So to continue the discussion, Metformin is the active ingredient that is eliminated by the

kidneys and has a half-life of 1.5–3 hours. It is also not metabolized or bound to plasma
proteins. Metformin's inhibition of gluconeogenesis may lead to a decrease in lactic acid
metabolism in the liver. Lactic acidosis is a potentially dose-related effect that occurs when
biguanide builds up in patients with renal failure.

The first line of treatment for type 2 diabetes is Metformin, which is a Biguanide drug noh.
Metformin has clear advantages over drugs like insulin or sulfonylureas in treating
hyperglycemia in such patients because it is an insulin-sparing medication that does not
produce hypoglycemia or raise body weight.

Up to 20% of patients experience gastrointestinal adverse effects from metformin, which include
anorexia, nausea, vomiting, abdominal pain, and diarrhea. They frequently occur at the start of
therapy, are dose-related, and are temporary.

According to Katzung this Metformin noh is contraindicated if a patient’s eGFR is less than 30
mL/min per 1.73 m2. (Milliliter per minute per 1.72 square meter).

So thus, and as shown in the slide this Metformin drug can’t be used by patients with impaired
liver or kidney, as well as patients with congestive heart failure.