Metformin vs Metformin Hydrochloride: Similarities & Differences

Key Takeaways

Metformin is commonly prescribed for people with type-2 diabetes. The drug name on the label would be either metformin hydrochloride or metformin HCl. However, metformin, metformin hydrochloride, and metformin HCl are the exact same medication.

If you have been prescribed an oral medication called metformin, you may find mention of it as metformin hydrochloride or metformin HCl. Please continue reading to learn more about metformin and metformin hydrochloride.

Why take metformin hydrochloride?

Taking metformin can help you achieve glucose control if you have been diagnosed with type 2 diabetes mellitus, a chronic condition causing high fasting plasma glucose levels that can lead to serious health complications.

Metformin works by reducing glucose formation in the liver, lowering insulin resistance, and improving insulin sensitivity. It is also used off-label to treat polycystic ovary syndrome and prevent antipsychotic-induced weight gain.

Metformin can also be used to treat gestational diabetes mellitus. It is important to keep your blood sugar under control during pregnancy to prevent complications, and metformin is safe to use during pregnancy.

Before starting metformin treatment, tell your doctor if you have a history of allergic reactions to metformin or if you have metabolic acidosis or diabetic ketoacidosis.

Give your healthcare professional a complete list of your medications to avoid possible drug interactions. Drug interactions can lead to adverse effects such as hypoglycemia (low blood sugar) and other potentially life-threatening conditions such as metabolic acidosis and acute kidney injury.

Is metformin the same as metformin hydrochloride?

A lot of people wonder about the difference between metformin vs metformin hydrochloride, and it is indeed confusing, but the answer is that metformin, metformin hydrochloride, and metformin HCl are the exact same medication.

Hydrochloride is the salt form of metformin and of many other drugs on the market. In many cases, chemical compounds exist in certain forms that do not allow them to be absorbed properly in the body to carry out the intended function. As a result, salt forms are created to overcome these problems.

HCl is just the abbreviation of hydrochloride.

What is metformin hydrochloride 500 milligrams (mg) equivalent to?

Metformin hydrochloride 500 mg is equivalent to 389.93 mg metformin base.

Are there two different types of metformin?

Yes, there are two different formulations of metformin. One is immediate-release (or just regular), and the other is extended-release. Both metformin forms contain the same active ingredient and are used for long-term diabetes management along with diet and exercise. One formulation is not better than the other.

Immediate-release metformin

Immediate-release metformin tablets release the medicine within minutes of taking a dose. Generic immediate-release metformin is also sold under the trade name Glucophage, though the brand name Glucophage is no longer available in the U.S.

Generic metformin IR comes in doses of 500 mg, 850 mg, and 1,000 mg metformin HCl. The usual starting dose of immediate-release metformin is 500 mg twice a day or 850 mg once a day. Your doctor may slowly titrate your metformin dose based on your blood sugar levels and how you tolerate the side effects.

The maximum dose is 2,550 mg per day in adults and 2,000 mg per day in children between 10 and 16 years of age.

Extended-release metformin

A metformin extended-release tablet releases the medicine a little bit at a time so that the medication slowly absorbs into the bloodstream. As a result, you only need a once-daily dose of the extended-release formulation to manage your blood glucose levels. Generic metformin ER is sold under the brand names Glucophage ER, Glumetza, and Fortamet. It comes in doses of 500 mg, 750 mg, and 1000 mg.

The usual starting dose of metformin extended release is 500 mg once daily with the evening meal. The dose may be increased by 500 mg every week, based on glycemic control, up to a maximum dose of 2,000 mg once daily.

Can you switch from metformin immediate release to extended-release?

While both metformin immediate-release and extended-release are approved to treat type-2 diabetes with diets and exercise, one formulation is not better than the other. However, some people may prefer the extended-release formulation for the following reasons:

You prefer to take fewer doses daily. Metformin IR is taken twice daily, while the extended-release formulation allows once-daily dosing;
You are unable to tolerate the gastrointestinal side effects of metformin IR. Compared to the immediate-release form, metformin ER typically causes less nausea, vomiting, stomach pain, and diarrhea.

Notably, health plans may require prior authorization for metformin ER. Metformin ER is only to be used in adults 18 years and older, while metformin IR can be used in children as young as 10 years old.

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