Dosing & Administration
Adult Dose
500-1000 mg PO BID with meals. Max 2550 mg/day.
Pediatric Dose
500 mg PO BID (for children ≥10 years).
Renal Adjustment
eGFR 30-45: Do not initiate. Max 1000 mg/day if already on it. eGFR < 30: Contraindicated.
Hepatic Adjustment
Avoid in severe hepatic disease (increased risk of lactic acidosis).
Safety & Special Populations
Pregnancy Category
B - Generally considered safe.
Lactation Safety
Compatible.
Contraindications & Adverse Effects
Contraindications
- Severe renal impairment (eGFR < 30)
- Metabolic acidosis / DKA
Common Adverse Effects
- GI upset (Diarrhea, Nausea)
- Vitamin B12 deficiency
- Lactic acidosis (rare but fatal)