save metformin er 500mg

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 save metformin er 500mg. Lactic acidosis has occurred most often in people whose kidneys were not workingproperly save metformin er 500mg. Liver problems may also increase the risk of developing lactic acidosis save metformin er 500mg. 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 save metformin er 500mg. These may be signs of lactic acidosis save metformin er 500mg.
• Avoid excessive alcohol intake while taking metformin save metformin er 500mg. Together, alcoholand metformin may increase the risk of lactic acidosis and hypoglycemia save metformin er 500mg.
• Metformin does not usually cause hypoglycemia (low blood sugar) save metformin er 500mg. Nevertheless,hypoglycemia may occur, as a result of skipped meals, excessive exercise, oralcohol consumption save metformin er 500mg. Know the signs and symptoms of low blood sugar, which includehunger, headache, drowsiness, weakness, dizziness, a fast heartbeat, sweating,tremor, and nausea save metformin er 500mg. Carry candy or glucose tablets to treat episodes of lowblood sugar save metformin er 500mg.

What is metformin?
• Metformin is used to regulate blood glucose (sugar) levels save metformin er 500mg. 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 save metformin er 500mg.
• Metformin is used to treat non-insulin-dependent diabetes mellitus (NIDDMor Type II diabetes) save metformin er 500mg.
• Metformin may also be used for purposes other than those listed in thismedication guide save metformin er 500mg.

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 save metformin er 500mg.
• 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 save metformin er 500mg.
• Metformin is in the FDA pregnancy category B save metformin er 500mg. This means that it is unlikelyto harm an unborn baby save metformin er 500mg. Usually, your doctor will want to prescribe insulinto control diabetes during pregnancy save metformin er 500mg. Do not take metformin without first talkingto your doctor if you are pregnant save metformin er 500mg.
• Metformin passes into breast milk and may affect a nursing baby save metformin er 500mg. Do nottake metformin without first talking to your doctor if you are breast-feedinga baby save metformin er 500mg.
• 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 save metformin er 500mg. A lower dose or special monitoring may be necessaryduring your treatment save metformin er 500mg.

How should I take metformin?
• Take metformin exactly as directed by your doctor save metformin er 500mg. If you do not understandthese directions, ask your pharmacist, nurse, or doctor to explain the instructionsto you save metformin er 500mg.
• Take each dose with a full glass of water save metformin er 500mg.
• Take metformin with a meal to reduce nausea, diarrhea, and upset stomachthat may occur with metformin therapy save metformin er 500mg. These symptoms may be more likely tooccur during the first few weeks of therapy save metformin er 500mg.
• A decrease in vitamin B12 may also occur during metformin therapy save metformin er 500mg. Yourdoctor may want to monitor your blood levels of vitamin B12 and you may needto take B12 supplements save metformin er 500mg. A vitamin B12 deficiency may rarely cause anemia save metformin er 500mg.
• Your doctor may want to monitor your blood sugar control and other factorswith regularly scheduled blood tests save metformin er 500mg.
• 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 save metformin er 500mg. This is not harmful, and the medication has been absorbedby your body save metformin er 500mg.
• Store metformin at room temperature away from moisture and heat save metformin er 500mg.

What happens if I miss a dose?
• Take the missed dose as soon as you remember save metformin er 500mg. However, if it is almosttime for your next dose, skip the missed dose and only take your next regularlyscheduled dose save metformin er 500mg. Do not take a double dose save metformin er 500mg.

What happens if I overdose?
• Seek emergency medical attention save metformin er 500mg.
• An overdose of metformin is likely to cause lactic acidosis save metformin er 500mg. 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 save metformin er 500mg.

What should I avoid while taking metformin?
• Avoid excessive alcohol intake while taking metformin save metformin er 500mg. Together, alcoholand metformin may increase the risk of lactic acidosis and hypoglycemia save metformin er 500mg.
• Follow your diet, medication, and exercise routines very closely save metformin er 500mg. Changingany of these things can effect your blood sugar levels save metformin er 500mg.
• 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 save metformin er 500mg. Treatment with metformin may need to be stopped for a shortperiod of time save metformin er 500mg.
• 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 save metformin er 500mg. You may need to stop your treatment with metformin for a short amount of timeuntil you are feeling better save metformin er 500mg.

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) save metformin er 500mg.
• 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 save metformin er 500mg. Lactic acidosis has occurred most often in people whose kidneys were not workingproperly save metformin er 500mg. Liver problems may also increase the risk of developing lactic acidosis save metformin er 500mg. 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 save metformin er 500mg. These may be signs of lactic acidosis save metformin er 500mg.
• Other, less serious side effects may be more likely to occur save metformin er 500mg. 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) save metformin er 500mg.
• Side effects other than those listed here may also occur save metformin er 500mg. Talk to yourdoctor about any side effect that seems unusual or that is especially bothersome save metformin er 500mg.

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) save metformin er 500mg.
• 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 save metformin er 500mg.
• Drugs other than those listed here may also interact with metformin oraffect your condition save metformin er 500mg. Talk to your doctor and pharmacist before taking anyprescription or over-the-counter medicines save metformin er 500mg.

Where can I get more information?
• Your pharmacist has more information about metformin written for healthprofessionals that you may read save metformin er 500mg.

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