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It is important to be aware of the potential safety concerns associated with the use of metformin. A rare but serious condition known as lactic acidosis can occur if too much metformin accumulates in the body. This condition can be fatal and is more likely to develop in certain situations, including:

• Advanced age.
• Pre-existing kidney or liver disease.
• Dehydration.
• Heart failure.
• Heavy alcohol consumption.
• Recent surgery.
• Undergoing X-ray or scanning procedures that use iodinated contrast.
• Concurrent use of certain medications.

In some cases, your doctor might advise temporarily discontinuing metformin. Consult your doctor or pharmacist for more specific guidance.

If you experience any symptoms indicative of lactic acidosis, it is crucial to cease taking metformin immediately and seek medical attention. Symptoms to watch for include:

• Unusual fatigue or extreme drowsiness.
• Dizziness or chills.
• Blue or cold skin.
• Muscle pain.
• Rapid or difficult breathing.
• Irregular or slow heartbeat.
• Abdominal pain accompanied by nausea, vomiting, or diarrhea.

Following these precautions can help manage the risks associated with metformin use.

Common side effects:

• Headache
• Diarrhea
• Nausea
• Vomiting
• Runny nose

• Sore throat

  Less common but important to monitor:

• Symptoms of low blood sugar (sweating, shaking, fast heartbeat, dizziness)
• High blood sugar symptoms (increased thirst and urination)

• Dehydration (reduced urination, dry mouth, dizziness)

  Serious side effects:

• Urinary tract infection symptoms (burning or painful urination)
• Kidney problems (changes in urination frequency, swelling in legs and feet)
• Yeast infections in the genital area
• Fournier's gangrene
• Severe allergic reactions (rash, swelling, difficulty breathing)

Interactions with moderate risk that may require dose adjustment, closer monitoring, or timing changes:

• metoprolol
• Propranolol
• Timolol