Following a second resubmission, the Scottish Medicines Consortium (SMC) has accepted the restricted use of metformin hydrochloride prolonged release tablets (Glucophage SR®) for the treatment of type 2 diabetes mellitus in adults, particularly in overweight patients, when dietary management and exercise alone does not result in adequate glycaemic control.

Use is restricted to patients who are intolerant of immediate release metformin and in whom the prolonged release tablet allows the use of a dose of metformin not previously tolerated or in patients for whom a once-daily preparation offers a clinically significant benefit.

The drug advice notes that evidence of Glucophage SR® improving gastro-intestinal tolerability is not convincing and it is more expensive than the immediate-release formulation.