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Metformin gastrointestinal effects — GPhC CRA MCQ

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HardEndocrine TherapeuticsMetformin gastrointestinal effectsGPhC CRA

A 55-year-old newly started on metformin immediate-release 500mg twice daily reports diarrhoea and abdominal discomfort after one week. His diabetes review is due in two weeks. What would you advise the patient?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: C — Take doses with meals and discuss gradual titration or modified-release if symptoms persist

Metformin commonly causes gastrointestinal adverse effects, particularly at initiation or after dose increases. Taking it with meals and gradual titration can improve tolerability, and modified-release metformin may be considered by the prescriber. Persistent or severe symptoms need review rather than unsupervised dose escalation.

Reference: BNF; NICE CKS