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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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How Should Metformin Be Taken While Fasting?

I have been taking metformin for a month now . Once a day before breakfast . I don’t take it because of diabetes but to help weight loss. (Recommended by my doctor) so now since Ramadan is here and I have to fast. I have to eat food at 4am then no food or water until 9pm. So how should I take my metformin pill? Before eating at 9pm or 4am?
Thu, 28 Jun 2018
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Internal Medicine Specialist 's  Response
Hello and Welcome to ‘Ask A Doctor’ service.
I have reviewed your query and here is my advice.

I understand that you've been given Metformin for weight loss by your doctor but let me note that this is not an adequately documented indication although there are some - not many - results from studies to back it up. In some studies, the participants achieved minor weight loss. The problem with these studies is that they were not properly designed to prove without doubt that Metformin is appropriate for this indication or were under powered (the number of participants was not high enough). Metformin is not supposed to cause any serious harm when taken without food but most doctors would instruct a patient to avoid it. Metformin is well-known for causing gastrointestinal side effects. Taking Metformin with food reduces the likelihood of these side-effects. Regarding hypoglycemia this is not very likely to occur as Metformin does not normally cause low blood sugar on its own.
So in conclusion, if you'd like to continue taking Metformin during Ramadan then you can change the dosing schedule a bit and take it with your meal, that is stop taking it in the morning and start taking it at 4 am or 9 pm.

Hope I have answered your query. Let me know if I can assist you further.
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How Should Metformin Be Taken While Fasting?

Hello and Welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice. I understand that you ve been given Metformin for weight loss by your doctor but let me note that this is not an adequately documented indication although there are some - not many - results from studies to back it up. In some studies, the participants achieved minor weight loss. The problem with these studies is that they were not properly designed to prove without doubt that Metformin is appropriate for this indication or were under powered (the number of participants was not high enough). Metformin is not supposed to cause any serious harm when taken without food but most doctors would instruct a patient to avoid it. Metformin is well-known for causing gastrointestinal side effects. Taking Metformin with food reduces the likelihood of these side-effects. Regarding hypoglycemia this is not very likely to occur as Metformin does not normally cause low blood sugar on its own. So in conclusion, if you d like to continue taking Metformin during Ramadan then you can change the dosing schedule a bit and take it with your meal, that is stop taking it in the morning and start taking it at 4 am or 9 pm. Hope I have answered your query. Let me know if I can assist you further.