Lactic acidosis. Hypoxic states, surgical procedures, alcohol intake. Use of concomitant medications that may affect renal function or metformin disposition eg, cationic drugs. Temporarily discontinue treatment in patients if radiologic studies are planned. Change in clinical status of patients w/ previously controlled type 2 diabetes. Debilitated or malnourished patients. Hypoglycemia. Impaired renal & hepatic function. Pregnancy & lactation. Childn. Elderly.
Enhanced absorption w/ nifedipine. Cationic medications that are excreted via renal tubular secretory system (eg, amiloride, digoxin, morphine, procainamide, quinidine, quinine, ranitidine, triamterene, trimethoprim, vancomycin). Concomitant use w/ thiazide & other diuretics, corticosteroids, phenothiazines, thyroid products, estrogens, OCs, phenytoin, nicotinic acid, sympathomimetics, Ca channel blocking drugs, & INH may lead to loss of blood glucose control.
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