Patient/caregiver was educated on how to take Metformin as follows:

1. Take the medication at the same time, every day, to avoid forgetting the medication. Taking this medication at regularly spaced intervals along with compliance for recommended dietary measures helps to prevent any gross fluctuations in blood sugar numbers and maintain them in the target range. This can also help with preventing any undesired side-effects and toxicity with the medication.
2. Maintain strict compliance with intake of the medication as ordered, with regards to dosage and frequency, to derive the benefit of the medication.
3. Do not change the dose on metformin without consulting your physician.
4. This medication can induce some nausea, vomiting, and metallic taste in the mouth, especially when taken on empty stomach. Taking the medication with a glass of water and some food or snack can help avoid/reduce these unpleasant gastrointestinal symptoms.
5. Do not take metformin with alcohol. Both metformin and alcohol can independently contribute to increased acid ion and induce risk for acidosis in the body. Taken together, they can complement each other, to increase this risk significantly.
6. Discuss with your physician or nutritionist regarding your recommended diet plan and calorie intake limitations, if any. Observe compliance with any recommendations made to derive the benefit of metformin intake. Grossly overeating or undereating in comparison to the recommended calorie intake can lead to poor blood sugar control and compromise the therapeutic benefit of metformin.
7. Do not skip a meal, while taking any medications to regulate your blood sugars. Skipping a meal or undereating can bring the blood sugars down. Observing compliance with medication intake in the backdrop of skipped meal or undereating can lower the blood sugars to dangerous levels, thus precipitating an emergency.
8. Determine your meal and snack times and strictly adhere to the time. Observing compliance with the time of nutrition intake and the time of medication intake can help significantly with the goal of regulating blood sugar numbers at the desired level and prevent development of undesired complications.
9. Observe compliance with checking your blood sugar readings, as recommended by your doctor. Maintaining a log of all the blood sugar readings helps for a comparative feedback, as to how well the drug is helping control the blood sugars.
10. Take the regular tablet as a whole with a glass of water. If you encounter difficulty swallowing the whole regular tablet, check with your doctor if you may cut the pill and swallow it in pieces with a glass of water. Usually tablets that can be cut bear a scoreline, displaying the line of cut. Check if your tablet has any. For individuals with severe swallowing difficulties, check with your doctor if you may also crush the tablet and sprinkle the powder on a spoonful of soft jelly or applesauce and swallow the jelly or sauce along with the medication. Other preparations of medication could also be available to help an easy intake. Check with your physician on the same.
11. Metformin could be prescribed as an extended-release tablet. If you are prescribed an extended-release tablet of metformin, do not cut or crush the extended-release tablet. Cutting or crushing the extended-release tablet can result in rapid absorption of the drug into the blood stream, thus resulting in toxicity and compromised therapeutic effect. Swallow the extended-release tablet or capsule as a whole, using a glass of water.
12. Metformin could also be prescribed as an oral syrup/suspension, especially for individuals with swallowing difficulty. When taking metformin as an oral syrup/suspension, use a measuring spoon/cup to measure the correct dose being taken, in order to avoid risk for over/under dosing. Also, do not forgot to shake the suspension well before you use it. This oral suspension can be concentrated and likely to precipitate unpleasant nausea and vomiting sensations. Mixing the concentrated liquid medication into a salad or snack and consuming it after gentle stirring for a few seconds can help avoid the unpleasant gastrointestinal symptoms.
13. Observe compliance with taking your daily blood sugar readings, as recommended. Log maintenance of all the blood sugar readings help for a comparative feedback. Maintaining a log of dietary items consumed on each meal and snack can provide input with regards to foods that help/harm your plan for blood sugar regulation.
14. Metformin can take some time, about a week or ten days, to fairly adjust to your body, before improvement in blood sugar control and stabilization of blood sugar readings is noticed. So, do not discontinue taking the medication without your physician’s consult, as you failed to see the desired result immediately after taking the medication.
15. While taking metformin, notify your doctor of any continuing poorly controlled blood sugars. This can assist your doctor with increasing the dose of metformin or adding another medication to help better control your numbers on blood sugar. Also, notify your doctor regarding any continuing or worsening unpleasant side-effects of metformin use, so that, your dosage on the medication could be revised.
16. If the blood sugars are getting too low with metformin use, despite compliance with recommended calorie intake, your dose of metformin may need to be revised or change of plan considered. Notify your physician regarding any overly corrected blood sugars with metformin use, resulting in episodes of hypoglycemia with extremely low blood sugars, confusion, and dizziness.
17. While taking metformin, periodical labs could be ordered for evaluation of kidney functions. So, maintain compliance with follow-up physician appointments and lab draws ordered to evaluate kidney function. Be accommodative to the plan of dose changes to achieve an optimum blood sugar control response and prevent development of any undesired side-effects.
18. If you miss a dose, try taking it at the earliest notice of noncompliance. If it is time for the next dose, skip the missed dose and take the dose scheduled. Do not take an extra dose to try making up for the missed dose, which can result in toxicity and an episode of dangerous hypoglycemia. Notify your doctor and other health care personnel regarding your dose noncompliance.