Do not take METFORMIN PHARMC:
- If you are hypersensitive (allergic) to metformin hydrochloride or any of the other ingredients of METFORMIN PHARMC (listed in section 6).
- If you have severe complications of your diabetes such as diabetic ketoacidosis, a metabolic state resulting from a profound lack of insulin.
- If your kidneys do not work properly or do not work at all.
- If you have a short term conditions that may affect your kidney function e.g. dehydration, severe infection, shock.
- administration of iodinated contrast media through the veins.
- If you have short or long term conditions that may cause a lack of oxygen to your tissues such as heart or breathing failure, a recent heart attack, shock.
- If you suffer from a liver condition, or use excessive amounts of alcohol.
- If you have or have a history of inflammation of your pancreas.
- If you are pregnant or breastfeeding.
Warnings and precautions
Take special care with METFORMIN PHARMC if you have the following:
Risk of lactic acidosis METFORMIN PHARMC may cause a very rare, but very serious side effect called lactic acidosis, particularly if your kidneys are not working properly. The risk of developing lactic acidosis is also increased with uncontrolled diabetes, serious infections, prolonged fasting or alcohol intake, dehydration (see further information below), liver problems and any medical conditions in which a part of the body has a reduced supply of oxygen (such as acute severe heart disease).
If any of the above apply to you, talk to your doctor for further instructions.
Stop taking METFORMIN PHARMC for a short time if you have a condition that may be associated with dehydration (significant loss of body fluids) such as severe vomiting, diarrhoea, fever, exposure to heat or if you drink less fluid than normal. Talk to your doctor for further instructions.
Stop taking METFORMIN PHARMC and contact a doctor or the nearest hospital immediately if you experience some of the symptoms of lactic acidosis, as this condition may lead to coma. Symptoms of lactic acidosis include:
- vomiting
- stomach ache (abdominal pain)
- muscle cramps
- a general feeling of not being well with severe tiredness
- difficulty in breathing
- reduced body temperature and heartbeat.
Lactic acidosis is a medical emergency and must be treated in a hospital.
If you need to have major surgery, you must stop taking METFORMIN PHARMC during and for some time after the procedure. Your doctor will decide when you must stop and when to restart your treatment with METFORMIN PHARMC.
METFORMIN PHARMC on its own does not cause hypoglycaemia (a blood glucose level which is too low). However, if you take METFORMIN PHARMC together with other medicines to treat diabetes that can cause hypoglycaemia (such as sulphonylureas, insulin, meglitinides), there is a risk of hypoglycaemia. If you experience symptoms of hypoglycaemia such as weakness, dizziness, increased sweating, fast heart beating, vision disorders or difficulty in concentration, it usually helps to eat or drink something containing sugar.
During treatment with METFORMIN PHARMC, your doctor will check your kidney function at least once a year or more frequently if you are elderly and/or if you have worsening kidney function.
The use of METFORMIN PHARMC may cause reduction in your levels of vitamin B12. Your doctor will check your levels of B12 at least once a year.
Other precautions:
- All patients should continue their diet with a regular distribution of carbohydrate intake during the day. Overweight patients should continue their energy-restricted diet.
- The usual laboratory tests for diabetes monitoring should be performed regularly.
- Although METFORMIN PHARMC alone never causes hypoglycaemia, caution is advised when it is used in combination with insulin or sulphonylureas.
Other medicines and METFORMIN PHARMC
Always tell your health care provider if you are taking any other medicine. (This includes all complementary or traditional medicines.)
If you need to have an injection of a contrast medium that contains iodine into your bloodstream, for example in the context of an X-ray or scan, you must stop taking METFORMIN PHARMC before or at the time of injection. Your doctor will decide when you must stop and when to restart your treatment with METFORMIN PHARMC.
Tell your doctor if you are taking, have recently taken or might take any other medicines. You may need more frequent blood glucose and kidney function tests, or your doctor may need to adjust the dosage of METFORMIN PHARMC.
It is especially important to mention the following:
- medicines which increase urine production (diuretics),
- medicines used to treat pain and inflammation (NSAID and COX-2-inhibitors, such as ibuprofen and celecoxib),
- certain medicines for the treatment of high blood pressure (ACE inhibitors and angiotensin II receptor antagonists),
- beta-2 agonists such as salbutamol or terbutaline (used to treat asthma),
- corticosteroids (used to treat a variety of conditions, such as severe inflammation of the skin or in asthma),
- medicines that may change the amount of METFORMIN PHARMC in your blood, especially if you have reduced kidney function (such as verapamil, rifampicin, cimetidine, dolutegravir, ranolazine, trimethoprime, vandetanib, isavuconazole, crizotinib, olaparib),
- other medicines used to treat diabetes.
METFORMIN PHARMC with alcohol
Avoid consumption of alcohol or alcohol containing medicine while taking METFORMIN PHARMC since this may increase the risk of lactic acidosis (see section ‘Warnings and precautions’).
METFORMIN PHARMC with food and drink
METFORMIN PHARMC can be taken with or after food.
Pregnancy, breastfeeding and fertility
If you are pregnant or breastfeeding, think you may be pregnant or are planning to have a baby, please consult your doctor, pharmacist or other health care provider for advice before taking this medicine. METFORMIN PHARMC is not recommended if you are pregnant or breastfeeding or if you are planning to breastfeed your baby.
