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Metformin Side Effects

In Summary

Commonly reported side effects of metformin include: lactic acidosis, diarrhea, nausea, vomiting, nausea and vomiting, and flatulence. Other side effects include: diarrhea, nausea, vomiting, decreased vitamin b12 serum concentrate, and weakness. See below for a comprehensive list of adverse effects.

For the Consumer

Applies to metformin: oral solution, oral tablet, oral tablet extended release

In addition to its needed effects, some unwanted effects may be caused by metformin. In the event that any of these side effects do occur, they may require medical attention.

Major Side Effects

You should check with your doctor immediately if any of these side effects occur when taking metformin:

More common:

Abdominal or stomach discomfort

cough or hoarseness

decreased appetite

diarrhea

fast or shallow breathing

fever or chills

general feeling of discomfort

lower back or side pain

muscle pain or cramping

painful or difficult urination

sleepiness

Less common:

Anxiety

blurred vision

chest discomfort

cold sweats

coma

confusion

cool, pale skin

depression

difficult or labored breathing

dizziness

fast, irregular, pounding, or racing heartbeat or pulse

feeling of warmth

headache

increased hunger

increased sweating

nausea

nervousness

nightmares

redness of the face, neck, arms, and occasionally, upper chest

seizures

shakiness

shortness of breath

slurred speech

tightness in the chest

unusual tiredness or weakness

wheezing

Rare

Behavior change similar to being drunk

difficulty with concentrating

drowsiness

lack or loss of strength

restless sleep

unusual sleepiness

Minor Side Effects

Some of the side effects that can occur with metformin may not need medical attention. As your body adjusts to the medicine during treatment these side effects may go away. Your health care professional may also be able to tell you about ways to reduce or prevent some of these side effects. If any of the following side effects continue, are bothersome or if you have any questions about them, check with your health care professional:

More common:

Acid or sour stomach

belching

bloated

excess air or gas in the stomach or intestines

full feeling

heartburn

indigestion

loss of appetite

metallic taste in the mouth

passing of gas

stomachache

stomach upset or pain

vomiting

weight loss

Less common:

Abnormal stools

bad, unusual, or unpleasant (after) taste

change in taste

difficulty with moving

discoloration of the fingernails or toenails

flu-like symptoms

joint pain

rash

runny nose

sneezing

stuffy nose

swollen joints

For Healthcare Professionals

Applies to metformin: compounding powder, oral solution, oral tablet, oral tablet extended release

General

Gastrointestinal events such as nausea, vomiting, diarrhea, abdominal pain, and loss of appetite have been frequently reported during therapy initiation and resolve spontaneously in most cases.

Adverse events in the pediatric population appear to be similar in nature and severity to that published in adults. [Ref ]

Metabolic

Common (1% to 10%): Hypoglycemia Very rare (less than 0.01%): Lactic acidosis [Ref ]

Gastrointestinal

Very common (10% or more): Diarrhea (53.2%), nausea/vomiting (25.5%), flatulence (12.1%) Common (1% to 10%): Indigestion, abdominal discomfort, abnormal stools, dyspepsia, loss of appetite [Ref ]

Hematologic

Very rare (less than 0.01%): Subnormal vitamin B12 levels [Ref ]

Other

Common (1% to 10%): Asthenia, chills, flu syndrome, accidental injury [Ref ]

Hepatic

Very rare (less than 0.01%): Liver function test abnormalities, hepatitis [Ref ]

Cardiovascular

Common (1% to 10%): Chest discomfort, flushing, palpitation [Ref ]

Dermatologic

Common (1% to 10%): Rash, nail disorder, increased sweating Very rare (less than 0.01%): Erythema, pruritus, urticaria [Ref ]

Endocrine

Frequency not reported: Reduction in thyrotropin (TSH) levels [Ref ]

Immunologic

Very common (10% or more): Infection (20.5%) [Ref ]

Musculoskeletal

Common (1% to 10%): Myalgia [Ref ]

Nervous system

Common (1% to 10%): Lightheadedness, taste disturbances [Ref ]

Psychiatric

Common (1% to 10%): Headache [Ref ]

Respiratory

Common (1% to 10%): Rhinitis [Ref ]

References

1. "Product Information. Glucophage (metformin)." Bristol-Myers Squibb, Princeton, NJ.

2. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0

3. "Product Information. Fortamet (metFORMIN)." Physicians Total Care, Tulsa, OK.

4. Cerner Multum, Inc. "Australian Product Information." O 0

5. "Product Information. Riomet (metFORMIN)." Ranbaxy Pharmaceuticals, Jacksonville, FL.

6. "Product Information. Glumetza (metFORMIN)." Biovail Pharmaceuticals Canada, Mississauga, IA.

Not all side effects for metformin may be reported. You should always consult a doctor or healthcare professional for medical advice. Side effects can be reported to the FDA here .

More about metformin

Consumer resources

Professional resources

Related treatment guides

Disclaimer: Every effort has been made to ensure that the information provided is accurate, up-to-date and complete, but no guarantee is made to that effect. The information is not a substitute for the knowledge and judgement of a healthcare professional. Always consult with your doctor, nurse, or pharmacist before taking medication.

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