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Metformin can occasionally accumulate in the body, leading to a rare but potentially fatal condition known as lactic acidosis. The risk of developing lactic acidosis increases in certain situations and populations:

• Older adults.
• Individuals with kidney or liver disease.
• Those experiencing dehydration or heart failure.
• Heavy alcohol consumers.
• Patients undergoing surgery or procedures involving iodinated contrast, such as X-rays or scans.
• People using specific other medications.

In certain cases, your healthcare provider may advise pausing the use of this medication temporarily. It is important to seek advice from your doctor or pharmacist for more information.

Immediate discontinuation of metformin and urgent medical attention are necessary if you experience symptoms indicative of lactic acidosis. These symptoms include:

• Unusual fatigue or tiredness.
• Dizziness or severe drowsiness.
• Chills or blue/cold skin.
• Muscle pain.
• Rapid or difficult breathing.
• Slow or irregular heartbeat.
• Stomach pain accompanied by nausea, vomiting, or diarrhea.

Always follow your healthcare provider’s instructions and seek medical help right away if these symptoms occur.

While using this medication, you might experience mild side effects such as nausea, upset stomach, diarrhea, or weight gain. These are generally manageable, but if they persist or worsen, it’s important to consult your healthcare provider. If you notice any stomach issues after the initial days of treatment, it could indicate a more serious condition known as lactic acidosis, which requires immediate medical attention.

For more serious side effects, be vigilant and seek medical advice promptly. These include persistent nausea, easy bruising or bleeding, signs of infection like a persistent sore throat or fever, severe abdominal pain, jaundice (yellowing of the skin or eyes), and dark urine.

This medication may also cause low blood sugar (hypoglycemia), especially if meals are skipped or during intense exercise. Symptoms include sudden sweating, shaking, rapid heartbeat, hunger, blurred vision, dizziness, or tingling in your hands or feet. It's advisable to carry glucose tablets or gel, or consume sugary foods or drinks for quick relief. Regular meals can help prevent these episodes.

High blood sugar (hyperglycemia) may present as increased thirst and urination. If you experience these symptoms, consult your healthcare provider, as adjustments to your treatment plan might be necessary.

Though rare, serious allergic reactions can occur. Seek emergency medical help if you experience a rash, itching, swelling particularly around the face or throat, severe dizziness, or difficulty breathing. Always report any unusual side effects to your healthcare provider.