Directions
Take metformin tablets by mouth, with meals. Follow the directions on the prescription label. Swallow the tablets with a drink of water. Take your doses at regular intervals. Do not take your medicine more often than directed.
Contact your pediatrician or health care professional regarding the use of this medicine in children. Special care may be needed.
Side efects
Side effects that you should report to your prescriber or health care professional as soon as possible:
breathing difficulties or shortness of breath
dizziness
muscle aches or pains
passing out or fainting
severe vomiting or diarrhea
slow or irregular heartbeat
unusual stomach pain or discomfort
unusual weakness, fatigue or discomfort
In combination with other diabetic medications, (like acarbose, glyburide, glipizide, miglitol, or insulin), metformin may cause low blood sugar (hypoglycemia). Contact your health care professional if you experience symptoms of low blood sugar, which may include:
anxiety or nervousness, confusion, difficulty concentrating, hunger, pale skin, nausea, fatigue, sweating, headache, palpitations, numbness of the mouth, tingling in the fingers, tremors, muscle weakness, blurred vision, cold sensations, uncontrolled yawning, irritability, rapid heartbeat, shallow breathing, and loss of consciousness
Symptoms of high blood sugar (hyperglycemia) include:
dizziness, dry mouth, flushed dry-skin, fruit-like breath odor, loss of appetite, nausea, stomach ache, unusual thirst, frequent passing of urine
Side effects that usually do not require medical attention (report to your prescriber or health care professional if they continue or are bothersome):
decreased appetite
gas
heartburn
metallic taste in the mouth
mild stomachache
nausea
weight loss
Precautions
Visit your prescriber or health care professional for regular checks on your progress. Your prescriber will check your blood sugar, kidney function, and other tests from time to time.
Learn how to monitor your blood sugar. Learn what to do if you have high or low blood sugar. Do not skip meals. If you are exercising much more than usual you may need extra snacks to avoid side effects caused by low blood sugar. Do not change your medication dose without talking to your prescriber.
If you have mild symptoms of low blood sugar, eat or drink something containing sugar at once and contact your health care professional. It is wise to check your blood sugar to confirm that it is low. It is important to recognize your own symptoms of low blood sugar so that you can treat them quickly. Make sure family members know that you can choke if you eat or drink when you develop serious symptoms of low blood sugar, such as seizures or unconsciousness. They must get medical help at once.
If you develop a severe diarrhea or vomiting, or are unable to maintain proper fluid intake, you should contact your prescriber. "Sick-days" may require adjustments to your dosage or your illness may need to be evaluated. Ask your prescriber what you should do if you become ill.
If you are going to have surgery or will need an x-ray procedure that uses contrast agents, tell your prescriber or health care professional that you are taking this medicine.
Wear a medical identification bracelet or chain to say you have diabetes, and carry a card that lists all your medications.
WARNING: Metformin (Glucophage?) can rarely cause a condition called lactic acidosis, which can be fatal. Seek immediate medical attention if you develop any of the following symptoms of lactic acidosis: unusual tiredness (fatigue) or severe drowsiness, cold skin, muscle pain, breathing trouble or rapid breathing, unusually slow or irregular heartbeat. Lactic acidosis is more likely to occur in patients who have: heart failure, kidney or liver problems, excessive alcohol use, a lack of body fluids (dehydration), x-ray or scanning procedures that require an injectable iodinated contrast drug, surgery, a serious infection, heart attack or stroke, Also at higher risk are the elderly, especially if you are over 80 years of age and have not had kidney and liver tests.
Drug Interactions
alcohol
cephalexin
cimetidine
digoxin
dofetilide
entecavir
morphine
nifedipine
procainamide
propantheline
quinidine
quinine
ranitidine
trimethoprim
trospium
vancomycin
water pills (diuretics like amiloride, furosemide, triamterene)
Many medications may cause changes (increase or decrease) in blood sugar, these include:
alcohol containing beverages
aspirin and aspirin-like drugs
beta-blockers, often used for high blood pressure or heart problems (examples include atenolol, metoprolol, propranolol)
chromium
female hormones, such as estrogens, progestins, or contraceptive pills
isoniazid
male hormones or anabolic steroids
medications for weight loss
medicines for allergies, asthma, cold, or cough
niacin
pentamidine
phenytoin
some herbal dietary supplements
steroid medicines such as prednisone or cortisone
thyroid hormones
water pills (diuretics)
Tell your prescriber or health care professional about all other medicines you are taking, including non-prescription medicines, nutritional supplements, or herbal products. Also tell your prescriber or health care professional if you are a frequent user of drinks with caffeine or alcohol, if you smoke, or if you use illegal drugs. These may affect the way your medicine works. Check with your health care professional before stopping or starting any of your medicines.
Overdose
If overdose is suspected, contact your local poison control center or emergency room immediately. Symptoms of overdose may include severe dizziness, fainting, or prolonged erection.
NOTES: Do not share this medication with others, since they may have a problem that is not effectively treated by this drug. Use of this drug does not protect against sexually transmitted diseases (e.g., HIV, Hepatitis B, gonorrhea, syphilis)
Missed Dosage
Not applicable
Storage
Keep out of the reach of children in a container that small children cannot open.
Store at room temperature between 15 and 30 degrees C (59 and 86 degrees F). Protect from moisture and light. Throw away any unused medicine after the expiration date.