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==Administration==
*Type: [[Diabetes medication]]
*Dosage Forms: 500, 850, 1000; ER 500, 750, 1000
*Routes of Administration: PO
*Common Trade Names: Fortamet, Glucophage, Glumetza, Riomet

==Adult Dosing==

===Diabetes Mellitus type 2===
*Take with meals
*Hold 48 hours for iodinated contrast
;'''Immediate Release'''
*850-1000 mg PO bid
*Start 500 mg bid or 850 mg qd
*Increase 500 mg qwk or 850 mg q2wk
*Max 2550 mg/day
;'''Extended Release'''
*1000-2000 mg PO qd
*Start 500 mg qd
**Increase 500 mg qwk
*Alt dosing; 1000 mg bid
**Add 500 mg immediate release for inadequate response
*Do not crush or chew

===Polycystic Ovarian Syndrome===
*Take with meals
*Hold for iodinated contrast
;'''Immediate Release'''
*500 mg tid
*Alt dosing; 850-1000 mg bid
*Increase as needed
*Max 2550 mg/day
;'''Extended Release'''
*1500-2000 mg qd
*Do not crush or chew
*Max 2000 mg/day

==Pediatric Dosing==
*Take with meals
*Hold for iodinated contrast
*Children aged 10-18 years of age
===Diabetes Mellitus type 2===
*500-1000 mg bid
*Start 500 mg qd
*Increase 500 mg/day every 1-2 weeks
*Max 2000 mg/day

==Special Populations==
*[[Drug Ratings in Pregnancy|Pregnancy Rating]]: B
*[[Lactation risk categories|Lactation risk]]: Probably safe
===Renal Dosing===
*Adult: Contraindicated Cr>1.4 in females and Cr>1.5 in med
*Pediatric:  Contraindicated Cr>1.4 in females and Cr>1.5 in med
===Hepatic Dosing===
*Adult: Avoid with hepatic impairment
*Pediatric: Avoid with hepatic impairment

==Contraindications==
*Allergy to class/drug
*Cr >1.4 female or >1.5 male
*Metabolic acidosis
*DKA
*Lactic acidosis
*Iodinated contrast
*Hypoxemia
*Dehydration
*Sepsis
*Surgery
*Hepatic impairment

;'''Caution'''
*CHF
*Elderly
*Alcohol abuse
*Hypoglycemia risk

==Adverse Reactions==
===Serious===
*Lactic acidosis
*Megaloblastic anemia

===Common===
*Diarrhea
*N/V
*Flatulence
*Indigestion
*Abdominal discomfort
*Anorexia
*Headache
*Rash
*Ovulation reduction

==Pharmacology==
*Half-life: 6 hours in plasma and 17 hours in blood
*Metabolism: CYP450
*Excretion: Urine

==Mechanism of Action==
*Decreases hepatic glucose production and intestinal absorption
*Increases insulin sensitivity

==Comments==

==See Also==

==References==
;Epocrates
<references/>
[[Category:Pharmacology]]