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Side effects

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

These include:

  • diarrhoea, nausea - occasionally accompanied by a metallic taste - these side effects are not uncommon after commencement of metformin therapy - these side effects may resolve with time
  • if treatment is started with a small initial dose (e.g. metformin 500mg od) and dosage is increased gradually then gastrointestinal effects are less likely
  • there have been malabsorption syndromes reported associated with metformin treatment
  • lactic acidosis may occur with metformin use although Salpeter et al concluded that the use of metformin in type 2 diabetes does not increase the risk for fatal or non-fatal lactic acidosis or increase in blood lactate concentrations compared with placebo or other hypoglycaemic treatments (1)

Reference:

  1. Salpeter S et al (2002). Risk of fatal and nonfatal lactic acidosis with metformin use in type 2 diabetes. Cochrane Database Syst Reve: CD002967 (latest version 27 Feb 2002).
  2. Prescribers' Journal (2000), 40 (1), 38-48.

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