PHYSIOPHORMINE

Lactation General anesthesia Peridural anesthesia Insulin combination Combination with a sulphonylurea Significant alcohol consumption Unbalanced diabetes Child under 10 years Child aged 10-12 Female likely to be pregnant Pregnancy Iodized contrast product injection Mild to moderate renal impairment Surgical intervention Fast Mitochondriopathy Cardiopulmonary pathology Rachianesthesis Septicaemia Elderly Subject at risk of lactic acidosis Subject at risk of renal failure Subject at risk of vitamin B12 deficiency Overweight.

Mechanism of action

Metformin is a biguanid with antihyperglycemic effects, reducing basal and postprandial blood glucose levels.

It does not stimulate insulin secretion and therefore does not cause hypoglycaemia.

It can act through three mechanisms: reducing hepatic glucose production, inhibiting neoglucogenesis and glycogenolysis; at the muscle level, increasing insulin sensitivity, promoting glucose uptake and peripheral use; and, at last, delaying glucose intestinal absorption.

Metformin stimulates intracellular glycogen synthesis, acting on glycogen-synthase.

It increases the transport capacity of all types of glucose membrane carriers (GLUTs) known to date.

• Liver status (abnormality) (Very rare)
• Urticaria (Very rare)
• Rash (Very rare)
• Dermatosis (Very rare)
• Pruritus (Very rare)
• Skin reaction (Very rare)
• Skin Erythema (Very rare)
• Bully dermatosis
• Exfoliative dermatitis Bully pemphigoid Megaloblastic anaemia (Very rare)
• Liver disorder (Very rare)
• Hepatitis (Very rare)
• Vitamin B12 malabsorption (Common)
• Anorexia (Very common)
• Vitaminosis B12 (Common)
• Lactic acidosis (Very rare)
• Dysgueusia (Common)
• Metallic taste (Common)
• Digestive disorder (Very common)
• Nausea (Very common)
• Abdominal pain (Very common)
• Diarrhoea (Very common)
• Vomiting (Very common).