Let’s say you’ve been taking metformin for a while and either you’re not seeing results, you’re experiencing harmful side effects, or the drug just doesn’t fit into your lifestyle anymore.
In this case, you may wonder when and how to stop taking it. However, stopping prescription drugs after a while can be more complicated than you might think.
This article explains everything you need to know about when and how to stop taking metformin if it is no longer working.
Why do you want to stop taking metformin?
Metformin is extremely popular, generally safe, inexpensive, and widely available in the United States. People who take metformin for improved blood sugar (and moderate weight control) appear to be effective, with short-term and minimal side effects.
Metformin is most commonly used by people with type 2 diabetes and prediabetes, and is sometimes prescribed “off-label” for people with insulin resistance or for weight management.
However, there are reasons why people taking metformin may want to stop taking it.
Metformin doesn’t work
Not everyone who takes metformin can enjoy the improvements in blood sugar and HbA1c, let alone the weight loss that the drug often promises.
If you’ve been taking metformin for a few months but you’re not seeing an improvement in your health and life, you may be starting to re-evaluate why you’re spending money on the drug!
This is a common reason why people stop taking metformin, and it’s perfectly reasonable.
Metformin does not work and will not work for everyone who takes it.
You experience harmful side effects
Metformin side effects include:
- Decreased appetite
- Weight loss
- Metallic taste in the mouth
- Low blood sugar (if you are taking insulin)
These side effects are usually minimal and go away within a few weeks of starting metformin treatment.
However, for some people, the side effects are so severe and last so long (or become permanent) that they completely disrupt their lives, preventing them from working or maintaining a social life or close relationships.
If you experience side effects such as chronic diarrhoea, debilitating low blood sugar or severe bloating, gas, vomiting or nausea for more than a few weeks after starting treatment, it may be time to talk to your doctor about weaning off metformin and find alternative medicine.
Metformin doesn’t fit your lifestyle
If you have difficulty remembering to take your metformin pill every day or sometimes twice a day, disagree with the dosage, or find it a hassle, it may be time to find an alternative medication that doesn’t need to be taken as often.
Talk to your doctor about finding an alternative, such as a GLP-1 agonist like Trulicity or Ozempic (both are injections), which should only be taken once a week.
Your health insurance no longer covers it
While metformin is reasonably priced with health insurance and is widely covered by health insurance, if your health insurance changes or you become uninsured, you may not want to pay the over-the-counter price of it, which can become expensive in the US.
The United States has an employer-based private health care system, so when your employment changes, your health insurance usually changes as well.
Make sure all your medications are covered by the new health insurance plan you’re signing up for, and if they’re not and the over-the-counter price is prohibitive, talk to your doctor about finding more affordable alternatives.
Your health has improved and you no longer need it
Taking metformin, in addition to eating healthy and exercising regularly, can be a great start to a healthier lifestyle, better blood sugar levels, and lower weight.
Over time, some people may find that they no longer need medication to control their diabetes, and doctors may wean them off medication.
It’s a good news! But always talk to your doctor first before stopping metformin.
When can you stop taking metformin?
Metformin takes a few weeks to fully activate in your body, so if you’ve just started taking it, you’ll need to give it some time to work.
Many people notice lower blood sugar levels within a few weeks of starting metformin, but with weight loss and lower A1c levels, it may take several months before results are noticeable.
Unless there are debilitating side effects, it’s usually best to give the drug some time to work.
The risk of stopping metformin
If you stop taking metformin suddenly, your health may suffer. Side effects such as higher blood sugar, increased A1c and even weight gain may occur.
Over time, higher blood sugar levels can lead to diabetes complications, including:
- Retinopathy and blindness
- Neuropathy and foot problems
- Heart disease and increased risk of heart attack
- Lower limb amputations
- Kidney disease, kidney failure and dialysis
- premature death
Before stopping treatment with metformin, talk to your doctor about your treatment options and eat a healthy diet and exercise regularly to keep your blood sugar levels within the appropriate range.
How can you stop taking metformin?
Never stop taking prescribed medications without consulting your doctor first. It’s important to be able to sustainably manage your blood sugar first. Your doctor will use certain benchmarks to see if you should stop taking metformin.
- Having a random blood sugar test of 180 mg/dL or lower
- Maintaining an HbA1c of 7% or less
- Fasting or pre-meal blood sugar between 80-130 mg/dL
In addition, it is unlikely that your doctor will tell you to stop taking metformin suddenly, especially if you have been taking it for a long time.
They will most likely reduce the dose over time so that the body has time to get used to the lower dose without experiencing negative side effects such as high blood sugar or weight gain.
Your doctor can advise you on weaning techniques and how much you should reduce your dose each week until weaning is complete.
What are the alternatives to metformin?
There are several alternatives to metformin. These include injections, oral medications, or lifestyle changes.
- Prandine (repaglinide), which lowers blood sugar quickly but may lead to weight gain
- Canagliflozin (Invokana) reduces blood sugar and cardiovascular disease (CVD) risk, but has health risks including increased chance of amputation
- Dapagliflozin (Farxiga), also lowers blood sugar levels and the risk of cardiovascular disease
- Empagliflozin (Jardiance), which lowers blood sugar and blood pressure and may help with weight loss
- Actos (pioglitazone) lowers blood sugar and the risk of heart attack and stroke, but increases the risk of heart failure, weight gain, edema and bone fractures
- Insulin, including basal-only therapy or basal-and-bolus therapy, increases the risk of low blood sugar and weight gain
- Increasing the amount of physical activity you do and maintaining a healthy diet, which if you can keep your blood sugar in the proper range through a healthy lifestyle, can be a great option
There are also several combination drugs with metformin that combine metformin with another type 2 diabetes drug in one tablet.
Stopping metformin can be problematic, but not impossible. The drug doesn’t work for everyone, and some people experience negative side effects that can make life unfriendly. With health insurance changes, metformin may not always be a covered drug, and some people just want to stop taking it.
There are safe ways to stop metformin, but always talk to your doctor before stopping any diabetes medicine, which can cause higher blood sugar and A1c levels, weight gain, and an increased risk of diabetes complications later in life.
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