FDA approved for the treatment of diabetes, Metformin has been championed as a leading longevity treatment for decades. It remains among the safest and most effective medications in the world, according to the World Health Organization’s List of Essential Medicines.

Before you get started, read more about important usage information for Metformin.

Quick tips

Here are some simple steps to help you get the most from each dose:

• Slowly titrate up to your prescribed dose
• Try taking Metformin at the same time each day
• Take Metformin with your largest meal of the day
• You can split your daily dose in half to help your body adjust

Getting started

When you first receive your Metformin prescription, follow proper storage guidelines to maintain the quality of the medication.

Before you begin, review the titration instructions provided by your prescriber.

Understand Metformin benefits and what to expect.

Learn the best strategy for reducing side effects in your first weeks.

Storage

When your prescription arrives, check that the contents are properly sealed and undamaged. Be sure to keep your medication in its original container to maintain the utmost quality.

Store at room temperature (between 68°F and 77°F) and away from direct light, like in your pantry. Avoid storing Metformin in areas with excessive heat or humidity, like your laundry room or utility closet. Always keep Metformin where your children or pets can’t reach it.

Titration instructions

Your Metformin titration will vary depending on your prescribed dose:

	Metformin, 1000mg	Metformin, 1500mg	Metformin, 2250mg
Weeks 1-2	1 tablet/day	1 tablet/day	1 tablet/day
Weeks 3-4	2 tablets/day	2 tablets/day	2 tablets/day
Weeks 5-6	–	3 tablets/day	3 tablets/day
Weeks 7-12	–	–	4 tablets/day
Weeks 13-52	–	–	3x 750mg tablets/day

Your dose and titration will always be available on your Rx bottle as a reminder.

If you miss a dose, you can still take it so long as it’s the same day. If the day has passed, skip the dose you missed and continue dosing as normal. For example, if you remember that you didn’t take Metformin that morning, you can still take it that afternoon. However, if you remember on Tuesday that you missed your dose on Monday, skip that dose. Never double up on doses to compensate for a missed dose.

Keep in mind that your titration instructions may differ from those described above. Your prescriber will clearly inform you if they recommend unique titration instructions for you. Always follow your prescriber’s instructions.

If you feel you’re not meeting your health goals on your prescribed dose, contact your prescriber to see if changing your target dose is right for you.

Metformin benefits

Metformin works by minimizing the amount of glucose released from the liver into our bloodstream, and maximizing how much glucose our cells absorb. The overall effect is a balance of glucose distribution within our bodies, which can lead to the following noticeable benefits:

• Improved blood sugar (glucose) levels
• Decreased appetite/cravings
• Weight loss (see section below)

The longer you take Metformin, the better the benefits. To experience the most optimal benefits of Metformin, it should be taken over an extended period of at least 6-12 months.

Many benefits of Metformin occur on a cellular level and may be difficult to feel or appreciate. Using a CGM can show how Metformin improves your blood sugar levels, while biological age tests can help you see if Metformin has slowed your biological aging, as compared to your chronological aging.

For more information on the longevity benefits of Metformin, please visit our Metformin Science page.

Weight loss with Metformin

How much weight you lose while taking Metformin depends largely on what dose you’re taking and how long you stay on the medication.

When taking Metformin for longevity, the prescribed dose is typically 2 tabs per day, or 1000mg. At this dose, some patients may not notice significant weight loss within the first 6 months of use. However, this dose may keep you from gaining weight.

Patients taking between 1500mg and 2250mg per day have shown more pronounced weight loss during clinical trials, ranging from 3-12 lbs, or 5-7% of your body weight, over 6-12 months. Higher doses tend to produce greater weight loss benefits, but the incidence of side effects also increases. Those with higher BMIs may achieve greater weight loss in a shorter time span, but this may not be true for everyone. Some patients may notice the lower range of weight loss within 2-3 months, while some patients may not notice any weight loss benefit at all.

If weight loss is your primary reason for taking Metformin, contact your prescriber to see if increasing your dose is right for you.

Side effects

The most commonly reported side effects of Metformin are minor gastrointestinal issues, which usually occur within the first 2 weeks of starting Metformin. These side effects often resolve within 2 weeks, as your body adjusts to the medication. These include:

• Loose stool or diarrhea
• Stomach cramps
• Gas & bloating
• Nausea
• B12 deficiency

Though Metformin side effects only occur in about 5-10% of patients, the rate of side effects increases with higher doses, such as those greater than 2000mg.

Your titration plan may help you avoid experiencing these side effects. You will also likely be prescribed the extended release (ER) form of Metformin to help your body adjust to the medication.

If you still experience side effects, try eating Metformin with a meal. Healthy, low-fat foods also help relieve gastrointestinal issues. Alcohol or sugary drinks should be avoided if you’re experiencing side effects. You can also try over-the-counter solutions if your symptoms persist, like Imodium for diarrhea, simethicone for gas or bloating, and ginger candies for nausea. However, an estimated 3-5% of patients may not be able to tolerate Metformin.

You should also stay well hydrated while taking Metformin, especially during the spring and summer months, to avoid potential dizziness, lightheadedness, blurred vision, and dehydration.

Some who take Metformin may experience Vitamin B12 deficiency. Though B12 deficiency may not be a direct side effect of Metformin, it’s still associated with Metformin use. Consider supplementing with B12 while taking Metformin.

For a full list of possible side effects, please see Metformin Side Effects.

Important safety information

Metformin includes a box warning for lactic acidosis. Though rare, lactic acidosis may develop in patients who take too much Metformin and who have other health conditions such as kidney damage. Patients who are recommended a target dose of 2000mg or higher will be asked to complete a SCORED evaluation to assess their risk for chronic kidney disease (CKD) before receiving Metformin.

You must stop taking Metformin for at least 1 week before any surgical or diagnostic procedures requiring contrast, such as a CT scan. If you’re not sure whether you need to stop Metformin for a particular procedure, speak to the doctor who ordered the procedure. Do not resume Metformin until at least 48 hours after the procedure, or until your doctor tells you.

Do not use Metformin if you are pregnant or breastfeeding, or plan to become pregnant or breastfeed after starting Metformin.

As with any prescription medication, the dose prescribed is for you and you alone. Do not, under any circumstances, share or allow anyone else to use your Metformin prescription.