Active ingredient: metformin
This happens not only in presentations containing metformin alone, but also in those that contain at once other antidiabetic agents. However, clinical relevance of this reduction of bioavailability is low.
Other studies seem to suggest that the decline in the rate of absorption is reduced only in the presence of low-fat meals (and high in carbohydrates).
Despite the above, it is preferable to take this medicine with or after meals to reduce gastrointestinal side effects of metformin.
Alcohol should be avoided, as well as drugs that contain it, for risk of lactic acidosis, particularly in patients with liver disorders.
1: Sambol NC, Brookes LG, Chiang J, Goodman AM, Lin ET, Liu CY, Benet LZ. Food intake and dosage level, but not tablet vs solution dosage form, affect the absorption of metformin HCl in man. Br J Clin Pharmacol. 1996 Oct;42(4):510-2.
2: He YL, Flannery B, Campestrini J, Leon S, Zinny MA, Ligueros-Saylan M, Jarugula V. Effect of food on the pharmacokinetics of a vildagliptin/metformin (50/1000 mg) fixed-dose combination tablet in healthy volunteers.Curr Med Res Opin. 2008 Jun;24(6):1703-9. doi: 10.1185/03007990802114070.
3: Marathe PH, Arnold ME, Meeker J, Greene DS, Barbhaiya RH. Pharmacokinetics and bioavailability of a metformin/glyburide tablet administered alone and with food.J Clin Pharmacol. 2000 Dec;40(12 Pt 2):1494-502.
4. Saffar F, Aiache JM, Andre P.Influence of food on the disposition of the antidiabetic drug metformin in diabetic patients at steady-state.Methods Find Exp Clin Pharmacol. 1995 Sep;17(7):483-7.