Can Metformin cause stomach pain and dry mouth?

Question

Hi doctor,

I recently started with Metformin tablet 1000 mg and raised it in 10 days up to 2000 mg. Since then, I have been feeling awful, and my adjustment was very rough as I felt nauseous. So, I skipped a day, and felt okay; the next day, I took it again and felt sick. Now I have permanent pain across my upper stomach, with a dry mouth, generally unwell after having medicine, and which goes up to the next day. I also have a history of gallbladder pain, so I am sensitive to what I eat. And years ago, I had the Metformin for PCOS and type 2 diabetes, but I stopped it as my diabetes number was stable with a plant-based diet. My laboratory test showed no issues except for A1C, which was high and all was normal. My A1C was 7.2 %. However, after two hours of eating last night, I had pain, and I am sick again this morning. I have taken a Metformin 1000 mg twice daily and Synthroid 25 mg for the last four years. So, my question is can it be a gallbladder or pancreas issue?

Thank you.

Answer 1

Hi,

Welcome to icliniq.com.

I have reviewed your case history in detail. As a tablet, Metformin is known to cause of gastric upset and upper abdominal discomfort. As you have already noticed, this occurs after increasing the dose of Metformin; I would like to suggest you reduce the dose or even stop it for a few days. You can visit your endocrinologist or physician to tell him that you are unable to tolerate a high dose of Metformin 2000 mg. Meanwhile, I would like to add some medicine for the symptomatic treatment of your complaints so that you can feel better. Consult your specialist doctor, talk to them, and take medications with their consent.

Take a tablet Pantoprazole 40 mg (proton pump inhibitor) a half hour before breakfast for one to three weeks for acid suppression.
Take 10 ml syrup Gaviscon (Sodium alginate, Sodium bicarbonate, and Calcium carbonate) after every meal.

And regarding your other question, whether it is coming from the gall bladder or not, for this, you have to go for an ultrasound abdomen, and liver function tests to rule out biliary causes of abdominal pain or your symptoms. But I feel Metformin (metformin hydrochloride) 2000 mg can cause such issues.

Thank you.