J Assoc Physicians India. May; Efficacy of once- or twice-daily extended release metformin compared with thrice-daily immediate release. Metformin oral tablet is a prescription drug that's used along with diet and exercise to Typical starting dosage: mg, twice per day, or mg, once per day. Metformin alone (Fortamet®): At first, milligrams (mg) once a day taken with the evening meal. Your doctor may increase your dose if. If you pass out because of a low sugar reaction or cannot swallow, someone will have to give you an injection of glucagon to treat the low sugar reaction. The extended-release form of this drug has not been established as safe and effective for use in children younger than 18 years. Carefully follow the special meal plan your doctor gave you. The following information describes dosages that are commonly used or recommended. In addition, since there are different formulations of metformin ER in each country, we can suggest to replace the total daily dose of metformin IR with the same daily dose of metformin ER divided twice a day. Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. Metformin Images. Research in animals has not shown negative effects to the fetus when the metflrmin takes the drug. If you have here questions, ask your doctor. Note that especially for metgormin 2 folks out there on metformin and insulin or sulfonylureas, hypoglycemia is a real risk.