| Summary: | Metformin is in the biguanide class that has been considered as the treatment for insulin
resistance diabetes and polycystic ovarian disease. Many mechanisms have been suggested for it
such as inhibition of the mitochondrial respiratory chain and mitochondrial glycerophosphate
dehydrogenase, activation of adenosine monophosphate-activated protein kinase, inhibition
of glucagon-induced elevation of cyclic adenosine monophosphate with reduced activation of
protein kinase A, an effect on gut microbiota and activation of adenosine monophosphateactivated
protein kinase. Metformin is a suppressor for transforming growth factor-β1 via
directly binding and interact with transforming growth factor-β1 receptor. Lactic acidosis is
one of the adverse and noxious effects of metformin. Nowadays, metformin has an important
role in inflammation pathways and antioxidant pathways that can prevent or decrease kidney
fibrosis, cardiac remodeling in hypertensive heart disease, and cell death in cerebral ischemia,
kidney crystal formation, immunological diseases and cancer. Although there has been strong
evidence for the potential harm caused by metformin, several studies have shown beneficial
effects for it. Hence, it is necessary to revision and modification in contraindications for
prescription of this drug
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