Metformin

What you should know before using

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatrics

Metformin tablets have been tested in children older than 10 years old and, in effective doses, have not been shown to cause different side effects or problems than it does in adults.

Studies with metformin extended-release tablets have been done only in adult patients, and there is no specific information comparing use of this medicine in children with use in other age groups.

Geriatric

Use in older adults is similar to use in adults of younger age. However, if you have blood vessel disorders or kidney problems, your health care professional may adjust your dose or tell you to stop taking this medicine, if necessary.

Breast Feeding

Studies in women suggest that this medication poses minimal risk to the infant when used during breastfeeding.

Drug Interactions

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

• Acetrizoic Acid
• Diatrizoate
• Ethiodized Oil
• Iobenzamic Acid
• Iobitridol
• Iocarmic Acid
• Iocetamic Acid
• Iodamide
• Iodipamide
• Iodixanol
• Iodohippuric Acid
• Iodopyracet
• Iodoxamic Acid
• Ioglicic Acid
• Ioglycamic Acid
• Iohexol
• Iomeprol
• Iopamidol
• Iopanoic Acid
• Iopentol
• Iophendylate
• Iopromide
• Iopronic Acid
• Ioseric Acid
• Iosimide
• Iotasul
• Iothalamate
• Iotrolan
• Iotroxic Acid
• Ioversol
• Ioxaglate
• Ioxitalamic Acid
• Ipodate
• Metrizamide
• Metrizoic Acid
• Tyropanoate Sodium

Other Interactions

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

• Acid in the blood (ketoacidosis or lactic acidosis) or
• Burns (severe) or
• Dehydration or
• Diarrhea (severe) or
• Female hormone changes for some women (e.g., during puberty, pregnancy, or menstruation) or
• Fever, high or
• Infection (severe) or
• Injury (severe) or
• Ketones in the urine or
• Mental stress (severe) or
• Overactive adrenal gland (not properly controlled) or
• Problems with intestines (severe) or
• Slow stomach emptying or
• Surgery (major) or
• Vomiting or
• Any other condition that causes problems with eating or absorbing food or
• Any other condition in which blood sugar changes rapidly—Metformin in many cases will be replaced with insulin by your doctor, possibly only for a short time. Use of insulin is best to help control diabetes mellitus in patients with these conditions that without warning cause quick changes in the blood sugar.

• Heart or blood vessel disorders or
• Kidney disease or kidney problems or
• Liver disease (or history of)—Lactic acidosis can occur in these conditions and chances of it occurring are even greater with use of metformin

• Kidney, heart, or other problems that require medical tests or examinations that use certain medicines called contrast agents, with x-rays—Metformin should be stopped before medical exams or diagnostic tests that might cause less urine output than usual. Passing unusually low amounts of urine may increase the chance of a build up of metformin and unwanted effects. Metformin may be restarted 48 hours after the exams or tests if kidney function is tested and found to be normal

• Overactive thyroid (not properly controlled) or
• Underactive thyroid (not properly controlled)—Until the thyroid condition is controlled, it may change the amount or type of antidiabetic medicine you need

• Underactive adrenal gland (not properly controlled) or
• Underactive pituitary gland (not properly controlled) or
• Undernourished condition or
• Weakened physical condition or
• Any other condition that causes low blood sugar—Patients who have any of these conditions may be more likely to develop low blood sugar, which can affect the dose of metformin you need and increase the need for blood sugar testing