, usually in divided doses
Maximum dose: 2550 mg/day
Extended-release:
Initial dose: 500 to 1000 mg orally once a day
Dose titration: Increase in 500 mg increments weekly as tolerated
Maximum dose: 2000 mg/day
Pediatric Dose of Metformin With Type-2 Diabetes
Pediatric doses are usually intended for those 10-years-of-age or older.
Immediate-release:
Initial dose: 500 mg orally twice a day
Dose titration: Increase in 500 mg increments weekly as tolerated. Each daily dose should be taken in divided doses 2 to 3 times a day with meals.
Maximum dose: 2000 mg/day
Extended-release oral suspension:
Initial dose: 500 mg orally once a day with a meal
Dose titration: Increase in 500 mg increments weekly based on glycemic control and tolerability
Maximum dose: 2000 mg/day
Signs of Taking Too Much Metformin
Common symptoms include stomach pain, diarrhea, and fast or shallow breathing (usually from an increased heart rate). If you feel like you’ve taken too much metformin, stop consumption immediately and contact your primary care provider.
Extended vs. Immediate Release
Extended release tablets may be used by patients who are looking to subside some of the common side effects of metformin. Most commonly, these are issued related to stomach pains and diarrhea. While both immediate and extended release tablets generally have the same maximum dosage of 2000 mg/day, you may be able to take up to 2550 mg/day of immediate release tablets.
However, if you’re starting to experience stomach pains, increased heart rate, or fast and shallow breathing, discontinue the consumption of metformin until these symptoms subside. Speak with your healthcare provider about your dosage schedule or why you’re looking to take larger doses of metformin (i.e., the weight loss benefits).
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Sources
Corcoran C, Jacobs TF. Metformin. In: Feingold KR, Anawalt B, Boyce A, et al., eds. Endotext. MDText.com, Inc.; 2000. Updated September 18, 2023. Accessed November 3, 2024. https://www.ncbi.nlm.nih.gov/books/NBK518983/
Nasri, H., & Rafieian-Kopaei, M. (2014). Metformin: Current knowledge. Journal of Research in Medical Sciences, 19(7), 658–664. PMCID: PMC4214027, PMID: 25364368.
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