What side effects are possible with this medication?
A side effect is an unwanted response to a medication when it is taken in normal doses. It can be mild or severe, temporary or permanent, but does not occur in everyone. The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away over time. If you develop any of these side effects (or any other side effects not listed here) or they change in intensity, speak to your doctor or pharmacist for advice on managing them and on the risks and benefits of the medication.
- diarrhea
- flatulence (passing of gas)
- loss of appetite
- metallic taste in mouth (usually lasts for a short time)
- nausea
- upset stomach
- vomiting
- weight loss
Click here to learn about serious side effects that can potentially occur with any medication. These examples are provided for information purposes only and are not meant to be exhaustive. Always consult your doctor for sound medical advice specific to your particular medication and treatment.
If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online or by phone at 1-800-332-1088.
Are there any other precautions or warnings for this medication?
Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.
Alcohol intake: Anyone taking metformin extended release should avoid excessive alcohol intake. Alcohol increases the risk of lactic acid buildup (lactic acidosis) with metformin. If you have fatigue, muscle aches, abdominal pain, or trouble breathing while taking metformin, seek immediate medical attention.
Blood glucose control: When a person taking metformin extended release experiences fever, trauma, infection, or surgery, a temporary loss of blood glucose control may occur. It may be necessary to stop the medication and temporarily inject insulin. Metformin extended release may be started again after the problem is resolved.
Blood glucose monitoring: Monitor your blood glucose at regular intervals as discussed with your doctor or diabetes specialist.
Diet and exercise: Metformin extended release is a treatment to be taken in combination with a proper diet and exercise program. It is not a substitute for proper diet and exercise.
Dehydration: Tell your doctor if you have an illness that causes severe vomiting, diarrhea or fever, or if you drink a much lower amount of liquid than normal. These conditions can lead to severe dehydration (loss of water in your body). You may need to stop taking this medication for a short time.
Lactic acidosis: Lactic acidosis is a rare but serious condition that occurs when metformin accumulates in the body (i.e., the body doesn't get rid of it fast enough) during treatment. People with severe kidney disease are at higher risk of developing lactic acidosis. When it does occur (very rarely), it is fatal in about 50% of cases. People with kidney or liver disease should be monitored very closely by their doctor while taking metformin extended release. Signs of lactic acidosis include: feeling very weak, tired, or uncomfortable; unusual muscle pain; trouble breathing; unusual or unexpected stomach discomfort; feeling cold; feeling dizzy or lightheaded; and suddenly developing a slow or irregular heart beat. If your medical condition suddenly changes, stop taking this medication and call your doctor right away. This may be a sign of lactic acidosis or another serious side effect.
Low blood glucose: Under usual circumstances, low blood glucose does not occur for people who take only metformin extended release. However, low blood glucose could occur if you have not eaten enough food, and especially if you exercise strenuously or consume excessive amounts of alcohol while taking this medication.
Reduced response: Over time, people may become progressively less responsive to a particular treatment for diabetes because their diabetes worsens. If metformin extended release fails to lower blood glucose to target levels, talk to your doctor. Your doctor may want to stop the medication or recommend another one.
Surgery: Metformin extended release should be stopped temporarily for any surgical procedure associated with a restricted food and drink intake.
Vitamin B12 levels: Blood levels of vitamin B12 may drop in people taking metformin extended release. This can be corrected by taking vitamin B12 supplements. Vitamin levels should be monitored by your doctor regularly.
Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, stop taking it immediately and call your doctor.
Breast-feeding: This medication may pass into breast milk. If you are a breast-feeding mother and are taking this medication, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.
Children: The safety and effectiveness of this medication have not been established for children under 17 years of age.
What other drugs could interact with this medication?
There may be an interaction between metformin extended release and any of the following:
- alcohol
- amiloride
- birth control pills
- calcium channel-blocking medications (e.g., nifedipine, verapamil)
- cimetidine
- clofibrate
- corticosteroids (e.g., prednisone, hydrocortisone)
- digoxin
- diuretics (water pills; e.g., hydrochlorothiazide, triamterene, furosemide)
- estrogen
- iodinated contrast material (dyes used for medical tests)
- isoniazid
- MAO inhibitors (e.g., phenelzine, tranylcypromine)
- morphine
- nicotinic acid
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- nifedipine
- phenothiazines (e.g., methotrimeprazine, fluphenazine)
- phenylbutazone
- phenytoin
- probenacid
- procainamide
- propranolol
- quinidine
- quinine
- ranitidine
- salicylates
- sulfonamides
- sulfonylureas
- sympathomimetics (e.g., pseudoephedrine, epinephrine)
- thyroid products (e.g., levothyroxine)
- trimethoprim
- vancomycin
- warfarin
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If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:
- stop taking one of the medications,
- change one of the medications to another,
- change how you are taking one or both of the medications, or
- leave everything as is.
An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.
Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.