Can Metformin Cause Severe Diarrhea?

Posted on Tue, 27 Oct 2015

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Tue, 27 Oct 2015 Answered on

Tue, 17 Nov 2015 Last reviewed on

Question : My doctor is insisting that I take Metformin because my type 2 diabetes is not being controlled with Tradjenta. I am definitely afraid of Metformin because of the danger of diarrhea. I already have digestive problems, so I am thinking that the Metformin will only aggravate the problem. I also work everyday, so I don't want the danger of not being able to commute. Your thoughts?

Answered by Dr. Shehzad Topiwala (2 hours later)

Brief Answer:
Metformin is good

Detailed Answer:
In general, it is well accepted within the endocrine community world-wide that metformin is one of the best oral agents to treat type 2 diabetes.

Major reasons to not use metformin are:

Heart failure
Lung failure
Liver failure
Kidney failure
Severe infection/ surgery/ hospitailization
Contrast XXXXXXX injection for CT scans
Past intolerance

Barring these situations, metformin should be strongly considered for the treatment of type 2 diabetes.

If you have had digestive trouble in the past it does not mean that you will not be able to handle metformin.

Ask your endocrinologist how to start low and go slow on the dose adjustment schedule. Most people are able to settle on this medication when it is followed in this manner.
However, there are 5 to 15 % individuals who will just not be able to tolerate metformin due to severe stomach upset.
There are slow release or special coated forms of metformin available in the market and you can check with your doctor if you can be tried on those options.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar