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What you should know about prescription metformin

Metformin must be prescribed by a licensed healthcare provider
By | Aug. 8, 2024
An Rx prescription pad and Rx pill bottle: Can you take metformin if you don't have diabetes?

Key takeaways

  • Metformin is a generic medication used with a healthy diet and exercise to treat Type 2 diabetes. It’s also used for several off-label uses, such as weight loss, polycystic ovary syndrome (PCOS), and aging.

  • Because metformin’s benefits extend well beyond diabetes, it’s possible to obtain a metformin prescription even if you don’t have diabetes. However, you’ll likely need to consult a medical professional before they can write you a prescription.

  • There isn’t an exact over-the-counter (OTC) substitute for metformin. However, several OTC medications are available to help with diabetes, PCOS, and weight loss.

In this article:

Metformin is a common, affordable medication with mild side effects. In 2021 alone, healthcare providers in the United States wrote over 91 million prescriptions for metformin. Although it’s primarily used for Type 2 diabetes, metformin is also prescribed for many off-label uses. Beyond its use to help lower blood sugar, metformin may also aid in weight loss, lower the risk of cardiovascular disease, and manage polycystic ovary syndrome (PCOS). There is also evidence that metformin may help slow aging, increase life expectancy, and lower the risk of certain cancers. 

The benefits of metformin have been well-recognized over the years. This makes metformin an attractive therapy for many, including those without diabetes. Let’s discuss how you can get a metformin prescription without diabetes mellitus. 

Do you need a metformin prescription?

Metformin is a generic medication approved to improve blood sugar levels in people with Type 2 diabetes. Commonly referred to by its brand names Glucophage, Fortamet, Glumetza, or Riomet, metformin works by reducing the blood glucose levels made by the liver. This decreases the amount of glucose absorbed from food and increases insulin sensitivity. It is available in both immediate and extended-release forms.

As mentioned above, it’s also used off-label for several other medical conditions. These may include: 

Metformin is only available with a prescription from a licensed medical provider. Before issuing a metformin prescription, healthcare providers will likely conduct a thorough health evaluation. They may do a physical exam, order blood tests, or ask questions about your symptoms, medical history, and other medications. This information helps determine if metformin is right for you and to help avoid any medical interactions. 

Metformin is frequently associated with common side effects. The most common side effects of metformin include diarrhea, headache, and nausea. Although rare, metformin also can cause serious side effects, such as lactic acidosis or hypotension (low blood pressure). And it may not be safe if you have certain health conditions, such as kidney disease. Due to these risks, metformin isn’t available without a prescription, and doctors will likely only prescribe it after they’ve completed a medical exam. 

Who should not take metformin?

Although metformin is typically well tolerated, it’s not a safe choice for everyone. It’s only approved for use in adults and children ages 10 years and older. And like most medications, metformin has contraindications (specific situations or medical conditions when metformin shouldn’t be taken). These contraindications include: 

  • Previous allergic reaction to metformin or any of its ingredients. Taking metformin after you’ve had an allergic reaction to it in the past can cause another allergic reaction. Due to this risk, be sure your prescribing doctor knows of any allergies you have before you start metformin treatment. 
  • Severe kidney problems. Metformin is mainly cleared from the body by the kidneys. If you have severe kidney problems, your body may not be able to clear metformin as quickly as it normally would. This can cause metformin to build up in the body, which can increase the risk of side effects from the drug. 
  • Metabolic acidosis, including diabetic ketoacidosis with or without coma. Metformin has a boxed warning about the risk of lactic acidosis. Lactic acidosis is a rare and potentially life-threatening type of metabolic acidosis that may occur if metformin builds up in the body. Because metformin can increase the risk of lactic acidosis, you shouldn’t take metformin if you have any type of metabolic acidosis, including diabetic ketoacidosis. 

Additionally, healthcare providers typically won’t prescribe metformin for people with a history of heart disease, congestive heart failure, or liver disease because these conditions can increase the risk of lactic acidosis.

How to get a metformin prescription without diabetes

Because metformin’s benefits extend beyond diabetes, it’s possible to get a metformin prescription without having diabetes. However, you’ll likely need to visit a healthcare provider for a medical exam before obtaining a prescription. And the specific questions and tests they’ll order will depend on the condition being treated. 

For example, if you’re seeking a metformin prescription for weight loss, you may have to disclose your medical conditions and current medications to your doctor. They’ll probably measure your height and weight to calculate your body mass index (BMI). After analyzing this information, your doctor may prescribe the drug if you have Type 2 diabetes or prediabetes along with obesity. In some cases, they may prescribe the drug even if you don’t have diabetes. Some research supports the use of metformin for weight gain related to antipsychotic medications. If you’re experiencing weight gain while taking antipsychotics, talk with your healthcare provider about metformin and if it’s right for you. 

Getting an online metformin prescription

Fortunately, it’s possible to get a prescription for metformin online. People interested in obtaining a prescription can schedule an in-person or telehealth appointment with a licensed medical professional. If your provider determines metformin is appropriate for you, they can send a prescription to a local pharmacy so you can pick the medication up.

Who can prescribe metformin?

Because metformin is not a controlled substance, you can obtain a prescription from any licensed healthcare provider. These may include physicians, physician assistants, and nurse practitioners. These providers may also be your point of contact if you need a refill or renew an expired prescription. 

While any licensed medical professional can legally issue a metformin prescription, all prescriptions are at the sole discretion of your provider. For off-label use in particular, your provider may only prescribe metformin if they know the evidence supporting its use and feel it will benefit you.

Are there over-the-counter alternatives for metformin?

There are no exact over-the-counter (OTC) substitutes for metformin. However, several OTC medications are available to help with diabetes, PCOS, and weight loss. 

Diabetes

There aren’t any FDA-approved OTC drugs for diabetes. However, some OTC medications can help with certain complications. For example, those suffering from diabetic neuropathy may find relief with OTC pain relievers, such as Tylenol (acetaminophen) or Motrin (ibuprofen). 

Polycystic ovary syndrome (PCOS)

PCOS is a condition characterized by an imbalance in reproductive hormones. This can cause a wide range of issues, such as irregular periods, missed periods, unpredictable ovulation, excess hair growth, acne, infertility, and insulin resistance. In most cases, treatment consists of prescription medications, including drugs that block androgens, hormonal birth control, or drugs that make you more sensitive to insulin. However, OTC medications may be considered in certain situations. For example, those who develop acne related to PCOS can try OTC topical treatments. These can include products with benzoyl peroxide, salicylic acid, or alpha hydroxy acids. However, it’s best to seek medical advice from a healthcare provider before starting any new medications, including OTC products. 

Weight loss 

Alli (orlistat) is the only FDA-approved OTC medication for weight loss. It’s approved for use in adults and reduces the amount of fat the body absorbs. In studies, Alli helped participants lose 50% more weight than with diet alone. However, as with all medications, it comes with risks. These include potential side effects in the digestive tract and liver problems. Check with your healthcare professional before starting any new OTC medications.