Compounding Transdermal Metformin for Diabetes

More than 21 million adults in the United States have been diagnosed with Type 2 Diabetes, and over 84 million more adults have been diagnosed with pre-diabetes. Prediabetes is a condition where your blood sugar levels are higher than normal, but not quite high enough to warrant a diabetes diagnosis. It means the patient is trending in the wrong direction.

Fortunately, both of these conditions can be reversed by implementing lifestyle changes such as exercising regularly, and eating healthier… especially by monitoring carbohydrate (sugar) intake. If your doctor determines that pharmacologic therapy is necessary, the first line agent in both of these conditions is a drug called metformin. Metformin is a good drug, and can help stave off the progression of diabetes. However, some patients have trouble with taking their metformin medication because it happens to be a rather large pill to swallow. It is also associated with some gastrointestinal side effects, such as: diarrhea, bloating, nausea, vomiting, and flatulence. These side effects cause issues with patients taking their medication as prescribed.

How can we get this important diabetes medication into the system without these annoying gastrointestinal side effects? One way that we have used in our practice is through the transdermal route of administration. Transdermal creams can push the metformin through the skin, and into the bloodstream, bypassing the GI system altogether! This GI avoidance drastically reduces the amount of GI side effects of the drug. As an additional bonus, for those patients who have trouble swallowing large pills, there is no pill to swallow. The medicine comes as an easily absorbable cream that the patient applies to the inner arm or inner thigh.

Another benefit to this medication is that you only have to use 10% of the oral dose for it to be effective! This is easier on the metabolic system of the body. For example, say your doctor wrote a prescription for you to take metformin 500mg by mouth twice daily with food. To convert this dose to a cream, you would only have to apply 50mg of the drug transdermally to have the same desired effect. All of these benefits make compounding transdermal metformin for diabetes a great option for pre-diabetic patients, and patients with controlled A1c values who have been diagnosed with diabetes.