Titration of metformin
| 1)Begin with low-dose metformin (500 mg) taken once or twice per day with meals (breakfast and/or dinner). |
| 2)After 5–7 days, if GI side effects have not occurred, advance dose to 850 or 1,000 mg before breakfast and dinner. |
| 3)If GI side effects appear as doses advanced, can decrease to previous lower dose and try to advance dose at a later time. |
| 4)The maximum effective dose is usually 850 mg twice per day, with modestly greater effectiveness with doses up to 3 g per day. GI side effects may limit the dose that can be used. |
| 5)Based on cost considerations, generic metformin is the first choice of therapy. A longer-acting formulation is available in some countries and can be given once per day. |
| 1)Begin with low-dose metformin (500 mg) taken once or twice per day with meals (breakfast and/or dinner). |
| 2)After 5–7 days, if GI side effects have not occurred, advance dose to 850 or 1,000 mg before breakfast and dinner. |
| 3)If GI side effects appear as doses advanced, can decrease to previous lower dose and try to advance dose at a later time. |
| 4)The maximum effective dose is usually 850 mg twice per day, with modestly greater effectiveness with doses up to 3 g per day. GI side effects may limit the dose that can be used. |
| 5)Based on cost considerations, generic metformin is the first choice of therapy. A longer-acting formulation is available in some countries and can be given once per day. |
GI, gastrointestinal.