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Metformin, in rare instances, may accumulate in the body and lead to a serious condition known as lactic acidosis, which can be life-threatening. The risk of developing lactic acidosis increases under certain circumstances, such as being of advanced age, having kidney or liver impairment, dehydration, heart failure, excessive alcohol consumption, undergoing surgery, or if you are scheduled for X-ray or imaging procedures involving iodinated contrast. Additionally, the use of specific medications could further increase this risk. In some situations, your healthcare provider might advise you to temporarily discontinue the use of metformin. For detailed guidance, consult your doctor or pharmacist.

Be vigilant and discontinue metformin immediately if you experience any symptoms indicative of lactic acidosis. These symptoms include extreme fatigue, dizziness, severe drowsiness, chills, blue or cold skin, muscle pain, rapid or difficult breathing, slow or irregular heartbeat, or abdominal pain accompanied by nausea, vomiting, or diarrhea. Seek urgent medical assistance if these symptoms occur.

You might experience some mild side effects such as nausea, vomiting, an upset stomach, diarrhea, weakness, or a metallic taste in your mouth when taking this medication. These effects are generally not serious but if they persist or worsen, consult your healthcare provider. If your stomach symptoms return after several days or weeks, inform your doctor immediately, as this could indicate lactic acidosis, a serious condition.

While this medication typically does not cause low blood sugar on its own, it can occur if combined with other diabetes medications. Symptoms of low blood sugar include sudden sweating, shaking, a fast heartbeat, hunger, blurred vision, dizziness, or tingling in the hands or feet. To manage low blood sugar, keep glucose tablets or gel handy, or consume a quick sugar source like candy or fruit juice. Inform your doctor if you experience these symptoms.

High blood sugar symptoms include increased thirst or urination. If you notice these signs, your doctor may need to adjust your medication or lifestyle habits. Stop using the medication and seek medical attention if you suspect lactic acidosis. Allergic reactions to this drug are uncommon but can be severe, with symptoms such as rash, itching, swelling, severe dizziness, or trouble breathing requiring immediate medical help. If you experience any other side effects, contact your healthcare provider.