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Metformin (Glucophage) SACHETS discontinuation Merck Serono is discontinuing metformin 500mg and 1000mg sachets due to unforeseen manufacturing issues. Advice to Prescribers. Practices are advised to review all patients currently receiving metformin oral powder sachets to determine if a liquid formulation is still clinically appropriate. 1. Patients able to swallow tablets should be switched to metformin standard release tablets. 2. Metformin modified release (MR) tablets are oval-shaped and may be easier to swallow than standard release tablets. These could be considered in patients who are receiving other medication as solid dosage forms but just unable to swallow immediate release metformin. 3. There is a licensed liquid alternative, metformin oral solution 500 mg / 5 ml (£69.56 per 150ml) which should be offered to patients with swallowing difficulties or patients on a PEG tube. This is also the preferred choice of Warrington and Halton Hospitals Foundation Trust. Long term need for liquid formulation should be reviewed regularly at medication reviews. Product Metformin tablets 500mg tds Metformin MR tablets 500mg 3/day Metformin oral solution sugar-free 500mg/5ml 500mg tds Discontinued product: metformin sachets 500mg tds Lucy Reid Senior Prescribing Adviser 3rd June 2014 Cost for 28 days (Drug Tariff April 2014) £2.61 £7.98 £194.77 £9.21