Can you take metformin during pregnancy?

Research suggests metformin may be safe to use during pregnancy, but more studies are needed to confirm the drug’s safety profile in pregnancy.

Metformin belongs to a class of medications known as biguanides. It comes in tablet and liquid form, and it’s sold under different brand names, including:

• Fortamet
• Glucophage
• Glumetza
• Riomet

Metformin helps lower the amount of sugar your body absorbs from food. Doctors prescribe this medication to treat treat type 2 diabetes, gestational diabetes, and polycystic ovary syndrome (PCOS).

Read on to learn more about whether it’s safe to take metformin while pregnant.

Is metformin safe during pregnancy?

According to one 2020 review, metformin is generally safe for treating gestational diabetes and type 2 diabetes during pregnancy. However, it’s not typically the first-line treatment in these cases.

Metformin crosses the placenta, exposing the fetus to the medication a few hours after the pregnant person takes the drug. 

A 2018 review suggests that taking metformin during pregnancy did not lead to increases in miscarriages or congenital irregularities in the child.

A 2019 review notes that taking metformin during pregnancy was associated with lower birth weights, but researchers also found that those infants experienced faster growth later in childhood.

Researchers agree that more studies are needed to understand the effects of metformin on the development of the fetus, the health of the pregnant person, and any possible implications for the children later in life. 

Metformin dosage and side effects

Doctors typically only prescribe metformin if your blood sugar levels are difficult to manage with other medications.

The usual starting dosage is 500 milligrams (mg) once or twice a day, depending on your physician’s recommendation.

Your healthcare professional will carefully check you throughout your pregnancy and determine whether to increase your dosage, lower your dosage, or stop the medication altogether.

If your doctor prescribes metformin to manage gestational diabetes or type 2 diabetes during pregnancy, you may experience side effects, including:

• diarrhea
• bloating
• stomach pain
• gas
• indigestion
• constipation
• heartburn
• headaches
• nail changes
• muscle pain

Talk with your healthcare professional if you experience any of these side effects. 

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Treatment of diabetes during pregnancy

The American Diabetes Association recommends the following to manage diabetes during pregnancy:

• Insulin injections: Insulin injections can help regulate your blood sugar levels. The dosage will depend on your weight, height, and how far along you are in your pregnancy.
• Other medication: Glyburide (Diabeta) is another medication that can help manage diabetes during pregnancy. But, like metformin, glyburide can pass through the placenta.
• Lifestyle strategies: Eating a balanced diet rich in nutrients and exercising safely during pregnancy can help manage gestational diabetes symptoms.

Summary

Metformin is a prescription medication doctors prescribe to treat type 2 diabetes and gestational diabetes.

Metformin can help reduce the amount of sugar your body absorbs from food. Because there’s limited research on its effects during pregnancy, it’s not the first-choice treatment for diabetes in pregnant people.

If you’re pregnant and have type 2 diabetes or develop gestational diabetes, talk with a healthcare professional about your treatment options.

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