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Metformin, in rare cases, can accumulate in the body and lead to a severe and potentially life-threatening condition known as lactic acidosis. The risk of developing lactic acidosis is heightened for certain groups, including:

• Older adults.
• Individuals with kidney or liver problems.
• Those experiencing dehydration or heart failure.
• People who consume alcohol heavily.
• Patients undergoing surgery or X-ray procedures that involve iodinated contrast agents.
• Individuals taking specific medications.

In some situations, your healthcare provider may advise you to temporarily discontinue metformin. For further guidance, please consult your doctor or pharmacist.

Immediate cessation of metformin and seeking urgent medical attention is crucial if you experience any signs of lactic acidosis. These symptoms include:

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

When taking this medication, you might experience mild side effects such as headache, diarrhea, nausea, vomiting, runny nose, or sore throat. These are generally not severe, but if they persist or worsen, consult your healthcare provider. Occasionally, you might notice an empty tablet shell in your stool, which is harmless as the medication has already been absorbed.

More serious side effects require immediate attention. Stomach symptoms emerging after the first days of treatment could indicate lactic acidosis. Additionally, watch for urinary tract infection signs like painful or frequent urination, pink urine, or symptoms of kidney issues, such as changes in urine output or swelling in the legs.

There is a risk of developing yeast infections in the genital area. Report any unusual discharge, redness, itching, or swelling in these areas to your doctor promptly. A rare but severe bacterial infection, Fournier's gangrene, can also occur; seek urgent care if you experience pain, redness, swelling near the genital/anal area, especially with a fever.

While this drug doesn't typically cause low blood sugar, it might if combined with other diabetes medications, insufficient food intake, or excessive exercise. Symptoms like sweating, shaking, fast heartbeat, or dizziness should be addressed by consuming quick sugar sources. High blood sugar signs, such as increased thirst or urination, also need medical attention.

Dehydration could lead to serious kidney damage, so it’s important to stay hydrated. Alert your doctor if you have trouble maintaining fluid intake or notice decreased urination, dry mouth, or dizziness. Rise slowly from sitting or lying positions to avoid lightheadedness.

Though rare, serious allergic reactions are possible. Seek immediate medical help if you experience rash, swelling, severe dizziness, or breathing difficulties. Always discuss any unlisted side effects with your healthcare provider.