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Can I take two metformin at once?

Metformin is a commonly prescribed medication used to treat type 2 diabetes. It helps control high blood sugar by decreasing the amount of glucose released by the liver and increasing insulin sensitivity. Metformin is often recommended as a first line treatment for type 2 diabetes, but many people wonder if they can take two metformin pills at the same time to increase the effects or make up for a missed dose.

Quick Answer

In most cases, it is not recommended to take two metformin pills at the exact same time. Metformin is meant to be taken at regular intervals throughout the day, usually with meals. Taking two pills together can increase the risk of side effects. However, in some situations where a higher dosage is required, a doctor may prescribe two pills to be taken together. It’s important to follow the specific dosing instructions provided by your doctor and never double up on doses unless explicitly told to do so.

Can You Take 1000mg Metformin Twice A Day?

Yes, taking 1000mg of metformin twice per day, once in the morning and once in the evening, is a commonly prescribed dosing regimen. This totals 2000mg per day. Doctors may start at a low dose of metformin like 500mg once or twice per day, then increase to 1000mg twice a day as needed to control blood sugar levels. Taking 1000mg metformin twice a day, about 12 hours apart, is safe for most people if prescribed by a doctor. It allows the medication to work throughout the day and night.

Is It Safe To Take Two 500mg Metformin At Once?

No, it is generally not recommended to take two 500mg metformin tablets at the exact same time. The typical dosing for metformin is one 500mg pill twice a day, or one 1000mg pill twice a day. Taking two 500mg tablets together doubles the regular dose and may increase the risk of side effects like:

  • Nausea
  • Diarrhea
  • Stomach pain
  • Vomiting
  • Metallic taste in the mouth

In rare cases, very high metformin doses can cause a serious side effect called lactic acidosis. Symptoms include muscle cramps, fast heart rate, dizziness, and feeling faint. Lactic acidosis is more likely at doses of metformin higher than 2000mg per day.

When Would A Doctor Prescribe Two Metformin At Once?

In most cases, doctors will start with a low dose of metformin and increase gradually over time to avoid side effects. However, some situations where a doctor may prescribe two metformin tablets at once include:

  • A person has severe insulin resistance and needs a high dose.
  • The branded regular-release metformin tablets come in strengths of 500mg or 850mg. To make up other doses like 1000mg, 1500mg or 2000mg, two pills may be prescribed together.
  • A person is switching from regular metformin to extended-release metformin. The extended-release dose may be 1000mg or 2000mg once per day.

If your doctor has instructed you to take two metformin tablets at the same time, follow their specific directions carefully. Never double up doses on your own without consulting your doctor first.

Can You Take Two Metformin If You Miss A Dose?

No, you should not take two metformin tablets to make up for a missed dose. Doubling up on a dose increases the risk of side effects. If you miss a dose of metformin, here are some general guidelines on what to do:

  • If it has been over 12 hours since when you should have taken metformin, skip the missed dose and continue with your regular dosing schedule.
  • If it has been less than 12 hours, you may take the usual prescribed dose. Do not take two pills.
  • Avoid taking metformin with meals, as food can delay its absorption. Take it either before a meal or 1-2 hours after eating.
  • Do not take an extra dose later in the day.
  • Be sure to take your next scheduled dose as directed.

If you frequently miss doses or are unsure about making up missed metformin doses, talk to your doctor for specific advice.

Can You Split Metformin Tablets In Half?

Metformin tablets are not scored down the middle, so they should not be split in half. Breaking tablets without a score mark could result in uneven dosing. However, metformin is available in different tablet strengths like 500mg, 750mg, and 1000mg. Doctors may prescribe multiple strengths and direct you to take them together to make up the desired dose without splitting tablets.

What Are The Side Effects Of Taking Too Much Metformin?

Taking more metformin than prescribed can increase the risk of common gastrointestinal side effects like:

  • Diarrhea
  • Nausea
  • Vomiting
  • Stomach pain
  • Loss of appetite

More serious side effects are possible with metformin overdoses over 2000mg per day. These include:

  • Lactic acidosis – buildup of lactic acid in the bloodstream
  • Heavy or labored breathing
  • Dizziness or lightheadedness
  • Muscle pain or weakness
  • Cool, pale skin
  • Irregular heartbeat
  • Unusual sleepiness or tiredness

If you experience these reactions, seek medical attention immediately. Lactic acidosis from metformin is rare but potentially fatal if untreated. Notify your doctor right away if you take too much metformin.

Precautions When Taking Multiple Metformin Tablets

If your doctor instructs you to take multiple metformin tablets at certain times of the day, keep these precautions in mind:

  • Take them exactly as prescribed. Do not increase or double up doses on your own.
  • Space out the dosing times as directed, usually one dose in the morning and one dose in the evening.
  • Always check the dose of each pill before taking more than one at a time.
  • Eat regular meals and do not skip food. Metformin can cause stomach upset, especially on an empty stomach.
  • Stay hydrated by drinking water throughout the day to avoid dehydration.
  • Monitor your blood sugar closely when first starting this dosing regimen.
  • Contact your doctor if you experience concerning side effects.


In summary, taking two metformin tablets at once is generally not recommended and may increase the risk of side effects. However, some doctors may prescribe two pills to be taken together to make up a higher dose when needed. If your doctor advises taking multiple metformin tablets simultaneously or twice daily, follow their instructions carefully. Do not increase your dosage unless a doctor directs you to do so. Be aware of potential side effects and monitor your blood sugar closely when taking higher doses of metformin. Contact your healthcare provider with any concerns.

Other Frequently Asked Questions

How long does it take for metformin to work?

It may take a few weeks for the full effects of metformin to be felt. You may see improvements in blood sugar control in 1-2 weeks, but the maximum benefit may take up to 2-3 months. Metformin works gradually to lower blood sugar and A1C levels.

Should metformin be taken with or without food?

Metformin is ideally absorbed on an empty stomach, so many doctors recommend taking it before a meal or 1-2 hours after eating. However, taking metformin with food may help reduce stomach side effects if you experience them.

Can you drink alcohol while taking metformin?

Moderate alcohol consumption is usually okay with metformin. However, taking metformin and drinking excessive amounts of alcohol can increase the risk of lactic acidosis. Heavy or binge drinking is not recommended.

Does metformin cause weight loss?

Metformin does not directly cause weight loss, but may help stabilize or reverse weight gain associated with type 2 diabetes. By improving insulin sensitivity and lowering blood sugar, metformin may promote mild weight loss in some people.

What is the maximum daily dose of metformin?

The maximum recommended daily dose of metformin is 2550mg taken in divided doses. Doses above 2000mg may increase the risk of developing lactic acidosis in some people.