glyburide metformin 25

What is the most important information I should know about metformin?
• A small number of people who have taken metformin have developed a seriouscondition called lactic acidosis that has been fatal in up to 50% of cases glyburide metformin 25. Lactic acidosis has occurred most often in people whose kidneys were not workingproperly glyburide metformin 25. Liver problems may also increase the risk of developing lactic acidosis glyburide metformin 25. Stop taking metformin and call your doctor immediately if you experience a feelingof general discomfort or sickness; weakness; sore or aching muscles; troublebreathing, unusual drowsiness, dizziness or lightheadedness; unusual or unexplainedstomach upset (after the initial stomach upset that may occur at the start oftherapy with metformin); or the sudden development of a slow or irregular heartbeat glyburide metformin 25. These may be signs of lactic acidosis glyburide metformin 25.
• Avoid excessive alcohol intake while taking metformin glyburide metformin 25. Together, alcoholand metformin may increase the risk of lactic acidosis and hypoglycemia glyburide metformin 25.
• Metformin does not usually cause hypoglycemia (low blood sugar) glyburide metformin 25. Nevertheless,hypoglycemia may occur, as a result of skipped meals, excessive exercise, oralcohol consumption glyburide metformin 25. Know the signs and symptoms of low blood sugar, which includehunger, headache, drowsiness, weakness, dizziness, a fast heartbeat, sweating,tremor, and nausea glyburide metformin 25. Carry candy or glucose tablets to treat episodes of lowblood sugar glyburide metformin 25.

What is metformin?
• Metformin is used to regulate blood glucose (sugar) levels glyburide metformin 25. Metforminworks in three ways: first, it reduces the amount of glucose produced by yourliver; second, it reduces the amount of glucose absorbed from food through yourstomach; and third, it makes the insulin that your body produces work betterto reduce the amount of glucose already in your blood glyburide metformin 25.
• Metformin is used to treat non-insulin-dependent diabetes mellitus (NIDDMor Type II diabetes) glyburide metformin 25.
• Metformin may also be used for purposes other than those listed in thismedication guide glyburide metformin 25.

What should I discuss with my healthcare provider before taking metformin?
• Do not take metformin without first talking to your doctor if you
· have kidney disease;
· have liver disease;
· have congestive heart failure;
· have acute or chronic metabolic acidosis, including diabetic ketoacidosis;
· have had a heart attack or a stroke;
· have a serious infection, illness, or injury;
· need to have surgery;
· need to have x-rays or other procedures using injectable contrast agents;
· are dehydrated (have lost water from your body) due to diarrhea, vomiting,fever, heat stroke, decreased fluid intake, or any other cause;
· drink alcohol; or
· are 80 years of age or older and have not had your kidney functiontested glyburide metformin 25.
• You may not be able to take metformin, or you may require a dosage adjustmentor special monitoring during treatment if you have any of the conditions listedabove glyburide metformin 25.
• Metformin is in the FDA pregnancy category B glyburide metformin 25. This means that it is unlikelyto harm an unborn baby glyburide metformin 25. Usually, your doctor will want to prescribe insulinto control diabetes during pregnancy glyburide metformin 25. Do not take metformin without first talkingto your doctor if you are pregnant glyburide metformin 25.
• Metformin passes into breast milk and may affect a nursing baby glyburide metformin 25. Do nottake metformin without first talking to your doctor if you are breast-feedinga baby glyburide metformin 25.
• If you are over the age of 65 years, there may be an slight increasein the risk of developing lactic acidosis due to a natural decline in kidneyfunction with advancing age glyburide metformin 25. A lower dose or special monitoring may be necessaryduring your treatment glyburide metformin 25.

How should I take metformin?
• Take metformin exactly as directed by your doctor glyburide metformin 25. If you do not understandthese directions, ask your pharmacist, nurse, or doctor to explain the instructionsto you glyburide metformin 25.
• Take each dose with a full glass of water glyburide metformin 25.
• Take metformin with a meal to reduce nausea, diarrhea, and upset stomachthat may occur with metformin therapy glyburide metformin 25. These symptoms may be more likely tooccur during the first few weeks of therapy glyburide metformin 25.
• A decrease in vitamin B12 may also occur during metformin therapy glyburide metformin 25. Yourdoctor may want to monitor your blood levels of vitamin B12 and you may needto take B12 supplements glyburide metformin 25. A vitamin B12 deficiency may rarely cause anemia glyburide metformin 25.
• Your doctor may want to monitor your blood sugar control and other factorswith regularly scheduled blood tests glyburide metformin 25.
• Occasionally, inactive ingredients in the metformin extended-release(Glucophage XR) tablets may pass through your body undissolved and appear inthe stool as a soft mass glyburide metformin 25. This is not harmful, and the medication has been absorbedby your body glyburide metformin 25.
• Store metformin at room temperature away from moisture and heat glyburide metformin 25.

What happens if I miss a dose?
• Take the missed dose as soon as you remember glyburide metformin 25. However, if it is almosttime for your next dose, skip the missed dose and only take your next regularlyscheduled dose glyburide metformin 25. Do not take a double dose glyburide metformin 25.

What happens if I overdose?
• Seek emergency medical attention glyburide metformin 25.
• An overdose of metformin is likely to cause lactic acidosis glyburide metformin 25. Symptomsof lactic acidosis include a feeling of general discomfort or sickness; weakness;sore or aching muscles; trouble breathing; unusual drowsiness, dizziness orlightheadedness; unusual or unexplained stomach upset (after the initial stomachupset that may occur at the start of therapy with metformin); and the suddendevelopment of a slow or irregular heartbeat glyburide metformin 25.

What should I avoid while taking metformin?
• Avoid excessive alcohol intake while taking metformin glyburide metformin 25. Together, alcoholand metformin may increase the risk of lactic acidosis and hypoglycemia glyburide metformin 25.
• Follow your diet, medication, and exercise routines very closely glyburide metformin 25. Changingany of these things can effect your blood sugar levels glyburide metformin 25.
• Tell your doctor or other health care provider that you are taking thismedication if you need to have surgery or x-ray procedures that require injectionof contrast agents glyburide metformin 25. Treatment with metformin may need to be stopped for a shortperiod of time glyburide metformin 25.
• Tell your doctor that you are taking metformin if you become ill, ifyou have a heart attack; if you have a stroke; if you develop congestive heartfailure; if you experience diarrhea, vomiting, fever, or dehydration from anycause; or if you decrease the amount of food or liquid in your normal diet glyburide metformin 25. You may need to stop your treatment with metformin for a short amount of timeuntil you are feeling better glyburide metformin 25.

What are the possible side effects of metformin?
• Stop taking metformin and seek emergency medical attention if you experiencean allergic reaction (difficulty breathing; closing of your throat; swellingof your lips, tongue, or face; or hives) glyburide metformin 25.
• A small number of people who have taken metformin have developed a seriouscondition called lactic acidosis that has been fatal in up to 50% of cases glyburide metformin 25. Lactic acidosis has occurred most often in people whose kidneys were not workingproperly glyburide metformin 25. Liver problems may also increase the risk of developing lactic acidosis glyburide metformin 25. Stop taking metformin and call your doctor immediately if you experience a feelingof general discomfort or sickness; weakness; sore or aching muscles; troublebreathing, unusual drowsiness, dizziness or lightheadedness; unusual or unexplainedstomach upset (after the initial stomach upset that may occur at the start oftherapy with metformin); or the sudden development of a slow or irregular heartbeat glyburide metformin 25. These may be signs of lactic acidosis glyburide metformin 25.
• Other, less serious side effects may be more likely to occur glyburide metformin 25. Continueto take metformin and talk to your doctor if you experience
· nausea, vomiting, abdominal pain, or diarrhea at the start of therapy;
· abdominal bloating or increased gas production; or
· decreased appetite or changes in taste (metallic taste in your mouth) glyburide metformin 25.
• Side effects other than those listed here may also occur glyburide metformin 25. Talk to yourdoctor about any side effect that seems unusual or that is especially bothersome glyburide metformin 25.

What other drugs will affect metformin?
• Before taking this medication, tell your doctor if you are taking anyof the following medications:
· a diuretic (water pill) such as furosemide (Lasix), bumetanide (Bumex),ethacrynic acid (Edecrin), torsemide (Demadex), amiloride (Midamor), triamterene(Dyazide, Maxzide, Dyrenium), spironolactone (Aldactone), hydrochlorothiazide(HydroDiuril), chlorothiazide (Diuril), chlorthalidone (Hygroton), indapamide(Lozol), metolazone (Zaroxolyn, Mykrox), and others;
· a phenothiazine such as chlorpromazine (Thorazine), prochlorperazine(Compazine), promethazine (Phenergan), and others
· an estrogen (Premarin, Prempro, Ogen, and others) or birth controlpill (Ovral, Lo-Ovral, Ortho-Novum, Triphasil, Levlen, Tri-Levlen, Alesse, andothers)
· a calcium channel blocker such as nifedipine (Adalat, Procardia), verapamil(Calan, Verelan, Isoptin), diltiazem (Cardizem, Dilacor XR), felodipine (Plendil),bepridil (Vascor), amlodipine (Norvasc), and others;
· a steroid medication such as prednisone (Deltasone), methylprednisolone(Medrol), dexamethasone (Decadron), and others;
· a thyroid medication (Synthroid, Levoxyl, Levothroid, and others),
· digoxin (Lanoxin, Lanoxicaps);
· procainamide (Pronestyl);
· quinidine (Cardioquin, others);
· cimetidine (Tagamet, Tagamet HB) or ranitidine (Zantac, Zantac 75);
· morphine (Astramorph, MS Contin, Roxanol, and others);
· trimethoprim (Proloprim, Trimpex, Septra, Bactrim);
· phenytoin (Dilantin);
· isoniazid (Nydrazid); or
· nicotinic acid or niacin (Nicobid, Nicolar, others) glyburide metformin 25.
• You may not be able to take metformin, or you may require a dosage adjustmentor special monitoring if you are taking any of the medicines listed above glyburide metformin 25.
• Drugs other than those listed here may also interact with metformin oraffect your condition glyburide metformin 25. Talk to your doctor and pharmacist before taking anyprescription or over-the-counter medicines glyburide metformin 25.

Where can I get more information?
• Your pharmacist has more information about metformin written for healthprofessionals that you may read glyburide metformin 25.

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