At what minimum dosage is Metformin typically prescribed for pregnant patients?

Metformin is commonly prescribed to manage gestational diabetes due to its effectiveness in improving insulin sensitivity and lowering blood glucose levels. In pregnant patients, a minimum dosage of 500 mg taken twice daily (BID) is generally established as effective for glycemic control and is well-tolerated. This dosage allows for gradual titration, helping to minimize gastrointestinal side effects that can occur with higher initial doses.

In clinical practice, starting at 500 mg BID is also a pragmatic approach, as it allows healthcare providers to adjust the dosage as needed based on the patient's response and tolerance. As the pregnancy progresses or if additional glycemic control is needed, the dosage can be increased as warranted.

Higher dosages, such as 750 mg or 1000 mg BID, are often used in patients who require more intensive management of their blood glucose levels, but starting at 500 mg BID is typically considered the minimum effective dose for initiating treatment.