The following Information is intended to supplement, not substitute for, the expertise and judgment of your physician, pharmacist or other healthcare professional. It should not be construed to indicate that use of the drug is safe, appropriate, or effective for you.

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Metformin (met-FOR-min) is used to treat a type of diabetes mellitus (sugar diabetes) called type 2 diabetes. With this type of diabetes, insulin produced by the pancreas is not able to get sugar into the cells of the body where it can work properly. Using metformin alone, with a type of oral antidiabetic medicine called a sulfonylurea, or with insulin will help to lower blood sugar when it is too high and help restore the way you use food to make energy.

Many people can control type 2 diabetes with diet alone or diet and exercise. Following a specially planned diet and exercising will always be important when you have diabetes, even when you are taking medicines. To work properly, the amount of metformin you take must be balanced against the amount and type of food you eat and the amount of exercise you do. If you change your diet, your exercise, or both, you will want to test your blood sugar to find out if it is too low. Your health care professional will teach you what to do if this happens.

At some point, this medicine may stop working as well and your blood glucose will increase. You will need to know if this happens and what to do. Instead of taking more of this medicine, your doctor may want you to change to another antidiabetic medicine. If that does not lower your blood sugar, your doctor may have you stop taking the medicine and begin receiving insulin injections instead.

Metformin does not help patients who have insulin-dependent or type 1 diabetes because they cannot produce insulin from their pancreas gland. Their blood glucose is best controlled by insulin injections.

Glucophage comes in tablets to take by mouth. It usually is taken two or three times a day with meals. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take Glucophage exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor. Metformin hydrochloride extended-release tablets should be swallowed whole. Do not break, chew, or crush. Continue to take Metformin hydrochloride even if you feel well. Do not stop taking Metformin hydrochloride without talking to your doctor.

Although side effects from Metformin hydrochloride are not common, they can occur. If you have any of these symptoms, eat or drink a food or beverage with sugar in it, such as hard candy or fruit juice, and call your doctor immediately; symptoms of low blood sugar (hypoglycemia) include:

- shakiness
- dizziness
- rapid heartbeat
- sweating or confusion
- blurred vision
- headache
- numbness or tingling of the mouth
- weakness
- fatigue
- pale color - sudden hunger

If you have any of these symptoms, call your doctor immediately; symptoms of high blood sugar (hyperglycemia) i-nclude:

- thirst
- dry mouth
- tiredness
- flushing
- dry skin
- frequent urination
- loss of appetite
- trouble breathing

If you experience any of the following symptoms, or those listed in the IMPORTANT WARNING section, call your doctor immediately:

- seizures
- loss of consciousness
- skin rash
- itching or redness
- exaggerated sunburn
- yellowing of the skin or eyes
- light-colored stools
- dark urine
- unusual bleeding or bruising
- fever
- sore throat

Before taking Glucophage,

- tell your doctor and pharmacist if you are allergic to Glucophage or any other drugs.
- tell your doctor and pharmacist what prescription and nonprescription medications you are taking, especially cimetidine (Tagamet), diuretics ('water pills'), nifedipine (Procardia), and vitamins. in addition to the conditions listed in the IMPORTANT WARNING section, tell your doctor if you have or have ever had heart, pituitary, or thyroid disease; adrenal insufficiency; a severe infection; or hormone problems.
- tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking Metformin hydrochloride, call your doctor.
- if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking Glucophage.

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. Do not take any other medicine unless prescribed or approved by your doctor . When you are taking metformin, it is especially important that your health care professional know if you are taking any of the following:

- AlcoholSmall amounts of alcohol taken with meals do not usually cause a problem; however, either larger amounts of alcohol taken for a long time or a large amount of alcohol taken in one sitting without food can increase the effect of metformin. This can keep the blood sugar low for a longer period of time than normal
- Amiloride (e.g., Midamor) or
- Calcium channel blocking agents (amlodipine [e.g., Norvasc], bepridil [e.g., Bepadin], diltiazem [e.g., Cardizem], felodipine [e.g., Plendil], flunarizine [e.g., Sibelium], isradipine [e.g., DynaCirc], nicardipine [e.g., Cardene], nifedipine [e.g., Procardia], nimodipine [e.g., Nimotop], verapamil [e.g., Calan]) or * Cimetidine (e.g., Tagamet) or
- Digoxin (heart medicine) or
- Furosemide (e.g., Lasix) or
- Morphine (e.g., M S Contin) or
- Procainamide (e.g., Pronestyl) or
- Quinidine (e.g., Quinidex) or
- Quinine (malaria medicine) or
- Ranitidine (e.g., Zantac) or
- Triamterene (e.g., Dyrenium) or
- Trimethoprim (e.g., Proloprim) or
- Vancomycin (e.g., Vancocin)Use with metformin may cause high blood levels of metformin, which may increase the chance of low blood sugar or side effects

Store at room temperature between 59 and 86 degrees F (15-30 degrees C) away from light and moisture. Keep this and all medications out of the reach of children.