Metformin is primarily used to manage blood sugar as a diabetes medication, but research shows it may lead to modest weight loss in some people, particularly those with insulin resistance, obesity, or PCOS.

In clinical studies, metformin has been associated with an average 2-6% reduction in body weight or BMI over several months. Results vary based on dose, duration of use, and individual metabolic factors.

While metformin is sometimes prescribed to support weight management, it is not considered a standalone weight loss drug. Weight changes tend to be gradual and are most consistent when metformin is combined with lifestyle changes such as a balanced diet and physical activity.

Metformin is sometimes prescribed off-label for patients with PCOS because it can help improve insulin resistance, which is common in this condition. By lowering insulin and blood sugar levels, metformin may help reduce excess androgen production, which can contribute to symptoms like irregular periods, acne, and excess hair growth.

Research has shown that metformin may also help restore regular menstrual cycles, support ovulation, and improve fertility outcomes in some people with PCOS. Because insulin resistance is closely linked to weight gain in PCOS, metformin may additionally support modest weight loss and overall metabolic health, particularly when combined with lifestyle changes.

While taking metformin, avoid excessive alcohol, as it can raise your risk of lactic acidosis. Tell your healthcare provider about any prescription drugs, over-the-counter medications, or dietary supplements you’re taking, because of possible drug interactions.

This includes: other diabetes medicines or sulfonylureas, diuretics, corticosteroids, blood pressure medications, antipsychotics, hormonal contraceptives, thyroid medications, seizure medications, certain antivirals, cimetidine, anticoagulants, and antiplatelet drugs.

Always check with your provider before starting any new medication, supplement, or major dietary change while on metformin.

Metformin is not suitable for everyone. People with a history of severe kidney or liver disease, diabetic ketoacidosis, or heart failure may not be able to take it safely. Talk to your provider about precautions if you’re over 65, pregnant, planning to become pregnant, or breastfeeding. Precautions may include monitoring of vitamin B12 levels and kidney function.

Your healthcare provider will review your medical history, current medications, and overall health to determine if metformin is safe for you. If you have any conditions or concerns that could make metformin unsafe, your provider may recommend alternative treatments.

If you’re considering metformin as a medication to manage prediabetes, you can also explore a combination of lifestyle and medication options to manage or reverse your prediabetes risk.

If you forget to take a dose of metformin, take it as soon as you remember, unless your next dose is coming up soon. In that case, skip the missed dose and stick to your regular schedule. Avoid taking extra pills to catch up, as this can increase the risk of adverse side effects.

For the best results, try to take metformin at the same time every day. Even if your blood sugar seems under control or you’re feeling better, keep taking the medication as prescribed. Stopping suddenly can cause your levels to spike, so any changes should be discussed with your doctor.

If you’re unsure about a missed dose or need advice, you can reach out to your provider or book an online visit with Sesame.

Taking more metformin than prescribed can increase the risk of serious side effects, including low blood sugar and lactic acidosis, a rare but potentially life-threatening condition. Early symptoms of lactic acidosis include nausea and vomiting, fatigue, rapid or shallow breathing, and muscle cramping.

If you suspect an overdose, seek medical attention immediately or call your local poison control center. Always take metformin exactly as prescribed, and talk to your healthcare provider if you feel your dose may need adjusting. Never take extra doses to try to improve results.

Metformin is not available over the counter and can only be obtained with a prescription from a licensed healthcare provider.

Providers on Sesame can write a new prescription or refill an existing one through a virtual visit. Depending on the medication, you may be able to pick up your metformin the same day. Schedule an online consultation with a real, licensed provider to see if metformin is right for you.

Keep in mind that all prescriptions are at the discretion of your healthcare provider, and Sesame providers cannot prescribe controlled substances.