Skip to main content
British Journal of Clinical Pharmacology logoLink to British Journal of Clinical Pharmacology
. 1981 Aug;12(2):235–246. doi: 10.1111/j.1365-2125.1981.tb01206.x

Metformin kinetics in healthy subjects and in patients with diabetes mellitus

G T Tucker, C Casey, P J Phillips, H Connor, J D Ward, H F Woods
PMCID: PMC1401849  PMID: 7306436

Abstract

1 The kinetics of metformin were studied after i.v. and oral administration in four healthy subjects and after oral administration in twelve maturity onset (Type II) diabetic patients.

2 After i.v. administration most of the dose was rapidly eliminated but with a mean `terminal' T1/2 of 4 h measured up to 12 h in plasma and of 16 h measured up to 60 h from the urinary excretion rate. On average, 80% of the dose was recovered as unchanged drug in the urine with none detected in the faeces.

3 After single oral doses (0.5 and 1.5 g), maximum plasma concentrations and urinary excretion rates were observed at about 2 h with urinary recoveries of unchanged drug of 35-50% and faecal recoveries of about 30%. Urinary recoveries were significantly lower after the higher dose. Absolute oral bioavailability was 50-60% of the dose.

4 Deconvolution analysis showed that after a short lag-time, the available oral dose was absorbed at an exponential rate over about 6 h. Implications for the design of prolonged release dosage forms are discussed.

5 Plasma metformin concentrations measured throughout the seventh and fourteenth days of continuous 0.5 g twice daily treatment were accurately predicted from single dose data, although a discrepancy between observed and predicted trough levels reflected the existence of a slow elimination phase. Implications of the latter for a gradual accumulation of metformin in peripheral tissues and a possible association with lactic acidosis are discussed.

6 Renal clearance of metformin was highly correlated with creatinine clearance. However, a weaker relationship between total oral clearance of the drug and creatinine clearance suggests that the latter may not always be a reliable indicator of potential metformin accumulation owing to variability in absorption and possibly non-renal clearance of the drug,

Full text

PDF
235

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Assan R., Heuclin C., Ganeval D., Bismuth C., George J., Girard J. R. Metformin-induced lactic acidosis in the presence of acute renal failure. Diabetologia. 1977 May;13(3):211–217. doi: 10.1007/BF01219702. [DOI] [PubMed] [Google Scholar]
  2. Beckmann R. Resorption, Verteilung im Organismus und Ausscheidung von Metformin. Diabetologia. 1969 Oct;5(5):318–324. doi: 10.1007/BF00452906. [DOI] [PubMed] [Google Scholar]
  3. Bergman U., Boman G., Wiholm B. E. Epidemiology of adverse drug reactions to phenformin and metformin. Br Med J. 1978 Aug 12;2(6135):464–466. doi: 10.1136/bmj.2.6135.464. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Boxenbaum H. G., Riegelman S., Elashoff R. M. Statistical estimations in pharmacokinetics. J Pharmacokinet Biopharm. 1974 Apr;2(2):123–148. doi: 10.1007/BF01061504. [DOI] [PubMed] [Google Scholar]
  5. Gomeni C., Gomeni R. IGPHARM: interactive graphic package for pharmacokinetic analysis. Comput Biomed Res. 1978 Aug;11(4):345–361. doi: 10.1016/0010-4809(78)90017-4. [DOI] [PubMed] [Google Scholar]
  6. Gonda I., Harpur E. S. Accumulation in the peripheral compartment of a linear two-compartment open model. J Pharmacokinet Biopharm. 1980 Feb;8(1):99–104. doi: 10.1007/BF01059451. [DOI] [PubMed] [Google Scholar]
  7. Irsigler K., Kritz H., Regal H., Kaspar L. Biguanid-induzierte und Biguanid-assoziierte Laktazidose. Serum- und Gewebsspiegel der Biguanide bei Hyperlaktämie und Laktazidose. Wien Klin Wochenschr. 1979 Jan 19;91(2):59–65. [PubMed] [Google Scholar]
  8. Lennard M. S., Casey C., Tucker G. T., Woods H. F. Determination of metformin in biological samples. Br J Clin Pharmacol. 1978 Aug;6(2):183–185. doi: 10.1111/j.1365-2125.1978.tb00852.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Loo J. C., Riegelman S. New method for calculating the intrinsic absorption rate of drugs. J Pharm Sci. 1968 Jun;57(6):918–928. doi: 10.1002/jps.2600570602. [DOI] [PubMed] [Google Scholar]
  10. Pentikäinen P. J., Neuvonen P. J., Penttilä A. Pharmacokinetics of metformin after intravenous and oral administration to man. Eur J Clin Pharmacol. 1979 Sep;16(3):195–202. doi: 10.1007/BF00562061. [DOI] [PubMed] [Google Scholar]
  11. Phillips P. J., Thomas D. W., Harding P. E. Biguanides and lactic acidosis. Br Med J. 1977 Jan 22;1(6055):234–234. doi: 10.1136/bmj.1.6055.234-b. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Sirtori C. R., Franceschini G., Galli-Kienle M., Cighetti G., Galli G., Bondioli A., Conti F. Disposition of metformin (N,N-dimethylbiguanide) in man. Clin Pharmacol Ther. 1978 Dec;24(6):683–693. doi: 10.1002/cpt1978246683. [DOI] [PubMed] [Google Scholar]
  13. Vaughan D. P., Dennis M. Mathematical basis of point-area deconvolution method for determining in vivo input functions. J Pharm Sci. 1978 May;67(5):663–665. doi: 10.1002/jps.2600670524. [DOI] [PubMed] [Google Scholar]

Articles from British Journal of Clinical Pharmacology are provided here courtesy of British Pharmacological Society

RESOURCES