Metformin

Minimize acute COVID-19 symptoms and reduce the risk of developing Long COVID with metformin.

While metformin is best known for diabetes control, this FDA-approved medication may be used off-label to help you reduce your risk of getting Long COVID by as much as 53%.

Only pay if your prescription is approved.

Minimize acute COVID-19 symptoms

Metformin offers antiviral properties and, when given during acute COVID-19, helps to reduce symptom severity and minimize the risk of complications. A recent study shows that acute COVID-19 participants treated with metformin experienced a viral load four times lower than the placebo group.

Inflammation reduction

Metformin exhibits anti-inflammatory properties. Given that systemic inflammation characterizes both acute COVID-19 and Long COVID, there is a hypothesis that metformin’s effects may mitigate the severity of the initial acute infection and reduce the risk of Long COVID development.

Reduced risk of Long COVID  

Recent data presented in October 2024 at the Infectious Disease Week Annual Meeting shows a 53% reduction in Long COVID when metformin was prescribed within the first week of an acute SARS-CoV-2 infection.

Learn more about the promising benefits of metformin

Minimize Long COVID risk

Type II diabetes

Improve insulin sensitivity

Reduce inflammation

Reduce COVID-19 viral load

Metformin, derived from the French Lilac, has a long history of use in healthcare. Its excellent safety profile and affordability make it an effective on-label treatment for type II diabetes. Additionally, it is utilized off-label for purposes such as minimizing acute COVID-19 symptoms and reducing your Long COVID risk.

  • Metformin's mechanisms of action are multifaceted and contribute to its effectiveness as a treatment for type 2 diabetes and its potential benefits for other conditions. Metformin operates by these primary mechanisms:

    • Gluconeogenesis inhibition

    • Increased insulin sensitivity

    • Decreased absorption of glucose in the intestine

    • Activation of AMPK

    • Antiviral properties against SARS-CoV-2

    • Gut microbiota modulation

    • Anti-inflammatory effects

  • Metformin can be used to treat a variety of persistent and new symptoms impacting patients living with acute COVID-19. Metformin helps to:

    • Reduce symptoms severity during acute COVID-19 infection.

    • Reducing your risk of developing Long COVID after an acute infection.

  • While metformin is safe, there can be mild side effects that can occur during the first few months of use as your body adapts to the medication. These side effects can be mitigated by taking metformin with food. These can include:

    • Passing gas

    • Diarrhea

    • Nausea

    • Heartburn

    • Headache

    • Loss of strength or energy

    • Low blood sugar

    • Muscle pain

    • Unpleasant metallic taste

Ready to try metformin?

Take advantage of metformin in three easy steps.

Fill out a condition assessment.

1

Share your symptoms, current conditions, allergies, and complete a health assessment.

Our clinicians will review your health profile.

2

An expert clinician from RTHM Direct will review your assessment within 1 business day and prescribe the requested medication if it is a good fit for your case. Pay $0 unless medication is prescribed.

Get approved and pick-up your prescription.

3

Pick up and pay for the prescribed treatments at your preferred pharmacy using the coupon card we provide.

Pricing

Estimated price for 90 days

Online Assessment

Metformin (estimated price for 90 days)

Estimated total for 90 days

$49

$10.95*

$59.95

No payment is required until a prescription is approved. * Cash price using CareCard discount varies per pharmacy and location.

RTHM patient voices 

“RTHM has given me hope. After struggling with Long COVID for two years, even with the help of a Long COVID clinic, I was still doing all of my own research and trying to keep my doctors advised of the state of the art in treatments.”

— Stuart S.

How do RTHM clinicians prescribe metformin?

Every patient’s journey towards health is unique, especially when managing chronic, complex conditions like Long COVID and ME/CFS. That is why we start patients at lower doses and gradually increase them to find the most effective dose with the fewest side effects.

If you are taking metformin for the first time, you will initially receive a 30-day prescription at a lower dose, along with clear instructions on how to safely increase your dosage. Once you find your stable dose, you will receive a 60-day prescription at this stable dose.

If you have already found your stable dose of metformin, you will have the option to receive a 90-day supply of medication.

Safety is our top priority

The eligibility criteria, the dosing protocols and the treatment guides for every treatment offered via RTHM Direct have been designed by a team of clinicians and pharmacists focused on complex illnesses.

As we continue to navigate the complexities of Long COVID, ME/CFS, and other chronic conditions, we are upholding the highest patient safety standards while expanding access to treatments.

And in case you missed anything.

  • Metformin, originally derived from the French Lilac, has a long history of use in healthcare. Its excellent safety record and affordability make it an excellent on-label treatment for type II diabetes. Additionally, it is utilized off-label for purposes such as reducing Long COVID risk, managing weight, and even supporting longevity.

  • You should not take metformin for COVID if you have any of the following conditions as they can affect how metformin works in the body.

    • If you have elevated lactic acid or lactate in your blood or urine. Metformin increases your risk of lactic acidosis, a potentially severe side effect that can be compounded if you are already predisposed to high lactate levels. 

    • If you have low blood sugar or take insulin, metformin can excessively lower your blood sugar

    • Severe kidney or liver disease can adversely affect the metabolism of metformin

    • Radiologic procedures that use contrast (dye) can rarely interact with metformin and increase your risk of lactic acidosis. If you require diagnostic testing, such as x-rays, MRIs, and CT scans that require contrast, inform your provider that you are taking metformin. You may need to stop taking this medication for a day or two before having these tests as the interaction increases the risk of lactic acidosis. 

    • We recommend not drinking alcohol while taking metformin. Alcohol can increase your risk of low blood sugar as well as developing lactic acidosis, or a buildup of lactic acid in the bloodstream.

    • Metformin can worsen vitamin B6 or B12 deficiencies

    • There is mixed data about metformin’s effect on cardiac arrhythmias, heart disease or heart failure.

    Certain medications can also interact with metformin. Make sure to tell your provider all the medications you are currently taking and read through the potential list of medications on your Medication Information Sheet provided with your prescription.

  • For Long COVID prevention, Metformin is prescribed during acute infection for 14 days.

  • If you miss a dose, take it as soon as possible. If you are close to the time of your next dose, wait to take the next dose and then resume your normal dosing schedule. Do not “double-up” the dose.

  • While metformin is safe there can be mild side effects that typically improve as your body adjusts to the medication:

    • Passing gas

    • Nausea

    • Heartburn

    • Headache

    • Loss of strength or energy

    • Low blood sugar

    • Muscle pain

    • Unpleasant metallic taste

  • Keep this medication in the container provided by the pharmacy. Ensure it is properly closed and out of the reach of children. Store at room temperature and away from excess heat and moisture (not in the bathroom).

  • Our selected medications are low-risk and research-backed to improve symptoms of chronic complex conditions.

    Each medication assessment is approved by a team of expert clinicians and pharmacists, ensuring the highest standards of patient safety.