Austell Metformin is metformin, the first-line medicine for type 2 diabetes. It comes as 500 mg and 850 mg tablets. It lowers blood sugar without causing hypoglycaemia on its own, does not cause weight gain, and has the longest safety record of any diabetes tablet.
What is Austell Metformin?
The South African Medicine Price Registry lists two strengths, both Schedule 3:
| Product | Form | Strength |
|---|---|---|
| Austell-Metformin | Tablet | Metformin hydrochloride 500 mg |
| Austell-Metformin | Tablet | Metformin hydrochloride 850 mg |
Austell is the manufacturer; metformin is the medicine. Metformin is registered here under many names, and being given a different brand is ordinary generic substitution.
Metformin is a biguanide, and it works in three places at once:
- The liver. Its main effect. The liver continuously releases glucose into the blood, and in type 2 diabetes it releases too much. Metformin reduces that output.
- Muscle and fat. It improves how well cells respond to insulin — reducing insulin resistance, which is the core problem in type 2 diabetes.
- The gut. It slows glucose absorption from food, which contributes to the effect and also explains most of the side effects.
The important consequence: metformin does not make the pancreas release more insulin. That is why, taken on its own, it does not cause low blood sugar — a substantial advantage over the sulfonylureas, and the main reason it sits first in almost every treatment guideline in the world.
It is also weight-neutral or slightly weight-reducing, where several other diabetes medicines cause weight gain.
The 500 mg and 850 mg strengths are the same medicine. Metformin is started low and increased gradually over weeks, because building the dose slowly is what prevents the digestive side effects that otherwise make people stop.
What is Austell Metformin commonly used for?
- Type 2 diabetes — first-line treatment, alongside diet and activity, and continued when other medicines are added.
- Prediabetes, in some prescribing, to reduce progression to diabetes.
- Polycystic ovary syndrome (PCOS) — improving insulin resistance, helping restore ovulation and regularise cycles. A common use, and a frequent reason younger women are prescribed it.
- Gestational diabetes, in some cases, on specialist advice.
- Preventing weight gain with certain antipsychotic medicines.
It is not insulin, and it is not a cure. Type 2 diabetes is a progressive condition, and needing a second medicine later is the natural course of it rather than a personal failure — a distinction worth holding onto, because people frequently read an added tablet as a verdict on their discipline.
What it is actually for is preventing complications. High blood sugar damages small blood vessels over years, causing eye, kidney and nerve damage, and it accelerates heart disease and stroke. Metformin lowers blood sugar and, uniquely among the older diabetes tablets, has evidence for reducing cardiovascular events.
None of that is felt day to day, which is exactly why people stop taking it.
How Austell Metformin fits into this medicine category
| Group | Examples | Notes |
|---|---|---|
| Biguanides | Metformin (Austell Metformin) | First-line; no hypoglycaemia alone; weight-neutral |
| GLP-1 agonists | Semaglutide (Ozempic), tirzepatide | Injections; substantial weight loss |
| SGLT2 inhibitors | Empagliflozin, dapagliflozin | Glucose excreted in urine; heart and kidney benefits |
| Sulfonylureas | Gliclazide, glimepiride | Stimulate insulin release; can cause hypoglycaemia and weight gain |
| DPP-4 inhibitors | Sitagliptin, linagliptin | Well tolerated, modest effect |
| Insulin | Various | Replaces or supplements the body’s own |
Metformin is usually kept when others are added rather than replaced. See the endocrine and diabetes medicines hub and the guide to metformin.
What to check before using Austell Metformin
Kidney function is the central check. Metformin is cleared by the kidneys, and if they are not working well it accumulates. The dose is reduced in moderate kidney impairment and stopped in severe impairment. Kidney function is checked before starting and periodically thereafter — keep those blood tests.
Tell your doctor or pharmacist if you:
- Have kidney disease, or anything that could suddenly reduce kidney function.
- Have liver disease, heart failure, or a recent heart attack.
- Drink alcohol heavily, which raises the risk of lactic acidosis.
- Are due for a scan with contrast dye, or surgery. Metformin is usually stopped beforehand and restarted once kidney function is confirmed — tell the radiology or surgical team.
- Take diuretics, ACE inhibitors, anti-inflammatories, steroids, or cimetidine.
- Are pregnant, planning pregnancy or breastfeeding — metformin is used in pregnancy in some circumstances, but this should be a clinician’s decision.
Sick day rules matter and are rarely explained. If you develop vomiting, diarrhoea, a high fever, or cannot drink normally, you can become dehydrated quickly, and dehydration is what turns metformin from safe into dangerous. Stop metformin during such an illness and contact your doctor or clinic, restarting once you are eating and drinking normally again.
Practical points:
- Take it with or just after food, which greatly reduces stomach upset.
- Build the dose up slowly as prescribed.
- Ask about the slow-release form if side effects persist — it is often much better tolerated.
- Do not stop because your sugar is normal. That is the medicine working.
Possible cautions and when to ask a pharmacist or doctor
The common effects are nausea, diarrhoea, abdominal discomfort, wind, a metallic taste and reduced appetite. They are worst in the first weeks and after dose increases, and they are the main reason people abandon the medicine — usually unnecessarily, since taking it with food, increasing the dose more slowly, or switching to slow-release solves it for most.
Long-term use can cause vitamin B12 deficiency, which develops silently over years and can cause tiredness, numbness or tingling. B12 is worth checking periodically, particularly if you have been on metformin for several years.
Get emergency help for signs of lactic acidosis — rare, but serious:
- Deep or rapid breathing, or unusual breathlessness
- Severe muscle pain or cramps
- Severe abdominal pain with vomiting
- Unusual tiredness, weakness or feeling very cold
- Dizziness, or a slow or irregular heartbeat
This is far more likely when kidney function has dropped, during dehydrating illness, or with heavy alcohol use.
Contact your doctor if side effects persist beyond a few weeks, if blood sugars stay high, if you develop numbness or tingling in the hands or feet, if you are unwell and unsure whether to keep taking it, or if you are about to have a scan or an operation.
Related medicine guides
Frequently asked questions
What is Austell Metformin used for? Type 2 diabetes, as first-line treatment alongside diet and activity. It is also used for polycystic ovary syndrome and sometimes for prediabetes.
What is the difference between 500 mg and 850 mg? Only the amount. Treatment starts low and is increased gradually to reduce stomach side effects.
Does it cause low blood sugar? Not on its own — it does not push the pancreas to release insulin. Low blood sugar becomes a risk when combined with insulin or a sulfonylurea.
Why does it upset my stomach? Metformin acts partly in the gut. Take it with food, increase the dose slowly, and ask about the slow-release form if it persists.
Should I stop it if I have a stomach bug? Yes — stop it during vomiting, diarrhoea or fever where you cannot drink normally, and contact your clinic. Dehydration is what makes metformin risky.
Can I stop it when my sugar is normal? No. A normal reading means it is working. Any change should be your doctor’s decision.
Why was I prescribed it for PCOS? It improves insulin resistance, which underlies PCOS in many women, and can help restore ovulation and regularise cycles.
Do I need a scan precaution? Tell the radiology team you take metformin before any scan using contrast dye — it is usually stopped beforehand.