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Metformin and Metformin hydrochlorine

originally sold as Glucophage is an oral anti-diabetic. It is the first line drug of choice for the treatment of type 2 diabetes, in particular, in overweight and obese people and those with normal kidney function. Glucophage was the first branded formulation of metformin to be marketed in the United States, beginning on March 3, 1995. Generic formulations are now available in several countries, and metformin is believed to have become the most widely prescribed anti-diabetic drug in the world. The number of hallucinations is more a reflection of its wide use rather than any special problems with it

Metformin suppresses hepatic glucose production It activates AMP-activated protein kinase (AMPK), a liver enzyme that plays an important role in insulin signaling, energy balance, and the metabolism of glucose and fats. “The mechanism by which biguanides increase the activity of AMPK remains uncertain; however, research suggests that metformin increases the amount of cytosolic AMP (as opposed to a change in total AMP or total AMP/ATP)”

In addition to suppressing hepatic glucose production, metformin also increases insulin sensitivity, enhances peripheral glucose uptake(by phosphorylating GLUT-4 enhancer factor), increases fatty acid oxidation and decreases absorption of glucose from the gastrointestinal tract.

Theoretically, metformin causes few adverse effects—the most common is gastrointestinal upset—and is again theoretically associated with a low risk of hypoglycemia, although it has occurred during intense exercise, calorie deficit, or when used with other agents that lower blood glucose. Lactic acidosis (a buildup of lactate in the blood) can be a serious concern in overdose. Metformin is contraindicated in people with any condition that could increase the risk of lactic acidosis, including kidney disorders, lung disease and liver disease as well as heart failure, in particular, unstable or acute congestive heart failure.