The Food and Medication Organization (FDA) in May 2020 suggested that a few manufacturers of extended-release metformin remove some of their tablets in the US market. This is on the grounds that an unsuitable level of a cancer-causing agent (carcinogen) was traced in a few extended-release metformin tablets.
Call your doctor if you are taking this medication at the moment. They will tell you whether you should keep taking your medication or get a new one. Let’s discuss a bit more whether metformin is safe during pregnancy and if you can take metformin while pregnant.
What is Metformin?
Metformin is a medication for type 2 diabetes that lowers blood sugar. It may be safe for pregnant women to use, according to research, but still, they should probably talk to a doctor first.
Metformin may reduce body fat distribution and improve insulin sensitivity in addition to lowering blood sugar. Metformin use during and after pregnancy, as well as its connection to fertility, are the subject of this article. In addition, we discuss metformin alternatives, dosage, and side effects. Moreover, we answer the important question, “Is metformin safe during pregnancy?”
A note regarding gender and sex: Gender and sex are members of a broad spectrum. This article will utilize the expressions “male,” “female,” or both to allude to the sex assigned at birth.
Effects Of Taking Metformin During and After Pregnancy
Some people are worried about taking metformin while pregnant and afterward because it crosses the placenta. This indicates that a pregnant woman’s unborn child also takes metformin.
According to a 2018 study, there is no evidence that congenital anomalies or pregnancy loss are rising. This holds true regardless of whether a woman takes metformin prior to or during pregnancy. However, additional research might be required.
Effects of Metformin During Pregnancy
Gestational Diabetes
Pregnant women who had taken metformin to treat type 2 gestational diabetes lost less weight than those who took a placebo, according to a 2020 randomized control trial. In addition, the same trial found that the babies of women taking metformin had less fat, including a lower mean fat mass and lower birth weight.
However, the metformin group also had a higher proportion of babies who were smaller than anticipated for their gestational age. The researchers said that more research is needed to find out what these effects mean in the long run.
Polycystic Ovarian Syndrome (PCOS)
Specialists might recommend metformin to individuals with polycystic ovary disorder (PCOS) to assist with insulin resistance. The Centers for Disease Control and Prevention (CDC) state that insulin resistance is frequently present in PCOS and that they are more likely to develop type 2 diabetes, particularly if they are overweight.
PCOS can result in infrequent ovulation and missed periods, which can make it difficult to conceive or cause infertility. As per a 2021 systematic review, women who took metformin and had gestational diabetes or PCOS experienced lower weight gain during gestational when compared with the placebo groups.
Postnatal Effects of Metformin
In Women With PCOS
Studies in this regard have been conducted on children born to mothers with PCOS. One such study found that the use of metformin normalized insulin and androgen levels during pregnancy. It also reduced AMH levels (an ovarian marker that indicates PCOS in newborn girls as early as 2 months).
Another study showed that newborn girls whose mothers took 2.0gm of metformin daily weighed more than the placebo group at 1-year postpartum. They also have elevated systolic blood pressure and glucose levels with a lower LDL cholesterol level.
In Women WIth GDM
Children with mothers having Gestational Diabetes Mellitus (GDM) are taller and heavier at 18 months of age. They also exhibit larger skinfolds at 2 years of age and 7 years later they turn out to have a large waist circumference, triceps skinfold, BMI, and waist/height ratio.
Risks Of Metformin During Pregnancy
The risks of metformin might be somewhat low when an individual stays with the doctor’s prescription dosage. On the other hand, some people will only experience minor side effects. Metformin’s most common side effects include:
Some women may feel severe morning sickness due to these side effects. A specialist might recommend the least viable portion to help decrease or forestall side effects with metformin. Metformin rarely results in hypoglycemia, which manifests as the following signs and symptoms:
Metformin safety in pregnancy also includes a more serious complication, such as lactic acidosis, This condition may present the following symptoms:
- Sleep apnea
- Muscle aches
- Troubled breathing
- Extreme fatigue
- Feeling light-headed, weak, dizziness
- Irregular heartbeat
- Vomiting and nausea
- Strong stomach pains
If a person experiences any serious symptoms or signs of lactic acidosis, they should immediately contact the emergency medical team.
Dosage of Metformin During Pregnancy
Metformin dosage varies for type 2 diabetes patients. Based on a patient’s medical history, insulin sensitivity, and sensitivity to side effects, a doctor will select a dosage. Metformin may also be prescribed by a doctor to pregnant women taking insulin for type 2 diabetes to alleviate pregnancy-related symptoms.
The dosage of metformin for PCOS also varies based on how they react to the medication. To limit aftereffects, doctors start a person on extremely low dosages and bit by bit increment these until their side effects get to the next level.
Alternatives To Metformin
People who are pregnant and have gestational diabetes or type 2 diabetes can take metformin while they are pregnant if a doctor tells them to. However, pregnant women with type 2 diabetes are not permitted to take metformin for treatment. It may be prescribed by a doctor to a patient who cannot tolerate insulin or for other personal reasons.
What Should You Avoid While Taking Metformin During Pregnancy?
An individual ought to inform their doctor about any prescriptions they are taking, as some can interface with metformin. The following medications may make lactic acidosis more likely:
- carbonic anhydrase inhibitors
- Cimetidine
- cephalexin
- dolutegravir
- Bupropion
- ethanol
- lamotrigine
A few medications that might cause hypoglycemia when an individual takes them along with metformin include:
- androgens
- Salicylates
- quinolones
- alpha-lipoic corrosive
- particular serotonin reuptake inhibitors
Should A Person Stop Taking Metformin While They Are Pregnant?
If you are pregnant, you should stop taking metformin unless you talk to your doctor about continuing to take it. A person taking this medication will be monitored by a doctor to make sure they don’t get any unwanted effects. A substitute may be offered if a medical professional determines that a pregnant woman should not take metformin.
A Final Word On Metformin During Pregnancy
Research indicates that metformin has a low risk of pregnancy-related complications which means metformin is safe in pregnancy. However, additional research might be required. A few investigations propose that the medication might try and have benefits for pregnant individuals and their embryos following proper use. Specialists will cautiously oversee metformin doses relying upon every individual’s clinical history. An individual ought to talk with their PCP for additional exhortation about their interests.
