Metformin Dosage

C.,

If you are "borderline" you shouldn't be taking Metformin. Metformin is a diabetic medication. Yes, women with PCOS usually have insulin issues. However, you REALLY need to make sure you're taking the right drug for the right reason.

I would seek a second opinion. Go to an endocrinologist. Realize that once you start taking Metformin, you just can't "STOP" taking it. It's a CLASS B drug - in other words STILL unsure what, if any, problems it causes to an unborn baby.

Did you talk to your doctor about that? I'm sorry. I've been in your shoes. It took us almost 4 years to get pregnant. We did NOT use Metformin, our pharmacist - said NO WAY - if you are NOT diabetic, DO NOT take it...

Please get all the information you can. Get second opinions...but don't take a drug you do not need for diabetes to get pregnant.

C., I take Metformin for both metabolic syndrome & PCOS, and have for a number of years. I take 850mg 2x a day, with meals when I remember.

My guess for the split dosing in your case might be that people are less active in the evening & the body might need more "help" from the drug due to the inactivity as we sleep. That is just a guess however, I wasn't able to find anything online addressing the dosing.

While Metformin is used to help regulate insulin and is often prescribed to diabetic & prediabetic patients (like myself), it also helps to regulate other hormones, which is why it is often prescribed (and successful) for treating infertility in women with PCOS.

I did quite a bit of research on this drug for a friend who was TTC a few years ago. Unfortunately, the medical journal articles & studies are not easily found again online, but here are links to a few sites that have info supporting the use of Metformin in your situation.

http://www.lef.org/protocols/female_reproductive/polycyst...
(See specifically the yellow box on Metformin)

http://health.howstuffworks.com/pregnancy-and-parenting/p...

http://www.webmd.com/women/metformin-glucophage-for-polyc...

FYI, Wild Woman commented below regarding the safety of taking the drug prior to/during pregnancy. The first link I posted references that recent studies have shown no teratogenic effects, via studies in 2002 & 2010. Here is a link with more technical information regarding it's use during pregnancy

http://www.medscape.com/viewarticle/515581

Class A has been proven safe in humans & animals. Class B may have adverse effects in -animals- but is safe in humans, or is safe in animals & there haven't been adequate studies in humans.
These links explain the classification of drugs & Metformin specifically.

http://en.wikipedia.org/wiki/Pregnancy_category
http://www.drugs.com/pregnancy/metformin.html

As with all things in medicine, new studies come out to update information, and every doctor has their knowledge & opinion on the safety of what they prescribe.
If you have any questions about taking the drug prior to or during pregnancy, make sure to talk to your doctor & pharmacist about this. If you are unsure, it is always your choice to proceed with any treatment or not.

Best of luck! T. =-)

Metformin is used both for insulin resistance and to stimulate ovulation in PCOS patients. Are you both being treated for only insulin resistance or are you trying to get pregnant (she's clearly not). That could be a difference, are either of you testing your blood sugar before taking it? You should be, if you are not. She could need it with each meal to keep her blood sugar in a normal range and perhaps you do not.

The dosage is based on 1) what it is being used to treat, PCOS, Diabetes and so on), 2) dosage is also based on body weight , aand if you are diabetic, can aosl be based on your blood sugar. It isn't, obviously the same dosage for everyone. When I was on it ,it was 500mg in the am ,and 500 in the pm, then changed to 1000mg at night. C. S.

I use metformin for type 2 diabetes, and have experimented a lot with timing of doses (along with testing my blood glucose). Neither my doctor nor three different pharmacists were able to give me advice on this. Everyone is unique, so there could be variations on this pattern, but it works most effectively for me when I take it 30-60 minutes before a meal that will contain any carbohydrates (even veggies have some).

I don't know what action your doctor is looking for when TTC, but I'll bet the problem is largely linked to insulin resistance. I think Tara is right that in general, most people are usually less active after dinner, so use up those late-day carbs more slowly. Thus, a larger dose with a larger meal makes sense.