{"id":628576,"date":"2024-06-12T10:00:48","date_gmt":"2024-06-12T14:00:48","guid":{"rendered":"https:\/\/www.singlecare.com\/blog\/?p=628576"},"modified":"2025-08-20T13:35:39","modified_gmt":"2025-08-20T17:35:39","slug":"does-metformin-cause-diarrhea","status":"publish","type":"post","link":"https:\/\/www.singlecare.com\/blog\/does-metformin-cause-diarrhea\/","title":{"rendered":"Does metformin cause diarrhea?"},"content":{"rendered":"<p><span style=\"font-weight: 400;\"><a href=\"https:\/\/www.singlecare.com\/prescription\/metformin-hcl-er\">Metformin<\/a> is a commonly prescribed medication used together with diet and exercise to manage blood glucose levels in people with <\/span><a href=\"https:\/\/www.singlecare.com\/conditions\/type-2-diabetes-treatment-and-medications\"><span style=\"font-weight: 400;\">Type 2 diabetes<\/span><\/a><span style=\"font-weight: 400;\">. It works by reducing the amount of glucose the liver makes, by lowering the amount of glucose absorbed from food, and increasing glucose uptake into the body\u2019s cells. While it is often referred to by its brand names, Glucophage, Fortamet, or Glumetza, metformin is a generic medication that comes as an oral tablet and solution. The tablet comes in both an immediate-release and extended-release form.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Although it is an effective and popular treatment option for diabetes, metformin can cause gastrointestinal side effects in patients who take it\u2013especially when it\u2019s first started. These include diarrhea, nausea, vomiting, abdominal discomfort, and gas, with diarrhea being the most common side effect.\u00a0<\/span><\/p>\n<p><b>RELATED: <\/b><a href=\"https:\/\/www.singlecare.com\/prescription\/metformin\/what-is\"><b>What is metformin?<\/b><\/a><b> | <\/b><a href=\"https:\/\/www.singlecare.com\/blog\/metformin-side-effects\/\"><b>Metformin side effects<\/b><\/a><\/p>\n<h2 id=\"does-metformin-cause-diarrhea\"><span style=\"font-weight: 400;\">Does metformin cause diarrhea?<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">While metformin is considered one of the safest drugs for diabetes mellitus, digestive system effects can occur in <\/span><span style=\"font-weight: 400;\">up to 75%<\/span><span style=\"font-weight: 400;\"> of people who take metformin. Diarrhea is more common with the immediate-release form compared to the extended-release form. In clinical trials, diarrhea occurred in <\/span><span style=\"font-weight: 400;\">53.2%<\/span><span style=\"font-weight: 400;\"> of people taking immediate-release metformin and in <\/span><span style=\"font-weight: 400;\">10%<\/span><span style=\"font-weight: 400;\"> of people taking extended-release metformin.\u00a0<\/span><\/p>\n<h2 id=\"why-does-metformin-cause-diarrhea\"><span style=\"font-weight: 400;\">Why does metformin cause diarrhea?<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Diarrhea is most common when people first start taking metformin. However, the reason why metformin causes diarrhea isn\u2019t entirely clear.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Metformin has <\/span><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC4742508\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">several effects<\/span><\/a><span style=\"font-weight: 400;\"> on the gut, including:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Increasing glucose uptake and lactate production.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Increasing glucagon-like peptide-1 (GLP-1) and bile acids inside the intestine.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Changing the gut\u2019s microbiome.<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">By increasing bile acids, metformin may have an osmotic effect, drawing water into the intestine and leading to diarrhea. It may also alter the gut microbiome\u2013including fungi, bacteria, and viruses\u2013which may cause diarrhea. Metformin also increases the release of serotonin in the intestines, which has been associated with nausea, vomiting, and diarrhea.\u00a0<\/span><\/p>\n<h2 id=\"how-long-does-diarrhea-from-metformin-last\"><span style=\"font-weight: 400;\">How long does diarrhea from metformin last?<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">For most people, diarrhea is most common when you first start taking metformin or after a delay of a few weeks. Luckily, it\u2019s <\/span><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/11714216\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">less likely<\/span><\/a><span style=\"font-weight: 400;\"> to occur as treatment goes on. With that being said, there have been some reports of chronic (long-term) cases of diarrhea, even after several years of stable dosing.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">If you develop severe diarrhea or diarrhea that won\u2019t go away while taking metformin, talk with a healthcare professional. They can provide recommendations for <\/span><a href=\"https:\/\/www.singlecare.com\/conditions\/diarrhea-treatment-and-medications\"><span style=\"font-weight: 400;\">managing diarrhea<\/span><\/a><span style=\"font-weight: 400;\"> and help determine whether you should continue treatment with metformin.\u00a0<\/span><\/p>\n<h2 id=\"preventing-metformin-diarrhea\"><span style=\"font-weight: 400;\">Preventing metformin diarrhea<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Because diarrhea is a fairly common problem with metformin, prevention is key. Digestive side effects such as nausea, vomiting, and diarrhea may be more likely if you take metformin on an empty stomach. Therefore, metformin should be taken with a meal. Another way to minimize the risk of gut-related side effects is to increase your dose slowly. For this reason, your healthcare provider will likely start you on a low dose of metformin and increase the dose slowly over time.\u00a0<\/span><\/p>\n<p><a class=\"cta-button\" href=\"https:\/\/www.singlecare.com\/prescription\/metformin-hcl-er\"><span style=\"font-weight: 400;\">Metformin coupons<\/span><\/a><\/p>\n<h2 id=\"managing-diarrhea-from-metformin\"><span style=\"font-weight: 400;\">Managing diarrhea from metformin<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Although most cases of diarrhea will resolve on their own over time, there are some ways you can manage your symptoms.\u00a0<\/span><\/p>\n<ul>\n<li aria-level=\"1\"><b>Switching to the extended-release form. <\/b><span style=\"font-weight: 400;\">In studies, diarrhea was much more common with the <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/metformin-vs-metformin-er\/\"><span style=\"font-weight: 400;\">immediate-release (IR) tablet than with the extended-release (ER) <\/span><\/a><span style=\"font-weight: 400;\">tablet. This may be because the ER form releases the drug more slowly over time compared to the IR form. While healthcare providers usually start people on IR metformin initially, if the medication is well tolerated, they can seamlessly switch you to the ER form.\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li aria-level=\"1\"><b>Dosage adjustment.<\/b><span style=\"font-weight: 400;\"> As discussed above, one way to minimize gastrointestinal side effects is to increase your dosage slowly over time. This gives your body time to adjust to the medication. Doctors will likely start you on a low dose of metformin and gradually raise it until you reach the dose that best manages your blood sugar levels.\u00a0<\/span><\/li>\n<li aria-level=\"1\"><b>Switching medications.<\/b><span style=\"font-weight: 400;\"> If you\u2019re experiencing persistent and worsening diarrhea from metformin, it\u2019s important to talk to your healthcare provider. They can help determine if metformin is the cause and, if so, if it\u2019s safe for you to continue taking the drug. In some cases, you and your healthcare provider may decide that the <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/metformin-benefits\/\"><span style=\"font-weight: 400;\">benefits of metformin<\/span><\/a><span style=\"font-weight: 400;\"> aren\u2019t worth the risks. If this is the case, switching you to another diabetes medication may be helpful.\u00a0<\/span><\/li>\n<li aria-level=\"1\"><b>Antidiarrheal medications. <\/b><span style=\"font-weight: 400;\">In certain cases, metformin-induced diarrhea can be treated with antidiarrheal medications. However, these medications aren\u2019t safe for everyone, so it\u2019s best to consult a pharmacist or other healthcare provider before you take one. Over-the-counter and prescription medications,<\/span><span style=\"font-weight: 400;\"> such as <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/imodium-a-d\"><span style=\"font-weight: 400;\">Imodium<\/span><\/a><span style=\"font-weight: 400;\"> (loperamide) and <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/lomotil\"><span style=\"font-weight: 400;\">Lomotil<\/span><\/a><span style=\"font-weight: 400;\"> (diphenoxylate\/atropine), are available to treat diarrhea.<\/span><span style=\"font-weight: 400;\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li style=\"list-style-type: none;\"><\/li>\n<\/ul>\n<p><a class=\"cta-button\" href=\"https:\/\/www.singlecare.com\/prescription\/lomotil\"><span style=\"font-weight: 400;\">Immodium coupons<\/span><\/a><span style=\"font-weight: 400;\">, <\/span><a class=\"cta-button\" href=\"https:\/\/www.singlecare.com\/prescription\/lomotil\"><span style=\"font-weight: 400;\">Lomotil coupons<\/span><\/a><\/p>\n<h2 id=\"when-to-see-your-healthcare-provider\"><span style=\"font-weight: 400;\">When to see your healthcare provider<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">If you have diarrhea that lasts longer than a few weeks or diarrhea that\u2019s accompanied by severe symptoms such as bloody stools, fever, or severe abdominal pain, it\u2019s a good idea to talk with your healthcare provider. They can help determine the cause, and you can discuss the best ways to manage your symptoms together. These may include adjusting your metformin dosage, switching to the extended-release form, or taking antidiarrheal medications. If none of those strategies work, your healthcare provider can prescribe an alternative medication.\u00a0<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Metformin is a commonly prescribed medication used together with diet and exercise to manage blood glucose levels in people with Type 2 diabetes. It works by reducing the amount of glucose the liver makes, by lowering the amount of glucose absorbed from food, and increasing glucose uptake into the body\u2019s cells. While it is often [&hellip;]<\/p>\n","protected":false},"author":133,"featured_media":628577,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[4589],"tags":[10298,20948,16414],"coauthors":[20969],"class_list":["post-628576","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-drug-info","tag-diabetes","tag-diarrhea","tag-digestive-health","wpautop"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v27.4 (Yoast SEO v27.4) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>Does metformin cause diarrhea?<\/title>\n<meta name=\"description\" content=\"Gastrointestinal side effects may occur in up to 75% of people on metformin, especially when starting the medication. 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