METFORMIN DOSING





Acronyms


Metformin IR
Glucophage®, Riomet®

Dosage forms

Glucophage® tablet
  • 500 mg
  • 850 mg
  • 1000 mg
Riomet® solution
  • 500 mg/5 ml
  • Comes in 120 ml and 480 ml bottle
  • Comes in cherry and strawberry flavor

Dosing

Type 2 diabetes (adults)
  • Starting: 500 mg twice a day or 850 mg once daily
  • Maintenance: 850 - 2550 mg/day
  • Max: 2550 mg/day
  • Doses above 850 mg/day should be given in 2 - 3 divided doses
  • Increase dose by 500 mg a week or 850 mg every two weeks
  • Take with meals
Type 2 diabetes (children ≥ 10 years old)
  • Starting: 500 mg twice a day
  • Max: 2000 mg/day
  • Increase daily dose by 500 mg at weekly intervals
  • Take with meals

Generic / Price

  • Glucophage - YES/$
  • Riomet - NO/$$$$ (300 ml)

Other


Metformin ER
Glucophage XR®

Dosage forms

Tablet, extended-release
  • 500 mg
  • 750 mg

Dosing

Type 2 diabetes
  • Starting: 500 mg once daily with evening meal
  • Maintenance: 500 - 2000 mg/day
  • Max: 2000 mg/day
  • May be given in 1 - 2 divided doses
  • Increase dose in increments of 500 mg at 1 week intervals
  • Take with meals

Generic / Price

  • YES/$

Other


Metformin ER
Fortamet®

Dosage forms

Tablet, extended-release
  • 500 mg
  • 1000 mg

Dosing

Type 2 diabetes
  • Starting: 1000 mg once daily with evening meal
  • Maintenance: 1000 - 2500 mg once daily
  • Max: 2500 mg once daily
  • Increase dose in increments of 500 mg at 1 week intervals
  • Take with evening meal. Take with full glass of water.

Generic / Price

  • YES/$$-$$$

Other

  • Do not crush, cut, or chew tablet
  • Tablet shell may be seen in stool. This is normal.
  • For patients on insulin therapy, a starting dose of 500 mg is recommended
  • See switching between metformin IR and metformin ER for information on changing formulations

Metformin ER
Glumetza®

Dosage forms

Tablet, extended release
  • 500 mg
  • 1000 mg

Dosing

Type 2 diabetes
  • Starting: 500 mg once daily with evening meal
  • Maintenance: 500 - 2000 mg once daily
  • Max: 2000 mg once daily
  • Increase dose in increments of 500 mg at 1 - 2 week intervals
  • Take with evening meal

Generic / Price

  • YES/$$$$

Other


Janumet®
Sitagliptin + metformin

Dosage forms

Tablet
  • Sitagliptin - Metformin
    • 50 mg - 500 mg
    • 50 mg - 1000 mg

Dosing

Type 2 diabetes
  • Starting: 50/500 mg twice daily with meals
  • Max: 50/1000 mg twice daily with meals
  • Take with meals

Generic / Price

  • NO/$$$$

Other

  • Do not break or cut Janumet

Janumet® XR
Sitagliptin + metformin ER

Dosage forms

Tablet, extended-release
  • Sitagliptin - Metformin ER
    • 50 mg - 500 mg
    • 50 mg - 1000 mg
    • 100 mg - 1000 mg

Dosing

Type 2 diabetes
  • Starting: 100/1000 mg once daily with evening meal
  • Max: 100/2000 mg once daily
  • Take with evening meal

Generic / Price

  • NO/$$$$

Other

  • Do not split, crush, or chew tablets
  • There have been reports of incompletely dissolved Janumet XR tablets seen in the feces. It is not known whether this material seen in feces contains active drug. If tablet is repeatedly seen in feces, assess adequacy of glycemic control.

Jentadueto®
Linagliptin + metformin

Dosage forms

Tablet
  • Linagliptin - Metformin
    • 2.5 mg - 500 mg
    • 2.5 mg - 850 mg
    • 2.5 mg - 1000 mg

Dosing

Type 2 diabetes
  • Starting: 2.5/500 mg twice daily
  • Max: 2.5/1000 mg twice daily
  • Take with meals

Generic / Price

  • NO/$$$$

Jentadueto® XR
Linagliptin + metformin ER

Dosage forms

Tablet, extended-release
  • Linagliptin - Metformin ER
    • 2.5 mg - 1000 mg
    • 5 mg - 1000 mg

Dosing

Type 2 diabetes
  • Starting: 5/1000 mg once daily with a meal
  • Max: 5/2000 mg once daily
  • Take with a meal

Generic / Price

  • NO/$$$$

Other

  • Do not split, chew, crush, or dissolve tablet
  • Incompletely dissolved tablets have been reported with other metformin ER products. If a tablet is seen in the feces, assess adequacy of glycemic control.

Kazano®
Alogliptin + metformin

Dosage forms

Tablet
  • Alogliptin - Metformin
    • 12.5 mg - 500 mg
    • 12.5 mg - 1000 mg

Dosing

Type 2 diabetes
  • Dosing: 12.5/500 - 12.5/1000 mg twice daily
  • Max: 12.5/1000 mg twice daily
  • Take with food

Generic / Price

  • NO/$$$$

Other

  • Do not split tablets

Kombiglyze™ XR
Saxagliptin + metformin ER

Dosage forms

Tablet, extended-release
  • Saxagliptin - Metformin ER
    • 5 mg - 500 mg
    • 5 mg - 1000 mg
    • 2.5 mg - 1000 mg

Dosing

Type 2 diabetes
  • Starting: 5/500 mg once daily with evening meal
  • Max: saxagliptin 5 mg/day; metformin 2000 mg/day
  • Take with evening meal

Generic / Price

  • NO/$$$$

Other

  • Do not crush, cut, or chew tablets
  • Occasionally, the inactive ingredients of Kombiglyze XR will be eliminated in the feces as a soft, hydrated mass that may resemble the original tablet

Actoplus met®
Pioglitazone + metformin

Dosage forms

Tablet
  • Pioglitazone - Metformin
    • 15 mg - 500 mg
    • 15 mg - 850 mg

Dosing

Type 2 diabetes
  • Starting: 15/500 mg twice daily or 15/850 mg once daily
  • Max: pioglitazone 45 mg/day | metformin 2550 mg/day
  • Titrate to effect
  • May be given in one or two divided doses
  • Take with food to decrease GI upset

Generic / Price

  • YES/$$

Actoplus met XR®
Pioglitazone + metformin ER

Dosage forms

Tablet, extended-release
  • Pioglitazone - Metformin ER
    • 15 mg - 1000 mg
    • 30 mg - 1000 mg

Dosing

Type 2 diabetes
  • Starting: 15/1000 - 30/1000 mg once daily
  • Max: pioglitazone 45 mg/day | metformin ER 2000 mg/day
  • Titrate to effect
  • May be given in one or two divided doses
  • Take with food to decrease GI upset

Generic / Price

  • NO/$$$$

Other

  • Swallow whole. Do not crush, cut, or chew tablet.
  • Inactive ingredients may occasionally be eliminated in the feces as a soft mass that may resemble the original tablet

Avandamet®
Rosiglitazone + metformin

Dosage forms

Tablet
  • Rosiglitazone - Metformin
    • 2 mg - 500 mg
    • 2 mg - 1000 mg
    • 4 mg - 500 mg
    • 4 mg - 1000 mg

Dosing

Type 2 diabetes
  • Starting: 2/500 mg twice daily
  • Max: rosiglitazone 8 mg/day | metformin 2000 mg/day
  • Titrate to effect
  • Take with food to decrease GI upset

Generic / Price

  • NO/$$$$

PrandiMet®
Repaglinide + metformin

Dosage forms

Tablet
  • Repaglinide - Metformin
    • 1 mg - 500 mg
    • 2 mg - 500 mg

Dosing

Type 2 diabetes
  • Starting: 1/500 mg twice daily with meals
  • Max: repaglinide 10 mg/day; metformin 2500 mg/day
  • May be given two to three times a day
  • No more than 4 mg repaglinide or 1000 mg metformin should be taken per meal
  • Ideally taken 15 minutes prior to a meal, but can vary from 0 - 30 minutes

Generic / Price

  • YES/$$$$

Other

  • If meal is skipped, do not take dose

Glucovance®
Glyburide + metformin

Dosage forms

Tablet
  • Glyburide - Metformin
    • 1.25 mg - 250 mg
    • 2.5 mg - 500 mg
    • 5 mg - 500 mg

Dosing

Type 2 diabetes
  • Starting: 1.25/250 mg once or twice daily with meals
  • Max: glyburide 20 mg/day; metformin 2000 mg/day
  • Increase dose in increments of 1.25/250 mg/day at intervals of 2 weeks
  • Take with meals

Generic / Price

  • YES/$

Metaglip®
Glipizide + metformin

Dosage forms

Tablet
  • Glipizide - Metformin
    • 2.5 mg - 250 mg
    • 2.5 mg - 500 mg
    • 5 mg - 500 mg

Dosing

Type 2 diabetes
  • Starting: 2.5/250 - 2.5/500 mg once or twice daily with meals
  • Max: glipizide 20 mg/day; metformin 2000 mg/day
  • Increase dose in increments of 2.5/250 mg/day at intervals of 2 weeks
  • Take with meals

Generic / Price

  • YES/$

Invokamet®
Canagliflozin + metformin

Dosage forms

Tablet
  • Canagliflozin - Metformin
    • 50 mg - 500 mg
    • 50 mg - 1000 mg
    • 150 mg - 500 mg
    • 150 mg - 1000 mg

Dosing

Type 2 diabetes
  • Starting: 50/500 mg twice daily
  • Maintenance: 50/500 - 150/1000 mg twice daily
  • Max: 150/1000 mg twice daily
  • Take with food

Generic / Price

  • NO/$$$$

Invokamet® XR
Canagliflozin + metformin ER

Dosage forms

Tablet, extended-release
  • Canagliflozin - Metformin ER
    • 50 mg - 500 mg
    • 50 mg - 1000 mg
    • 150 mg - 500 mg
    • 150 mg - 1000 mg

Dosing

Type 2 diabetes
  • Starting: 50/500 mg once daily
  • Maintenance: 50/500 - 300/2000 mg once daily
  • Max: 300/2000 mg once daily
  • Take with morning meal

Generic / Price

  • NO/$$$$

Other

  • Swallow tablets whole. Do not crush, cut, or chew.

Segluromet®
Ertugliflozin + metformin

Dosage forms

Tablet
  • Ertugliflozin - Metformin
    • 2.5 mg - 500 mg
    • 2.5 mg - 1000 mg
    • 7.5 mg - 500 mg
    • 7.5 mg - 1000 mg

Dosing

Type 2 diabetes
  • Dosing: 2.5/500 mg - 7.5/1000 mg twice a day
  • Max: 7.5/1000 mg twice a day
  • Individualize starting dose based on patient's current regimen
  • Take with meals

Generic / Price

  • NO/$$$$

Synjardy®
Empagliflozin + metformin

Dosage forms

Tablet
  • Empagliflozin - Metformin
    • 5 mg - 500 mg
    • 5 mg - 1000 mg
    • 12.5 mg - 500 mg
    • 12.5 mg - 1000 mg

Dosing

Type 2 diabetes
  • Starting: 5/500 mg twice daily
  • Maintenance: 5/500 - 12.5/1000 mg twice daily
  • Max: 12.5/1000 mg twice daily
  • Take with meals

Generic / Price

  • NO/$$$$

Synjardy® XR
Empagliflozin + metformin ER

Dosage forms

Tablet, extended-release
  • Empagliflozin - Metformin ER
    • 5 mg - 1000 mg
    • 10 mg - 1000 mg
    • 12.5 mg - 1000 mg
    • 25 mg - 1000 mg

Dosing

Type 2 diabetes
  • Starting: 5/1000 mg once daily
  • Maintenance: 5/1000 - 25/2000 mg once daily
  • Max: 25/2000 mg once daily
  • Take with morning meal

Generic / Price

  • NO/$$$$

Other

  • Swallow tablets whole. Do not crush, cut, or chew.

Xigduo™ XR
Dapagliflozin + metformin ER

Dosage forms

Tablet, extended-release
  • Dapagliflozin - Metformin ER
    • 5 mg - 500 mg
    • 5 mg - 1000 mg
    • 10 mg - 500 mg
    • 10 mg - 1000 mg

Dosing

Type 2 diabetes
  • Starting: 5/500 mg once daily
  • Maintenance: 5/500 - 10/2000 mg once daily
  • Max: 10/2000 mg once daily
  • Take with food in the morning

Generic / Price

  • NO/$$$$

Other

  • Swallow tablets whole. Do not crush, cut, or chew.
  • Inactive ingredients may be eliminated in the feces as a soft, hydrated mass that may resemble the original tablet

Trijardy® XR
Empagliflozin + linagliptin + metformin ER

Dosage forms

Tablet, extended-release
  • Empagliflozin - Linagliptin - Metformin ER
    • 5 mg - 2.5 mg - 1000 mg
    • 10 mg - 5 mg - 1000 mg
    • 12.5 mg - 2.5 mg - 1000 mg
    • 25 mg - 5 mg - 1000 mg

Dosing

Type 2 diabetes
  • Starting:
    • For patients switching from metformin with or without linagliptin, use a dosage that gives a similar total daily dose of metformin and a total daily dose of empagliflozin 10 mg and linagliptin 5 mg
    • For patients switching from metformin and any regimen containing empagliflozin with or without linagliptin, use a dosage that gives a similar total daily dose of metformin, the same total daily dose of empagliflozin, and linagliptin 5 mg
  • Max: Empagliflozin 25 mg/day | Linagliptin 5 mg/day | Metformin ER 2000 mg/day
  • Take once daily with a meal in the morning

Generic / Price

  • NO/$$$$

Other

  • Swallow tablets whole. Do not crush, cut, dissolve, or chew.
  • Incompletely dissolved tablets may be seen in the feces. Patients should report this finding to their healthcare provider, and the provider should assess their glycemic control.






DRUG INTERACTIONS



CONVERTING BETWEEN METFORMIN IR AND METFORMIN ER


Maximum daily dose for metformin formulations
Drug Maximum daily dose
Metformin IR (Glucophage®) 2550 mg
Metformin ER (Glucophage XR®) 2000 mg
Fortamet® 2500 mg
Glumetza® 2000 mg


PRICE ($) INFO

  • $ = 0 - $50
  • $$ = $51 - $100
  • $$$ = $101 - $150
  • $$$$ = > $151
  • Pricing based on one month of therapy at standard dosing in an adult
  • Pricing based on information from GoodRX.com®
  • Pricing may vary by region and availability


BIBLIOGRAPHY