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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.
Pediatric
Appropriate studies performed to date have not demonstrated pediatric-specific problems that would limit the usefulness of metformin tablets in children 10 years old and above. However, safety and efficacy of metformin extended-release tablets in the pediatric population have not been established.
Geriatric
Although appropriate studies on the relationship of age to the effects of metformin have not been performed in the geriatric population, geriatric-specific problems are not expected to limit the usefulness of metformin in the elderly. However, elderly patients are more likely to have age-related kidney problems, which may require an adjustment of dosage in patients receiving metformin.
Pregnancy
| Pregnancy Category | Explanation | |
|---|---|---|
| All Trimesters | B | Animal studies have revealed no evidence of harm to the fetus, however, there are no adequate studies in pregnant women OR animal studies have shown an adverse effect, but adequate studies in pregnant women have failed to demonstrate a risk to the fetus. |
Breastfeeding
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
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Alatrofloxacin
- Balofloxacin
- Cimetidine
- Ciprofloxacin
- Clinafloxacin
- Dofetilide
- Enoxacin
- Fleroxacin
- Flumequine
- Gatifloxacin
- Gemifloxacin
- Grepafloxacin
- Levofloxacin
- Lomefloxacin
- Moxifloxacin
- Norfloxacin
- Ofloxacin
- Pefloxacin
- Prulifloxacin
- Rufloxacin
- Sparfloxacin
- Temafloxacin
- Tosufloxacin
- Trovafloxacin Mesylate
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Acebutolol
- Alprenolol
- Atenolol
- Betaxolol
- Bevantolol
- Bisoprolol
- Bitter Melon
- Bucindolol
- Carteolol
- Carvedilol
- Celiprolol
- Cephalexin
- Clorgyline
- Dilevalol
- Enalaprilat
- Enalapril Maleate
- Esmolol
- Fenugreek
- Glucomannan
- Guar Gum
- Iproniazid
- Isocarboxazid
- Labetalol
- Levobunolol
- Mepindolol
- Metipranolol
- Metoprolol
- Moclobemide
- Nadolol
- Nebivolol
- Nialamide
- Oxprenolol
- Pargyline
- Penbutolol
- Phenelzine
- Pindolol
- Procarbazine
- Propranolol
- Psyllium
- Selegiline
- Sotalol
- St John's Wort
- Talinolol
- Tertatolol
- Timolol
- Toloxatone
- Topiramate
- Tranylcypromine
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.
