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Stopping metformin: When and how to do it?

If your healthcare provider deems it safe to stop metformin, they will likely create a plan to gradually reduce your dose until you can safely discontinue the medication
By | Jul. 3, 2024
An Rx pill bottle with tablets: How to stop taking metformin

Key takeaways

  • Metformin is a generic medication approved by the FDA for Type 2 diabetes. It’s widely regarded as a safe and effective diabetes medication and is typically prescribed as a long-term treatment.

  • Still, there are several reasons why you may want to stop taking metformin. These include successful management of blood sugar levels through lifestyle changes, development of unpleasant side effects, or a desire to switch to a different medication.

  • It’s important to talk to your healthcare provider before stopping metformin. You shouldn’t stop taking metformin on your own, as doing so can result in uncontrolled blood sugar levels. This can increase your risk of diabetes complications.

In this article:

Metformin is one of the most commonly prescribed medications used to manage Type 2 diabetes. It’s widely regarded as a safe and effective drug and is often taken as a long-term treatment. But, metformin might not be suitable for everyone, especially if it causes unpleasant side effects. In these cases, you may want to stop taking metformin. However, there are important things to keep in mind before you stop the drug. 

Read on to learn about what to do if you want to stop taking metformin. 

Why stop metformin?

The American Diabetes Association (ADA) recommends metformin as the first-line treatment option for Type 2 diabetes, and in most cases, people take it for many years. This is because of its effectiveness, safety, and lower cost. Nevertheless, there are some reasons why someone might want to stop taking metformin. These include:

  1. To improve and control blood sugar levels through lifestyle changes. Some people with Type 2 diabetes can manage their condition through lifestyle changes. They may find that they no longer need metformin to control their blood sugar. Examples of lifestyle changes include eating a healthy diet, exercising regularly, losing weight, quitting smoking, and limiting alcohol consumption. 
  2. Intolerable side effects. Common side effects of metformin are diarrhea, nausea, vomiting, gas, indigestion, and abdominal discomfort. In most cases, these side effects go away if the drug is taken with food, or they may go away within a few weeks of starting the medication. But for some, these side effects can be severe and make you want to stop the medication. 
  3. There is a desire to switch to another diabetes medication. While metformin is the first-line treatment option recommended by the ADA, there are several other treatment options for diabetes. As newer medications continue to be approved, some medications may have added benefits over metformin, including reducing the risk of heart and kidney disease in addition to blood sugar management. Some healthcare professionals may recommend switching to a different medication depending on your medical history and individual risks. 
  4. A healthcare provider instructs you to stop, given a certain medical history. Metformin may not be right for you if you have or develop certain medical conditions. Metformin isn’t recommended in people with kidney disease or certain kidney problems. This is because the kidneys mainly break down metformin. If your kidneys aren’t working properly, your body may clear metformin more slowly. This can lead to a buildup of the drug in your body and increase the risk of serious side effects, including lactic acidosis. In addition, doctors typically avoid prescribing metformin for people with liver disease. 

How to stop taking metformin

Regardless of the reason why you’re stopping metformin, it’s important that you talk with your healthcare provider before making any changes to your drug regimen. They will likely want to know the reason you want to stop metformin and if you’re open to switching to other diabetes medications.

If you want to stop metformin because of side effects, your medical provider may suggest other strategies before stopping the drug. These include taking metformin with food or switching to extended-release metformin tablets.

Your provider may also want to measure your blood sugar and hemoglobin A1C levels to ensure your diabetes is well-managed before discontinuing metformin treatment. If you and your healthcare provider decide it’s safe for you to stop metformin, they’ll likely come up with a treatment plan for you to lower your dose gradually over time until it’s safe for you to stop the drug entirely.  

What to watch out for when stopping metformin

Metformin works to manage blood sugar levels in several ways. These include reducing the amount of glucose your liver makes, lowering how much glucose your body absorbs from food, and increasing your body’s sensitivity to the insulin it produces. Once metformin is stopped, these effects no longer take place. Unless you’re switching to another medication or your blood sugar is being managed successfully by lifestyle changes, this can cause your blood glucose levels to rise and increase your A1C. This can lead to symptoms such as:

  • Excessive hunger or thirst
  • More frequent urination
  • Tiredness
  • Blurry vision
  • Mood changes

Having high blood sugar levels for a long time can increase your risk of diabetes complications, including: 

  • Vision problems
  • Feet problems
  • Heart disease
  • Nerve damage
  • Kidney damage

In some instances, people may feel better after stopping metformin. This may be the case if you’re stopping metformin due to unpleasant side effects. But in general, you should expect metformin to be cleared from your body after about four days of stopping the drug. 

Managing diabetes without metformin

Although metformin is a very common, effective, and safe medication for Type 2 diabetes, there are several reasons why one may want to stop taking the drug. The good news is there are ways to stop the medication safely, and it’s possible to manage diabetes without it. Here are some ways you can manage diabetes without metformin:

  • Implement lifestyle changes, including:
    • Maintaining a healthy diet full of vegetables, whole fruit, whole-grain foods, lean protein sources, and oils
    • Limiting foods and beverages higher in added sugars, including alcohol
    • Engaging in regular physical activity, which is defined as 150 minutes per week of moderate-intensity aerobic activity or 75 minutes per week of vigorous-intensity aerobic activity
    • Quitting smoking
    • Minimizing stress
    • Weight loss
  • Choose an alternative medication: Whether metformin isn’t working well for you or you developed bothersome side effects on the medication, there are many alternatives available, such as:
  • Regular monitoring and communication with a healthcare provider: Over time, high blood sugar levels can lead to serious complications. To minimize this risk, it’s important that you see your medical professional regularly to ensure your blood sugar levels are in a safe range. It’s also important to promptly report any changes to your lifestyle, medical conditions, and medications to your provider, as these changes may also affect your blood sugar levels.

While metformin is effective and safe for many, there are viable reasons to stop taking it. By adopting lifestyle changes, considering alternative medications, and maintaining regular communication with healthcare providers, individuals can successfully manage diabetes without metformin.