Monitor for signs and symptoms of vitamin BOral solution (immediate release): Store at 15°C to 30°C (59°F to 86°F).Oral suspension (extended release): Store at 20°C to 25°C (68°F to 77°F); excursion permitted to 15°C to 30°C (59°F to 86°F). Management: Avoid use of OCT2 substrates with tafenoquine, and if the combination cannot be avoided, monitor closely for evidence of toxicity of the OCT2 substrate and consider a reduced dose of the OCT2 substrate according to that substrate's labeling.Thiazide and Thiazide-Like Diuretics: May diminish the therapeutic effect of Antidiabetic Agents.Topiramate: May enhance the adverse/toxic effect of MetFORMIN.Trimethoprim: May increase the serum concentration of MetFORMIN.Trospium: MetFORMIN may decrease the serum concentration of Trospium. Specifically, the risk of developing lactic acidosis may be increased.Cephalexin: May increase the serum concentration of MetFORMIN.Cimetidine: May increase the serum concentration of MetFORMIN. Consider a reduced dose of the MATE substrate according to that substrate's labeling if appropriate.Ritodrine: May diminish the therapeutic effect of Antidiabetic Agents.Salicylates: May enhance the hypoglycemic effect of Agents with Blood Glucose Lowering Effects.Selective Serotonin Reuptake Inhibitors: May enhance the hypoglycemic effect of Agents with Blood Glucose Lowering Effects.Tafenoquine: May increase the serum concentration of MATE1 Substrates. Available for Android and iOS devices. Management: Consider alternatives to this combination or use of lower metformin doses. However, metformin may be used as an alternative agent in some patients requiring therapy for gestational diabetes mellitus or type 2 diabetes mellitus (ACOG 190 2018; ACOG 201 2018). Vitamin K Antagonists may enhance the hypoglycemic effect of MetFORMIN. Use is contraindicated in patients with eGFR <30 mL/minute/1.73 m• Stress-related states: It may be necessary to discontinue metformin and administer insulin if the patient is exposed to stress (fever, trauma, infection, surgery).• Drug-drug interactions: Potentially significant interactions may exist, requiring dose or frequency adjustment, additional monitoring, and/or selection of alternative therapy. Metformin, a generic diabetes treatment usually sold under the brand name Glucophage, may help people with diabetes to lose weight by lowering their appetites. Use of metformin in patients with HF may be associated with reduced mortality and reduction in hospital readmission for HF (Crowley 2017; Eurich 2013).• Hepatic impairment: The manufacturer recommends to generally avoid use in patients with hepatic impairment due to potential for lactic acidosis. But some of the older Iodinated Contrast Agents: May enhance the adverse/toxic effect of MetFORMIN. Administer Riomet solution and suspension with supplied dosing cup.ER tablets: Swallow whole; do not crush, cut, or chew. Antipsychotic-induced weight gain Data from multiple meta-analyses of randomized controlled trials with varying degrees of heterogeneity (primarily in patients with schizophrenia and schizoaffective disorder) support the use of metformin in promoting modest weight loss and preventing weight gain associated with second-generation antipsychotics in adult patients [de Silva 2016] , … Take at the same time(s) each day. If so, it’s important that you tell your doctor or pharmacist before you start metformin. Specifically, alcohol may potentiate the risk of lactic acidosisAlpha-Lipoic Acid: May enhance the hypoglycemic effect of Antidiabetic Agents.Androgens: May enhance the hypoglycemic effect of Agents with Blood Glucose Lowering Effects.Bictegravir: May increase the serum concentration of MetFORMIN.Carbonic Anhydrase Inhibitors: May enhance the adverse/toxic effect of MetFORMIN.
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