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Biguanide — Gestational Diabetes / PCOS Pregnancy: Used in gestational diabetes and PCOS; long-term safety data reassuring but continue discussion with patient

Metformin (Gestational Diabetes / PCOS)

Brand names: Glucophage

Adult dose

Dose: 500-2000 mg/day in divided doses
Route: Oral (with meals)
Frequency: Two to three times daily
Max: 2500 mg/day
Gestational diabetes: NICE NG3 — metformin first-line pharmacological therapy when diet alone fails, before or alongside insulin. PCOS: off-label for ovulation induction and menstrual regulation

Paediatric dose

Dose: Not applicable in obstetric context N/A/kg
Route: Oral
Frequency: N/A
Max: N/A
Maternal medication

Dose adjustments

Renal

Avoid if eGFR under 30; reduce dose if eGFR 30-44; review at eGFR under 45

Hepatic

Avoid in hepatic impairment — lactic acidosis risk

Paediatric weight-based calculator

Maternal medication

Clinical pearls

  • NICE NG3 (Diabetes in Pregnancy): Metformin crosses the placenta — long-term follow-up data from MiG trial shows no adverse fetal outcomes; however, some centres avoid and use insulin only due to limited long-term neonatal data
  • PCOS: reduces insulin resistance, restores menstrual cycles in oligomenorrhoea, and improves ovulation rates — off-label use supported by ESHRE/ASRM PCOS guidelines
  • Ovarian hyperstimulation syndrome (OHSS) prevention in PCOS: metformin during IVF stimulation reduces OHSS risk
  • GI side effects: start at 500 mg once daily and titrate slowly over 4-8 weeks to improve tolerance; modified-release formulation better tolerated
  • Post-partum: continue in women with T2DM or pre-diabetes; review in gestational diabetes — usually stopped after delivery as glucose normalises

Contraindications

  • eGFR under 30
  • Hepatic impairment
  • Iodinated contrast media within 48 hours

Side effects

  • GI upset (nausea, diarrhoea, abdominal discomfort — most common, usually transient)
  • Lactic acidosis (rare, serious — predisposing factors: renal/hepatic impairment, dehydration)
  • Vitamin B12 deficiency (long-term use)
  • Metallic taste

Interactions

  • Iodinated contrast (hold metformin before IV contrast; restart 48 hours after if renal function stable)
  • Alcohol (increases lactic acidosis risk)

Monitoring

  • Blood glucose (fasting and post-prandial)
  • HbA1c
  • eGFR annually
  • Vitamin B12 (if long-term use)

Reference: BNFc; BNF 90; NICE NG3 (Diabetes in Pregnancy); MiG Trial (Rowan et al. NEJM 2008); ESHRE/ASRM PCOS Guidelines 2023. Verify against your local formulary and the latest BNF before prescribing.

Related

Curated clinical cross-links plus same-class fallbacks.