| Mechanism | “Increases Insulin sensitivity” * ↓ gluconeogenesis * ↑ peripheral use of glucose Only effective if some residual functioning of pancreatic islet cells |
| Typical Dose | 500mg OD taken with breakfast to a max of 2g |
| Indications | * Type II DM |
| Contra-indications | * Conditions predisposing to lactic acidosis (hepatic/ impairment, severe HF, infection, dehydration) * EGFR <36 |
| Side-effects | Anorexia, nausea, vomiting, diarrhoea, lactic acidosis GI symptom side effects (can switch to modified release) |
| Interactions | Alcohol: ↑ risk of lactic acidosis Corticosteroids: antagonise Hypoglycaemia effect |
| Elimination | Renal - tubular secretion |
| Additional Notes | Does not cause Hypoglycaemia |