A dangerous, potentially fatal condition known as lactic acidosis may occasionally be brought on by metformin. If you have kidney disease, let your physician know. Probably won’t recommend taking metformin, your doctor will say. Additionally, let your doctor know if you are over 65 years old, if you have ever suffered from a heart attack, a stroke, diabetic ketoacidosis (a condition where blood sugar levels are so high that they require immediate medical attention), a coma, or liver or heart disease, and if you have ever been diagnosed with any of these conditions. Lactic acidosis risk may be raised by taking some additional drugs with metformin. Mention to your physician any medications you are taking, including acetazolamide (Diamox), dichlorphenamide (Keveyis), methazolamide, topiramate (Topamax, in Qsymia), and zonisamide (Zonegran).

If you have recently experienced any of the following issues, or if you develop them while receiving medication, let your doctor know: a major infection; extreme diarrhoea, vomiting, or fever; or if you are drinking much less fluid than normal for any reason. Metformin usage may need to be suspended until your recovery.

Inform the surgeon that you are taking metformin before having any type of major surgery, including dental surgery. Additionally, inform your doctor if you want to undergo any x-ray technique involving the injection of dye, particularly if you currently or previously consume substantial amounts of alcohol, have liver disease, or are currently experiencing heart failure. Before the procedure, you might need to stop taking metformin and wait 48 hours before starting it again. When you should stop taking metformin and when you should resume taking it, your doctor will specify.

Call your doctor right away and stop taking metformin if you have any of the following signs: excessive fatigue, weakness, or discomfort; nausea; vomiting; stomach pain; loss of appetite; rapid, deep breathing; fainting; fast or slow heartbeat; flushing of the skin; pain in the muscles; or feeling cold, particularly in the hands or feet.

If you frequently consume substantial amounts of alcohol in a short period of time or occasionally do so, let your doctor know (binge drinking). Alcohol consumption raises your risk of lactic acidosis and may lower blood sugar levels. How much alcohol is safe to consume while taking metformin should be discussed with your doctor.

Keep all of your appointments with your physician and the lab. In order to monitor your kidney function and how your body is responding to metformin, your doctor will prescribe a number of tests both before and throughout therapy. Discuss the potential risks of taking metformin with your doctor.

Metformin is used to treat type 2 diabetes either alone or in combination with other drugs, such as insulin (condition in which the body does not use insulin normally and, therefore, cannot control the amount of sugar in the blood). A group of medications known as biguanides includes metformin. Your blood’s level of glucose (sugar) can be managed with the aid of metformin. It lessens the amount of glucose your liver produces and the amount you take in from food. Additionally, metformin improves your body’s reaction to insulin, a hormone that naturally regulates blood sugar levels. Metformin is not used to treat type 1 diabetes, a condition in which the body produces no insulin and is unable to regulate the quantity of sugar in the blood.

People with diabetes and high blood sugar over time may experience serious or fatal complications, such as heart disease, stroke, kidney issues, nerve damage, and vision issues. It may be possible to control your diabetes and enhance your health by taking medication(s), making lifestyle changes (such as diet, exercise, and quitting smoking), and monitoring your blood sugar frequently. This treatment may also lower your risk of heart attack, stroke, kidney failure, nerve damage (resulting in numb, cold legs or feet and diminished sex capacity in both men and women), eye issues, such as changes in eyesight or blindness, or gum disease, which are all symptoms of diabetes. The optimal strategy to manage your diabetes will be discussed with you by your doctor and other healthcare professionals.

The oral forms of metformin include liquid, tablet, and extended-release (long-acting) tablet. One or two times each day, the drink is typically consumed with meals. Two or three times a day, the standard tablet is typically taken with meals. The extended-release tablet is often taken with dinner once a day. Take metformin at roughly the same time(s) each day to make it easier for you to remember to take it. Ask your doctor or pharmacist to explain any instructions on your prescription label that you are unsure about following. Follow the metformin directions exactly. Never take it in larger or less amounts or more frequently than directed by your doctor.

Do not split, chew, or crush the extended-release metformin tablets; instead, swallow them whole.

Your doctor might prescribe you a modest dose of metformin to start, and then gradually raise it once every 1-2 weeks or so. To determine how effectively metformin is working, your doctor will need to closely monitor your blood sugar levels.

Diabetes is not cured by metformin, although it can be managed. Even if you feel good, keep taking metformin. Without consulting your doctor, do not discontinue taking metformin.

For a copy of the manufacturer’s information for the patient, ask your pharmacist or doctor.

Ask your doctor or pharmacist for more details if you believe this drug should be used for something else.

Before taking metformin,

• If you have an allergy to metformin, any of the substances in metformin liquid or tablets, any other drugs, or any food, tell your doctor and pharmacist. For a list of the ingredients, consult your pharmacist or the manufacturer’s patient information.
• Inform your doctor and pharmacist about any additional prescription and over-the-counter drugs, vitamins, dietary supplements, and herbal products you’re using. Incorporate any of the following: Amiloride (Midamor); ACE inhibitors such as benazepril (Lotensin, in Lotrel); captopril; enalapril (Vasotec, in Vaseretic); fosinopril; lisinopril (in Zestoretic); and moexipril; angiotensin-converting enzyme (ACE) inhibitors (Univasc), beta-blockers like atenolol (Tenormin), labetalol (Trandate), metoprolol (Lopressor, Toprol XL), nadolol (Corgard, in Corzide), and propranolol (Hemangeol, Inderal, InnoPran); perindopril (Aceon), quinapril (Accupril), ramipril (Altace), calcium channel blockers include verapamil (Calan, Covera, Verelan, in Tarka), amlodipine (Norvasc), diltiazem (Cardizem, Cartia, Diltzac, among others), felodipine, isradipine, nicardipine (Cardene), nifedipine (Adalat, Afeditab CR, Procardia), nimodipine (Sular), treatment for asthma and colds; cimetidine (Tagamet); digoxin (Lanoxin); diuretics (‘water pills’); furosemide (Lasix); hormone replacement therapy; insulin or other diabetic medications; isoniazid (Laniazid; in Rifamate; in Rifater); oral contraceptives (often known as “birth control pills”), oral steroids such dexamethasone, methylprednisolone (Medrol), and prednisone (Rayos), phenytoin (Dilantin, Phenytek), drugs for nausea and thyroid condition; morphine (MS Contin, etc); niacin; ranitidine (Zantac), procainamide, quinidine (in Nuedexta), quinine, triamterene (Dyrenium, in Maxzide, and other products), trimethoprim (Primsol), or vancomycin are some examples of related compounds (Vancocin). Your physician might need to adjust the dosage of your drugs or keep a close eye on you for side effects.
• If you have or have had had a medical condition, especially one listed in the IMPORTANT WARNING section, let your doctor know.
• If you are breastfeeding a child or intend to become pregnant, let your doctor know. Call your doctor if you become pregnant while taking metformin.
• If you eat less or exercise more than usual, let your doctor know. Your blood sugar may be impacted by this. If this occurs, your doctor will give you instructions.

Make sure to abide by all dietary and exercise advice given to you by your physician or nutritionist. It’s crucial to maintain a healthy diet.

If you miss a dosage, take it as soon as you recall. If the next dose is soon due, skip the missed one and carry on with your regular dosing plan. To make up for a missing dose, do not take a second one.

Your blood sugar levels may alter as a result of this drug. You should be aware of the signs of low and high blood sugar as well as what to do if you experience these signs.

Side effects from metformin are possible. If any of these symptoms are severe, persist, disappear only to return, or appear a while after you start taking metformin, let your doctor know right once:

• Diarrhea
• Bloating
• Abdominal pain
• Gas
• Indigestion
• Constipation
• Metallic taste in tongue that is unpleasant
• Heartburn
• Headache
• Skin-flushing action
• Changes in nails
• Muscle ache

Some adverse effects can be very harmful. Call your doctor right away or seek emergency care if you develop any of these signs or any of those in the IMPORTANT WARNING section:

• Chest pain
• Rash

Other negative effects of metformin are possible. If you experience any strange issues while taking this medicine, contact your doctor right away.

You or your doctor can submit a report to the Food and Drug Administration’s (FDA) MedWatch Adverse Event Reporting programme online or by phone if you have a serious side event (1-800-332-1088).

Keep this medication tightly closed in the original container and out of the reach of children. Store it away from light, excessive heat, and moisture at room temperature (not in the bathroom).

Unused prescriptions must be disposed of carefully to prevent pets, kids, and other people from ingesting them. You should not, however, dispose of this medication in the toilet. Instead, utilising a medicine take-back programme is the easiest approach to get rid of your medication. To find out about take-back programmes in your area, speak with your pharmacist or the garbage/recycling department in your city. If you do not have access to a take-back programme, see the FDA’s Safe Disposal of Medicines website at http://goo.gl/c4Rm4p for additional information.

As many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and are simple for young children to open, it is crucial to keep all medications out of sight and out of reach of children. Always lock safety caps and promptly stash medication up and away from young children where it is out of their sight and reach to prevent poisoning. http://www.upandaway.org

Call the poison control hotline at 1-800-222-1222 in the event of an overdose. Additionally, information can be found online at https://www.poisonhelp.org/help. Call 911 right once if the person has collapsed, experienced a seizure, is having difficulty breathing, or cannot be roused.

In addition to hypoglycemic symptoms, overdose symptoms may also include the following:

• Extreme fatigue
• Weakness
• Discomfort
• Vomiting
• Nausea
• Abdominal pain
• Diminished appetite
• Fast, deep breathing
• Breathing difficulty
• Dizziness
• Lightheadedness
• Abnormal heartbeat, either fast or sluggish
• Skin tingling
• Muscle ache
• Feel chilled.

Your doctor will instruct you on how to measure your blood sugar levels at home in order to monitor your response to this medicine. Pay close attention to these directions.

If you are taking the extended-release pills, you might see something in your stool that resembles a tablet. The fact that the tablet is empty does not imply that you did not take the whole prescribed amount of medication.

Wearing a diabetes identity bracelet will ensure that you receive the right care in an emergency.

No one else should take your medication. Any queries you may have regarding medication refills should be directed to your pharmacist.

You should keep a written record of every medication you take, including any over-the-counter (OTC) items, prescription drugs, and dietary supplements like vitamins and minerals. This list should be brought with you whenever you see a doctor or are admitted to the hospital. You should always have this information with you in case of emergencies.