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Metformin is a biguanide antidiabetic that is used for treating type 2 diabetes. It is usually used in combination with diet and exercise. It may be administered alone or with other antidiabetic drugs. It decreases the amount of sugar that the liver produces and the intestines absorb. Metformin also helps to make your body more sensitive to the insulin.

You should not use Metformin in case you have conditions mentioned below: you are allergic to any ingredient in Metformin; you have congestive heart failure that is treated by medicine; you have a severe infection, low blood oxygen levels, kidney or liver problems, high blood ketone or acid levels (eg, diabetic ketoacidosis), or severe dehydration; you have had a stroke or a recent heart attack, or you are in shock; you are 80 years old or older and have not had a kidney function test; you will be having surgery or certain lab procedures. In such cases it is obligatory to consult with your doctor or health care provider before taking this medicine.

Before using Metformin

Before using Metformin you should tell your doctor if you have any medical conditions listed below: you are pregnant, planning to become pregnant, or are breast-feeding a baby; you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement; you have allergies to medicines, foods, or other substances; you have a history of heart problems (eg, heart failure), lung or breathing problems, thyroid problems, stomach or bowel problems (eg, paralysis, blockage), adrenal or pituitary problems, or lactic acidosis; you have vomiting, diarrhea, poor health or nutrition, low blood calcium or vitamin B12 levels, or anemia, or if you are dehydrated; you have an infection, fever, recent injury, or moderate to severe burns; you drink alcohol or have a history of alcohol abuse; you will be having surgery or certain lab procedures; you take a beta-blocker (eg, propranolol).

Be aware that Metformin may interact with some medicines. Consult with your health care provider in case you are taking any other drugs, especially any of the next: amiloride, cimetidine, digoxin, morphine, procainamide, quinidine, quinine, ranitidine, triamterene, trimethoprim, or vancomycin because of increased risk of Metformin 's side effects; calcium channel blockers (eg, nifedipine), corticosteroids (eg, prednisone), diuretics (eg, furosemide, hydrochlorothiazide), estrogen, hormonal contraceptives (eg, birth control pills), insulin, isoniazid, nicotinic acid, phenothiazine (eg, chlorpromazine), phenytoin, sulfonylureas (eg, glipizide), sympathomimetics (eg, albuterol, pseudoephedrine), or thyroid hormones (eg, levothyroxine) because of the risk of high or low blood sugar.

It may not be a complete list of all interactions with other drugs. To prevent any complications you should check with your health care provider before you start, stop, or change the dose of any medicine.

How to use Metformin

You should use Metformin as recommended by your doctor with food. It is recommended to drink extra fluids while you are using Metformin.

Take Metformin regularly at the same time each day will help you not to forget to take it.

Do not give up taking Metformin even if you feel well. Try not to miss any doses.

In case you miss a dose, take it as soon as possible. If it is almost time for your next intake, skip the missed dose and take it according to your regular dosing schedule. Do not take double doses at once.

Important safety information

You should carry an ID card at all times that says you have diabetes.

Metformin usage may lead to dizziness. These effects may be worsening by taking alcohol or certain medicines. Prevent driving or performing any other possibly unsafe actions.

It is important to follow the diet and exercise program recommended by your doctor.

Large amounts of alcohol are avoided while you take Metformin. Consult with your doctor or health care provider before you drink alcohol.

Notice your doctor or dentist that you use Metformin before you receive any medical or dental care, emergency care, or surgery.

In case you have vomiting or diarrhea, you should prevent dehydration. Consult with your doctor for recommendations.

It is obligatory to check your blood sugar levels as recommended by your doctor. If they are higher than they should be and you use Metformin exactly as prescribed, consult with your doctor.

Be aware that Metformin does not usually decrease levels of sugar in your blood. Low levels are more likely to occur in case you skip a meal, exercise heavily, or drink alcohol, or you take Metformin along with certain drugs for diabetes (eg, sulfonylureas, insulin).

It is necessary to carry a reliable source of glucose (e.g., tablets or gel) to treat low blood sugar. In cases this is unavailable; you should eat or drink a quick source of sugar like table sugar, honey, candy, orange juice, or non-diet soda. It elevates your blood sugar level rather quickly. Consult with your doctor if this happens immediately. Do not skip meals and eat meals at the same time each day.

The risk of high or low blood sugar levels may be increased if you have fever, infection, injury, or surgery. In such cases, check your blood sugar closely and consult with your doctor immediately.

Metformin usage may lead to stomach upset, indigestion, nausea, vomiting, or diarrhea at the beginning of treatment. In case you suffer from unusual or unexpected stomach problems, or if you develop stomach problems later during the course of treatment, tell your doctor immediately. It may be a sign of lactic acidosis.

Lab tests, including kidney function, fasting blood glucose, hemoglobin A1c, and blood counts, may be performed while you are using Metformin. Follow all doctor and lab appointments strictly.

Elderly are more likely to be more sensitive to its effects and it may be difficult to recognize low blood sugar in this group. Use Metformin with caution in this group.

Do not use Metformin in children younger than 10 years old; safety and effectiveness in this group have not been proved.

PREGNANCY and BREAST-FEEDING

In case you become pregnant, consult with your doctor and discuss the benefits and risks of Metformin usage while pregnancy. Do not breast-feed a baby while using Metformin.

If you use Metformin for long periods of time, it may not work as well. In case your levels of blood sugar has been under control and then becomes hard to manage, you should consult with your doctor. It is not allowed to change the dose without consultation with your doctor.

Possible side effects of Metformin

You should consult with your doctor in case you have any of side effects especially bothersome listed below: diarrhea; gas; headache; indigestion; nausea; stomach upset; temporary metallic taste; vomiting.

Seek emergency in case you have any of these severe side effects: severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); chest pain or discomfort; dizziness or lightheadedness; fast or difficult breathing; feeling of being unusually cold; fever, chills, or persistent sore throat; general feeling of being unwell; muscle pain or weakness; slow or irregular heartbeat; unusual drowsiness; unusual or persistent stomach pain or discomfort; unusual tiredness or weakness.

What is the expiration date of the pills?

This information is mentioned on each blister. The expiration date is 2 years from the date of manufacture.