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Some side effects of Glucophage may not be reported. Always consult your doctor or healthcare specialist for medical advice. You may also report side effects to the FDA.
Get emergency medical help if you have any of these signs of an allergic reaction while taking metformin (the active ingredient contained in Glucophage) hives; difficult breathing; swelling of your face, lips, tongue, or throat.
This medication may cause lactic acidosis (a build-up of lactic acid in the body, which can be fatal). Lactic acidosis can start slowly and get worse over time. Get emergency medical help if you have even mild symptoms of lactic acidosis, such as:
· muscle pain or weakness;
· numb or cold feeling in your arms and legs;
· trouble breathing;
· feeling dizzy, light-headed, tired, or very weak;
· stomach pain, with vomiting; or
· slow or uneven heart rate.
Call your doctor at once if you have any other serious side effect such as:
· feeling short of breath, even with mild exertion;
· swelling or rapid weight gain; or
· fever, chills, body aches, flu symptoms.
Less serious side effects of metformin may include:
· headache or muscle pain;
· weakness; or
· mild nausea, , diarrhea, gas, stomach pain.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects.
Metformin (the active ingredient contained in Glucophage) has been generally well tolerated. About 20% of patients experienced mild, transient side effects sometime during therapy.
Lactic acidosis is a medical emergency requiring immediate evaluation and treatment. The case fatality rate may be as high as 50.3%. Patients taking metformin (the active ingredient contained in Glucophage) who present with even vague medical illnesses such as myalgia, malaise, somnolence, abdominal discomfort, and so forth, should be evaluated for a metabolic etiology like lactic acidosis.
Signs and symptoms of severe acidosis may include vomiting, abdominal pain, nausea, dyspnea, hypothermia, hypotension, and bradycardia.
Laboratory evaluation of metformin-induced lactic acidosis generally includes determination of the following: blood glucose concentration, lactic acid concentration, serum , blood pH, metformin concentration, and exclusion of ketoacidosis.
If lactic acidosis is present, immediate institution of general supportive is indicated. Prompt hemodialysis is also generally recommended in order to correct the acidosis and remove metformin. Hemodialysis often results in rapid improvement. Some investigators have suggested that dialysis with a bicarbonate-buffered dialysate may be particularly effective.
Metabolic side effects have included lactic acidosis, which is a potentially fatal metabolic complication. The incidence of lactic acidosis has been about 1.5 cases per 10,000 patient years. The risk of lactic acidosis has been particularly high in patients with underlying renal insufficiency. Cases of lactic acidosis occurring in patients with normal renal function have been rarely reported. Concomitant cardiovascular or liver disease, sepsis, and hypoxia have also increased the risk of lactic acidosis.
Hypoglycemia occurred uncommonly in patients receiving metformin as monotherapy. Strenuous , decreased caloric intake, general debilitation, adrenal insufficiency, pituitary insufficiency, and ethanol use have increased the risk of hypoglycemia.
Gastrointestinal effects have included nausea, anorexia, metallic taste, , dyspepsia, flatulence, and abdominal pain. One study has reported a 20% incidence of diarrhea.
Hematologic side effects have included malabsorption of vitamin B12, due to intrinsic factor deficiency and possibly other mechanisms, in as many as 30% of treated patients. Megaloblastic anemia has occurred. Discontinuation of metformin (the active ingredient contained in Glucophage) or supplementation with vitamin B12 has been necessary.
Other side effects include a single case of leukocytoclastic vasculitis with pneumonitis.
Hepatic side effects have included at least two cases of hepatitis associated with metformin (the active ingredient contained in Glucophage) use.
A 52-year-old female with a history of type II diabetes mellitus and hypertension developed lethargy, fatigue, and diarrhea after taking metformin for more than 2 weeks. After continuing metformin for a total of four weeks, her sclera became icteric and she was hospitalized. Aside from a soft systolic ejection fracture and a moderate degree of bilateral lower extremity edema, her physical examination was unremarkable. Laboratory data showed grossly elevated total bilirubin, AST, ALT, and alkaline phosphatase. Several days after her initial presentation all of her medications were discontinued. Her signs and symptoms significantly improved over the following several days, and she was discharged within two weeks of her hospitalization. The patient's presentation was considered consistent with drug-induced toxicity attributed to metformin.
Other side effects have included reports of a distinct drug odor. The odor is generally described as "fish or fishy". The odor report varies considerably between generic versions and seems to be less noticeable with film-coated formulations.
If you are currently taking prescription medication for your symptoms and are interested in building more health and perhaps getting off your medication by addressing the cause of your health concern, please call the office and let us discuss your options. I will work with your medical doctor to restore your health and reduce or eliminate the need for medication.
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