Tablets
Chemical Name: METFORMIN (met-FOR-min)

Common uses
This medicine is a biguanide-type medication that is used along with a diet and exercise program to control high blood sugar in diabetic patients. This medicine works by helping restore your body's proper response to the insulin you naturally produce, and by decreasing the amount of sugar that your liver makes and that your stomach/intestines absorb. Controlling high blood sugar helps prevent heart disease, strokes, kidney disease, blindness, and circulation problems, as well as sexual function problems (impotence).

Before using
WARNING: Metformin can rarely cause a condition called lactic acidosis, which can be fatal. Seek immediate medical attention if you develop any of the following symptoms of lactic acidosis: unusual tiredness (fatigue) or severe drowsiness, cold skin, muscle pain, breathing trouble or rapid breathing, unusually slow or irregular heartbeat. Lactic acidosis is more likely to occur in patients who have: heart failure, kidney or liver problems, excessive alcohol use, a lack of body fluids (dehydration), x-ray or scanning procedures that require an injectable iodinated contrast drug, surgery, a serious infection, heart attack or stroke, Also at higher risk are the elderly, especially if you are over 80 years of age and have not had kidney and liver tests. Some medicines or medical conditions may interact with this medicine. INFORM YOUR DOCTOR OR PHARMACIST of all prescription and over-the-counter medicine that you are taking. ADDITIONAL MONITORING OF YOUR DOSE OR CONDITION may be needed if you are taking other diabetes drugs (e.g., glyburide, insulin), "water pills" (diuretics such as hydrochlorothiazide, furosemide), cimetidine, birth control pills, estrogens, corticosteroids (e.g., prednisone), niacin, phenytoin, decongestants, high blood pressure drugs (beta-blockers such as propranolol, calcium channel blockers such as nifedipine, ACE Inhibitors such as captopril), phenothiazines (e.g., chlorpromazine), isoniazid, thyroid drugs, clomiphene, fenugreek, ginseng. USE OF THIS MEDICINE IS NOT RECOMMENDED if you have a history of kidney disease, liver disease, congestive heart failure, metabolic acidosis (e.g., diabetic ketoacidosis), recent heart attack, recent stroke, serious infection, and dehydration. Inform your doctor of any other medical conditions including blood problems (e.g., anemia, vitamin B-12 deficiency), scheduled upcoming surgery, scheduled upcoming x-ray or scanning procedures, alcohol use, any allergies, pregnancy, or breast-feeding. If you are scheduled to undergo any x-ray or scanning procedure using injectable iodinated contrast material, be sure to inform your doctor that you are taking this medicine. You will need to temporarily stop this medicine around the time of your procedure. Consult your doctor for further instructions. Do not start or stop any medicine without doctor or pharmacist approval. Contact your doctor or pharmacist if you have any questions or concerns about taking this medicine.

Directions
Follow the directions for using this medicine provided by your doctor. TAKE THIS MEDICINE with food. DRINK PLENTY OF FLUIDS while taking this medicine. CONTINUE TO TAKE THIS MEDICINE even if you feel well. Do not miss any doses. Use this medication regularly in order to get the most benefit from it. To help you remember, use it at the same time(s) each day. This medicine may come with a patient information leaflet. Read it carefully. Ask your doctor, nurse, or pharmacist any questions that you may have about this medicine. STORE THE U.S. PRODUCT at room temperature between 68 and 77 degrees F (20 and 25 degrees C), away from light and moisture. Brief storage from 59 and 86 degrees F (15 and 30 degrees C) is permitted. Do not store in the bathroom. STORE THE CANADIAN PRODUCT between 59 and 86 degrees F (15 and 30 degrees C). Keep all medicines away from children and pets. IF YOU MISS A DOSE OF THIS MEDICINE, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. DO NOT take 2 doses at once.

Cautions
FOLLOW THE DIETARY PLAN provided by your doctor. KEEP ALL DOCTOR AND LABORATORY APPOINTMENTS (e.g., liver and kidney function tests, fasting blood glucose, glycosylated hemoglobin, complete blood counts) while you are using this medicine. Regularly check your blood or urine sugar as directed by your doctor. BEFORE YOU HAVE ANY MEDICAL OR DENTAL TREATMENTS, EMERGENCY CARE, LABORATORY TESTS, OR SURGERY, tell the doctor or dentist that you are using this medicine. During times of stress such as fever, infection, injury or surgery it may be more difficult to control your blood sugar. Consult your doctor, as a change in your medication may be required. LIMIT ALCOHOL INTAKE while using this medicine. BEFORE YOU BEGIN TAKING ANY NEW MEDICINE, either prescription or over-the-counter, check with your doctor or pharmacist. Caution should be used in the elderly since they may be more sensitive to the effects of this drug. FOR WOMEN: This medicine can cause changes in the menstrual cycle (promote ovulation) in women with certain fertility problems, therefore increasing the risk of becoming pregnant. Consult your doctor or pharmacist about the use of reliable birth control while using this medicine. IF YOU PLAN ON BECOMING PREGNANT, discuss with your doctor the benefits and risks of using this medicine during pregnancy. IT IS UNKNOWN IF THIS MEDICINE IS EXCRETED in breast milk. DO NOT BREAST-FEED while taking this medicine.

Possible side effects
Also see WARNING. SIDE EFFECTS, that may go away during treatment, include metallic taste in mouth, nausea, stomach upset, and diarrhea. If they continue or are bothersome, check with your doctor. If stomach symptoms recur later (after you are on the same dose for several days or weeks), tell your doctor immediately. A late recurrence of stomach symptoms may be due to a serious medical condition (lactic acidosis). This medicine usually does not cause low blood sugar (hypoglycemia), but this effect may occur if you do not consume enough calories (from food, juices, fruit, etc.). The symptoms include chills, cold sweat, dizziness, drowsiness, shaking, rapid heartbeat, weakness, headache, fainting, tingling of the hands or feet, or hunger. It is a good habit to carry glucose tablets or gel to treat low blood sugar. If you are in a situation where you don't have these reliable forms of glucose, eat a quick source of sugar such as table sugar, honey, or candy, or drink a glass of orange juice or non-diet soda to quickly raise your blood sugar level. Tell your doctor immediately about the reaction. To help prevent hypoglycemia, eat meals on a regular schedule and do not skip meals. Symptoms of high blood sugar (hyperglycemia) include thirst, increased urination, confusion, drowsiness, flushing, rapid breathing, or fruity breath odor. If these symptoms occur, tell your doctor immediately. Your medication dosage may need to be increased. IF YOU EXPERIENCE difficulty breathing; tightness of chest; swelling of eyelids, face or lips; or if you develop a rash or hives, tell your doctor immediately. Do not take any more doses of this medicine unless your doctor tells you to do so. If you notice other effects not listed above, contact your doctor, nurse, or pharmacist.

Drug interactions
Drug interactions can result in unwanted side effects or prevent a medicine from doing its job. Use our drug interaction checker to find out if your medicines interact with each other.

If you take too much
If overdose is suspected, contact your local poison control center or emergency room immediately. Symptoms of overdose may include rapid or trouble breathing, severe drowsiness, and slow or irregular heartbeat.

Additional information
This medicine is not a substitute for proper diet and regular exercise. It is recommended you attend a diabetes education program to better understand diabetes, prevention of complications, and all the important aspects of its treatment. These include meals/diet, exercise, weight loss, personal hygiene, medicine and blood glucose monitoring, and the need for regular eye, foot, and medical exams. Follow your doctor's instructions carefully. DO NOT SHARE THIS MEDICINE with others for whom it was not prescribed. KEEP THIS MEDICINE out of the reach of children and pets. IF USING THIS MEDICINE FOR AN EXTENDED PERIOD OF TIME, obtain refills before your supply runs out.