es that there is strong evidence for the safety and effectiveness of using metformin during pregnancy.
This medicine may pass into breast milk in small amounts. The manufacturer recommends that it is not used during breastfeeding. However, if you were taking metformin for type 2 diabetes before you got pregnant, it is considered safe to continue to take it while you are breastfeeding. This is another recommendation from the 2008 NICE guideline. Seek further medical advice from your doctor.
Label warnings
Take this medication with or after food.
Side effects
Medicines and their possible side effects can affect individualpeople in different ways. The following are some of the side effects that areknown to be associated with this medicine. Just because a side effect is statedhere does not mean that all people using this medicine will experience thator any side effect.
Very common (affect more than 1 in 10 people)
Disturbances of the gut such as nausea, vomiting, diarrhoea or abdominal pain.
Loss of appetite.
Common (affect between 1 in 10 and 1 in 100 people)
Taste disturbance, usually a metallic taste.
Very rare (affect less than 1 in 10,000 people)
Elevated levels of lactic acid in the blood (lactic acidosis).
Decreased absorption of vitamin B12 during long-term use.
Skin reactions such as rash, itching or flushing.
The side effects listed above may not include all of the sideeffects reported by the medicine'smanufacturer.For moreinformation about any other possible risks associated with this medicine,please read the information provided with the medicine or consult your doctoror pharmacist.
How can this medicine affect other medicines?
It is important to tell your doctor or pharmacist what medicinesyou are already taking, including those bought without a prescription andherbal medicines, before you start treatment with this medicine. Similarly,check with your doctor or pharmacist before taking any new medicines whiletaking this one, to ensure that thecombination is safe.
When metformin is taken with other antidiabetic medicines, suchas sulphonylureas (eg gliclazide, glibenclamide) or insulin, there will be anenhanced blood sugar lowering effect. Your blood sugar level should bemonitored if you are taking metformin in combination with other antidiabetic medicines.
The following medicines may increase blood glucose levels. Ifyou start treatment with any of these your doctor may want to check your blood sugar level more frequently and your dose of metformin may needincreasing:
beta-2-agonists, such as salbutamol
corticosteroids, such as prednisolone
diuretics, especially thiazide diuretics, eg bendroflumethiazide
lithium
oestrogens and progesterones, such as those contained in oral contraceptives.
Octreotide and lanreotide may also affect blood sugar levels. If you are being treated with one of these medicines your doctor may want to check your blood sugar levels and adjust your metformin dose if necessary.
Low blood sugar levels (hypoglycaemia) may occur, sometimesunpredictably, if ACE inhibitors such as captopril are taken withmetformin. Your doctor may want you to temporarily check your blood sugar more frequently if you start treatment with an ACE inhibitor while taking metformin.
MAOI antidepressants, such as phenelzine, tranylcypromine or isocarboxazid, may enhance the blood sugar lowering effect of metformin. Your doctor may ask you to monitor y
