Stopping Metformin: When and How to Stop

Metformin is a commonly prescribed medication for managing type 2 diabetes. But some people experience severe side effects and feel better after stopping metformin.

Metformin can play an important role in managing diabetes. But for some people, it can also have unpleasant side effects, such as headaches or GI symptoms like diarrhea.

You may be able to stop taking metformin to switch to another treatment, but you should speak with your doctor before stopping. Stopping suddenly can cause additional unwanted side effects, and you’ll likely need to replace the medication with another therapy.

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Will I ever come off metformin?

Metformin helps manage type 2 diabetes by decreasing blood sugar made by your liver, reducing your body’s absorption of sugar, and making your body more sensitive to insulin. It’s generally taken every day as a long-term medication.

But you can eventually stop taking metformin if your health improves or due to unwanted side effects.

Side effects

Metformin can cause several side effects, and the most common affect your GI tract.

You may experience mild to severe side effects such as:

• flatulence
• abdominal bloating
• nausea
• vomiting
• heartburn
• loss of appetite
• diarrhea
• dizziness
• constipation
• headache
• agitation
• chills
• tiredness
• abdominal cramps or pain
• altered or metallic taste

Metformin can also make you more susceptible to upper respiratory infections.

Though less common, a 2017 study found that continued metformin use in people with type 2 diabetes and chronic kidney disease led to a decline in kidney function.

Metformin also has a black box warning for a rare, severe side effect known as lactic acidosis. Lactic acidosis occurs when too much lactic acid builds up in the blood, and it can be fatal.

You should discuss your full medical history with a doctor when considering medications such as metformin.

You may not experience any side effects from metformin. But if you do, switching medications should help them disappear.

In a 2010 study, participants experienced fewer side effects with extended-release (ER) metformin compared with immediate-release metformin. If you take immediate-release metformin, your doctor may transition you to the ER version as an alternative.

Other medications may be a better fit

Whether you experience severe side effects or metformin is not working well for you, there are other medication options.

Some alternatives include:

• GLP-1 receptor agonists: help lower glucose levels
• SGLT-2 inhibitors: help blood remove glucose
• DPP-4 inhibitors: prevents the release of chemicals that form glucose
• sulfonylureas (SFUs): help lower blood glucose levels
• thiazolidinediones (TZDs): help reduce insulin resistance

Improving health

Often, a doctor will prescribe metformin and recommend making lifestyle changes. These can include:

• exercising regularly
• losing weight if needed
• eating a nutrient-dense diet
• stopping smoking
• avoiding alcohol

It is possible for some people to manage their type 2 diabetes through lifestyle changes alone. If your prognosis improves, you may be able to reduce or stop taking medications like metformin altogether.

How do you feel when you stop metformin?

How you feel when you stop taking metformin will depend on how well you are able to manage your type 2 diabetes without the medication.

If you stop suddenly and your blood sugars become high again, it can lead to worsening symptoms, such as frequent urination, higher blood sugar levels, and increased thirst. Over time, high blood sugar levels can lead to additional complications, such as kidney issues, nerve damage, and issues with your feet.

But if your blood sugar level is well-managed with lifestyle changes, you may not notice any major changes. If you were experiencing symptoms associated with metformin, these should start to go away.

Is it OK to stop taking metformin cold turkey?

Before you stop taking metformin, make sure you speak with a doctor about your desire to quit using the medication.

They may want to know why you want to stop, whether you’re experiencing side effects, and if you want to manage diabetes without medications.

If side effects are an issue, they may recommend an alternative medication to help manage your blood sugar levels.

If you’re managing your diabetes with lifestyle changes, a doctor may suggest you stop taking metformin. They often measure your current status through an A1C test.

You may be in remission or have “reversed type 2 diabetes” if your A1C level is less than 6.5% for at least 6 months. At that point, you may not need metformin or any other medications.

How to stop taking metformin safely

Before you stop taking metformin, you should talk with your doctor. They will likely want to see evidence suggesting you are managing blood sugar levels well on your own with diet and exercise.

They may be able to do this with an A1C test. They may suggest additional testing and discuss what changes you’ve made that may affect your blood sugar levels.

If you’re still trying to manage your blood sugar levels, but the side effects of metformin are too much, your doctor will likely want to switch your medications.

The takeaway

Metformin is a common medication used to help lower blood glucose levels for people living with type 2 diabetes. The medication is generally safe and effective for most people, but it can cause mild to severe side effects in some and may not be safe for others.

If you experience side effects or want to use lifestyle changes alone to manage your blood sugar levels, you may be able to stop taking metformin safely. If you still need help managing your blood sugar, a doctor may be able to recommend alternative medications.

If you’re managing your blood sugar levels well, you may be able to stop metformin and continue management without medication.