Metformin Dosage Guide in Pakistan

Q: Metformin kitni dose se start karni chahiye?

500mg once daily dinner ke sath — pehle haftay. Phir 500mg twice daily (breakfast + dinner). Dose barhane mein jaldi nahi karni — stomach problems avoid hote hain.

Q: Metformin aur khana — timing kya hona chahiye?

Hamesha khane ke sath ya foran baad. Khali pait lena nausea aur diarrhea ka chance dramatically barhata hai.

Q: Maximum Metformin dose kitni hai?

2500mg per day (2–3 divided doses). Isse zyada dose ka benefit prove nahi hua aur side effects barhte hain.

Q: Kidney problem mein Metformin ki dose change hoti hai?

Haan. eGFR 45–60: max 1000mg/day, close monitoring. eGFR 30–45: max 500mg/day, caution. eGFR < 30: Metformin band karein.

Q: Extended-release (XR/SR) version better hai?

Haan, extended-release Metformin (once daily at dinner) stomach side effects less karti hai aur compliance improve hoti hai. Same efficacy.

Metformin ki sahi dose lena aur dheeray dheeray barhana stomach side effects kam karne ke liye zaroori hai. Is guide mein adult dose, elderly patients, kidney disease mein dose adjustment, aur missed dose guide hai.

Compiled by the PakVita Editorial Team · AI-assisted drafting with editorial review · Sourced from DRAP, WHO, BNF · Last updated: 2026-04-27

Dosage Guide

Quick Answer

Metformin standard starting dose is 500mg once daily with dinner. After 1–2 weeks, increase to 500mg twice daily with meals. Usual maintenance is 500–850mg twice daily. Maximum dose is 2500mg/day in 2–3 divided doses. Always take with food to minimise stomach side effects.

Dose at a Glance

Adult Dose

500mg once daily, titrate to 500–850mg twice daily

Twice daily with meals (breakfast + dinner)

Max: 2500mg/day in 2–3 divided doses

Child Dose (10 years and above only)

Not recommended under 10 years

10+ years — as prescribed by paediatrician (10mg/kg/day starting)

Missed Dose

Yaad aane par le lein agar meal time qareeb ho. Meal ke baghair na lein. Agar agli dose ka waqt aane wala ho to skip karein. Double dose kabhi na lein.

Overdose

Lactic acidosis — saans phoolna, muscle weakness, stomach dard, body thanda hona. Foran emergency se rabta karein.

Metformin Dosage (Kitni leni hai)

Metformin ki sabse zaroori baat yeh hai — dose slowly titrate karein. Jab bhi Metformin start ki jaye, dose gradually barhana stomach side effects (nausea, diarrhea) dramatically kam karta hai.

Standard Adult Titration Schedule

Week	Dose	Timing
Week 1	500mg once daily	Dinner ke sath
Week 2–4	500mg twice daily	Breakfast + Dinner ke sath
If needed	850mg twice daily	Breakfast + Dinner ke sath
Max	850mg three times daily or 1000mg twice daily	Meals ke sath

Maximum dose: 2500mg/day. Isse zyada lene ka koi proven benefit nahi.

Immediate-Release vs Extended-Release

Form	Dosing	Advantage
Immediate-release (IR)	2–3 times daily with meals	Cheaper, widely available
Extended-release (XR/SR)	Once daily at dinner	Fewer GI side effects, better compliance

XR form especially recommended for patients who develop diarrhea on IR.

Special Populations (Khaas Mareezon ke Liye Dose)

Elderly Patients (60+ saal)

Start low: 500mg once daily
Monitor kidney function (eGFR) every 6 months
Dose adjust as eGFR changes

Kidney Disease (Gurdey ki Bimari)

eGFR (mL/min/1.73m²)	Recommendation
≥ 60	Full dose (up to 2500mg/day)
45–59	Max 2000mg/day — monitor
30–44	Max 1000mg/day — caution, close monitoring
< 30	STOP — lactic acidosis risk

Hepatic Impairment

Mild/moderate: Use with caution
Severe liver disease: Avoid — lactate clearance impaired

Before Surgery or Contrast Scan (Zaroori)

CT scan ya angiography se 48 hours pehle Metformin band karein. Procedure ke baad bhi 48 hours wait karein before restarting (confirm with doctor that kidney function is stable).

Missed Dose (Dose Bhool Jayein)

Yaad aate hi le lein agar khana abhi kha rahe hain ya hua hai
Khali pait mat lein
Agli scheduled dose ka waqt aane wala ho: skip karein
Double dose kabhi nahi

Overdose (Zyada Dose)

Metformin overdose se lactic acidosis ka risk:

Symptoms: saans phoolna, severe weakness, stomach dard, body thanda hona, confusion
Foran hospital emergency — N-acetylcysteine ya dialysis zaroori ho sakta hai

Is guide ki maloomat sirf educational purpose ke liye hai. Dose hamesha doctor ya pharmacist se confirm karein.

Frequently Asked Questions

Metformin kitni dose se start karni chahiye?

500mg once daily dinner ke sath — pehle haftay. Phir 500mg twice daily (breakfast + dinner). Dose barhane mein jaldi nahi karni — stomach problems avoid hote hain.

Metformin aur khana — timing kya hona chahiye?

Hamesha khane ke sath ya foran baad. Khali pait lena nausea aur diarrhea ka chance dramatically barhata hai.

Maximum Metformin dose kitni hai?

2500mg per day (2–3 divided doses). Isse zyada dose ka benefit prove nahi hua aur side effects barhte hain.

Kidney problem mein Metformin ki dose change hoti hai?

Haan. eGFR 45–60: max 1000mg/day, close monitoring. eGFR 30–45: max 500mg/day, caution. eGFR < 30: Metformin band karein.

Extended-release (XR/SR) version better hai?

Haan, extended-release Metformin (once daily at dinner) stomach side effects less karti hai aur compliance improve hoti hai. Same efficacy.

Brand alternatives, same-class options, and other medicines used for the same conditions as Metformin Tablet.

Other diabetes medicines

Sibling medicines in the Diabetes Medicines class.

All in class →

Used for the same conditions

Other medicines commonly used for diabetes and overlapping conditions.

Diabetes hub →

Sources

BNF — Metformin Hydrochloride Dosage — BMJ Group & Pharmaceutical Press
DRAP Registered Products — Drug Regulatory Authority of Pakistan

Medical disclaimer

This page is for educational use only and does not replace professional medical advice. Always confirm diagnosis, dose, and interactions with a qualified doctor or pharmacist before starting or changing any medicine.