Lactic Acidosis
Glucophage XR can rarely cause lactic acidosis, a serious condition in which lactic acid builds up in the blood.
The risk is higher when too much metformin accumulates in the body, especially in people with kidney problems or other conditions that reduce the body’s ability to clear the medication.
Seek urgent medical attention if you develop symptoms such as severe weakness, unusual tiredness, muscle pain, trouble breathing, dizziness, abdominal discomfort, nausea, vomiting, or feeling unusually cold.
Kidney Problems
Metformin is removed from the body mainly through the kidneys.
If your kidneys are not working properly, metformin can build up in the body and increase the risk of lactic acidosis.
Your healthcare provider may check your kidney function before starting Glucophage XR and periodically during treatment.
Iodinated Contrast for Imaging Tests
Certain imaging procedures use iodinated contrast dye, which can temporarily affect kidney function.
Depending on your kidney function and the type of procedure, your healthcare provider may tell you to temporarily stop Glucophage XR before or at the time of the test and restart it only after your kidney function has been checked.
Always tell the healthcare team performing an imaging test that you take metformin.
Low Blood Sugar
Glucophage XR usually does not cause hypoglycemia when taken by itself.
However, low blood sugar can occur when it is used with other diabetes medicines, especially insulin or sulfonylureas.
Symptoms may include sweating, shakiness, hunger, dizziness, weakness, or confusion.
Vitamin B12 Deficiency
Long-term metformin use can lower vitamin B12 levels in some people.
Low vitamin B12 may contribute to anemia, numbness or tingling, weakness, or other nerve-related symptoms.
Your healthcare provider may check your vitamin B12 level periodically, especially if you have symptoms or other risk factors for deficiency.
Stomach and Digestive Side Effects
Glucophage XR may cause nausea, diarrhea, abdominal discomfort, gas, or reduced appetite.
These effects are often more noticeable when treatment begins or the dose is increased.
Taking the medication with your evening meal and increasing the dose gradually can help reduce stomach-related side effects.
Liver Problems
Tell your healthcare provider if you have liver disease before taking Glucophage XR.
Severe liver problems can increase the risk of lactic acidosis because the liver plays an important role in processing lactate.
Alcohol Use
Drinking large amounts of alcohol can increase the risk of lactic acidosis while taking metformin.
Avoid excessive or binge drinking and discuss your alcohol use with your healthcare provider.
Surgery and Medical Procedures
Tell your healthcare provider if you are scheduled for surgery or another major medical procedure.
Glucophage XR may need to be temporarily stopped in some situations, especially if you will not be eating normally, are at risk of dehydration, or could develop changes in kidney function.
Dehydration and Serious Illness
Severe vomiting, diarrhea, fever, or not drinking enough fluids can lead to dehydration.
Dehydration may increase the risk of kidney problems and metformin accumulation.
Contact your healthcare provider if you become seriously ill or cannot keep fluids down.
Heart Conditions
Glucophage XR is not generally known to raise blood pressure or directly increase cardiovascular risk.
However, people with unstable or severe heart failure or other conditions that reduce oxygen delivery to the tissues may have a greater risk of lactic acidosis.
Tell your healthcare provider about any serious heart condition before starting treatment.
Regular Monitoring
While taking Glucophage XR, your healthcare provider may monitor your blood sugar, A1C, kidney function, and vitamin B12 levels.
Regular monitoring helps ensure that the medication continues to work effectively and remains safe for you.
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