Elderly Patients
Metformin may increase the risk of lactate buildup in the body in elderly patients. Proper monitoring of the functioning of the kidneys is recommended in elderly patients. Avoid the use of Metformin in these patients.
Alcohol Consumption
Excessive
alcohol consumption may lead to an increased risk of the build-up of lactate in the body (lactic
acidosis). Avoid the consumption of alcohol while taking Metformin.
Heart Failure
Patients with heart failure are at an increased risk when using this medicine. Such patients may see an increased risk of the low level of oxygen in the blood (
hypoxemia) and abnormal functioning of the kidney. In patients with stable long-term heart failure, appropriate monitoring of the functioning of the heart and kidney is required while using this medicine. The use of Metformin is not recommended in patients with unstable heart failure.
Surgery
Patients at the time of
surgery under
anesthesia are at an increased risk when using Metformin. Discontinue the use of Metformin at the time of surgery for at least 48 hours. Restart the use of this medicine after the resumption of oral
nutrition or if the functioning of the kidney becomes stable.
Iodinated Contrast Agents
Use of iodinated contrast agents which are taken through the blood vessels (intravascular) may increase the risk of the build-up of lactate inside the body, decrease the functioning of the kidney. Discontinue the use of Metformin before or at the time of treatment with iodinated contrast agents for at least 48 hours. Restart the use of this medicine if the functioning of the kidney becomes stable.
Severe Conditions of Vomiting, Diarrhea, or Fever
Patients with severe conditions of vomiting,
diarrhea, or
fever may experience severe loss of water in the body (severe
dehydration). Discontinue the use of Metformin for a shorter time duration and consultation with a doctor is advised.
Build Up of Lactate in the Body
Patients with
diabetes, prolonged fasting,
alcohol intake, serious infections, liver problems,
dehydration, and decreased supply of oxygen are at increased risk when using this medicine. Patients using Metformin are at an increased risk of low body temperature, low blood pressure, abnormal heartbeat, and fatal conditions. These patients may see an increased level of lactate, Metformin, lactate/pyruvate ratio, and abnormal levels of negatively charged ions in the blood. Such patients may also develop symptoms of lactic
acidosis such as a feeling of discomfort, muscle
pain, etc. Discontinue the use of Metformin in these conditions. Supportive measures and immediate use of a therapy that purifies the blood (hemodialysis) is also recommended.