How To Stop Metformin Diarrhea? Dosage, Side Effects & Risks


Metformin is a common medicine for managing high blood sugar in people with type 2 Diabetes. It is known for its effectiveness and working well but can lead to a pesky problem: Diarrhea. Here is a detailed guide on how to deal with or prevent this issue when taking Metformin. 

Understanding Metformin-Induced Diarrhea

Before we get into solutions, Let’s understand why Metformin causes diarrhea. It helps control blood sugar by reducing the sugar made by the liver and making muscles respond better to insulin. But it can also affect the gut, causing problems leading to diarrhea. 

Understanding Metformin-Induced Diarrhea

Gradual Introduction to Metformin

Starting Metformin can be easier on your digestive system if you begin with a small dose, typically prescribed by your doctor. They will likely initiate your treatment with a minimal amount and then incrementally increase it as your body becomes accustomed to the medication. This gradual approach helps minimize the likelihood of experiencing troublesome stomach issues associated with Metformin.

Example Of Dosing

  • Week 1-2: 500mg once daily
  • Week 3-4: 500 twice daily
  • Week 5 onwards: Increase as tolerated

Proper Timing And Food Choices

Metformin should ideally be taken with meals to decrease upset stomach and diarrhea. Here’s Why:

  • During Meals: The presence of food in the stomach can help absorb the medication more gently.
  • Types of Foods: Whole, fiber-rich foods slow down digestion and the absorption of metformin, which can prevent diarrhea. However, introducing fiver gradually is key because a sudden increase can also contribute to gastrointestinal upset.

Stay Hydrated

With diarrhea, you risk losing too much water. Keeping your body well-hydrated is essential. 

Aim for clear fluids like water, broth, or herbal teas. The general recommendation is to drink at least eight glasses of water daily, but if you have diarrhea, you may need more. 

Extended-Release Metformin

Extended-release (ER) metformin can be gentler on the digestive system compared to the immediate-release formulation. The medication is released slowly over the day. Lessening the impact on the gut. 

Switching To ER Metformin

Discuss with your doctor the possibility of switching to an ER formulation.

Monitor any changes in symptoms and blood sugar levels. 

Dosage Check And Adjustment

If diarrhea is persistent, reviewing your dosage with your healthcare provider is crucial. They may suggest a lower dose or a split dose to be taken multiple times throughout the day, which can help ease Diarrhea. 

Example Of Dosage Adjustment

  • Reduce the dose by 500mg.
  • Take the reduced dose for several weeks.
  • Re-assess symptoms and blood control.

Alternative Medications

For some individuals, adding anti-diarrheal medications such as loperamide can help manage symptoms. Probiotics, which are beneficial bacteria, can also restore the natural balance of the gut and make you feel better. 

Using Anti-Diarrheal Medications

  • Start with the lowest dose after consulting with your doctor.
  • Use only as needed to manage symptoms.
  • Be aware of potential interactions with other medications.

Symptoms To Watch For

  • Persistent diarrhea lasting more than a few days.
  • Severe dehydration signs like dizziness or decreased urination.
  • Muscle pain or feeling very weak.

Be Patient and Keep Communicating

Adjusting to Metformin may take some time. Keep a regular dialogue with your health professional about your progress and any side effects you are experiencing. 

Communication Tips

  • Schedule regular check-ups to discuss your treatments
  • Share any concerns or side effects you are having. 
  • Ask about any dietary adjustments that may help.


  • Metformin, a common medication for type 2 diabetes, may lead to diarrhea.
  • Begin with a low dose and increase gradually under a doctor’s guidance.
  • Take Metformin with meals and stay adequately hydrated.
  • Extended-release Metformin can be a gentler option.
  • Adjust your dosage with your health provider’s supervision if diarrhea persists.
  • Consider anti-diarrheal medications and probiotics, consulting your doctor first.
  • Maintain a symptom diary and seek medical help for persistent or severe diarrhea to rule out serious conditions like lactic acidosis. 

To wrap up, Metformin is an effective drug for managing high blood sugar in people with type 2 diabetes. However, the medication can sometimes cause diarrhea. Start with a low-dose time with meals, stay hydrated, and consider extended-release formulations to alleviate diarrhea. If diarrhea persists, talk to your doctor and make the necessary adjustments to the medication. 

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Dr. David G Kiely is a distinguished Medical Reviewer and former General Medicine Consultant with a wealth of experience in the field. Dr. Kiely's notable career as a General Medicine Consultant highlights his significant contributions to the medical field.

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