Find & Manage Your Patient Assistance Programs
Estimated patient savings $600,000,000.00

Important Note

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. Consult your healthcare professional before using this drug.




WARNING: The metformin in this combination medication can rarely cause a condition called lactic acidosis, which can be fatal. If you develop any of the following symptoms of lactic acidosis, stop this medication and seek immediate medical attention: unusual tiredness (fatigue) or severe drowsiness, low body temperature, unexplained muscle pain, breathing trouble or rapid breathing, unusually slow or irregular heartbeat. Lactic acidosis is more likely to occur in patients who have: kidney or liver disease, conditions that may cause a low oxygen blood level or poor circulation (e.g., severe congestive heart failure, recent heart attack, recent stroke), excessive alcohol use, a lack of body fluids (dehydration), x-ray or scanning procedures that require an injectable iodinated contrast drug, surgery, or a serious infection. Also at higher risk are those who are elderly, especially if you are over 80 years of age and have not had kidney and liver tests.


This combination medication is used along with a diet and exercise program to control high blood sugar in diabetic patients. This medication works by releasing more of the insulin that your body naturally produces into your bloodstream and by helping your body use the insulin more effectively. Controlling high blood sugar helps prevent heart disease, strokes, kidney disease, blindness and circulation problems, as well as sexual function problems (impotence).

How To Use

Take this medication with meals. Use this medication regularly in order to get the most benefit from it. To help you remember, use it at the same time(s) each day. Your dosage is based on your medical condition and response to therapy. Read the patient information leaflet provided by your pharmacist. If you have any questions regarding the information, ask your doctor or pharmacist.

Side Effects

Also see Warnings. Nausea, stomach upset, diarrhea, vomiting or metallic taste may occur initially as your body adjusts to the medication. If stomach symptoms recur later (after you are on the same dose for several days or more), tell your doctor immediately. A late recurrence of stomach symptoms may be due to lactic acidosis. Headache, back pain, joint pain, weight gain, increased sensitivity to sunlight, cough or fever may also occur. If any of these effects persist or worsen, notify your doctor or pharmacist promptly. Tell your doctor immediately if any of these unlikely but serious side effects occur: unusual tiredness or weakness, trouble breathing. Tell your doctor immediately if any of these highly unlikely but very serious side effects occur: stomach pain, yellowing eyes or skin, dark urine, unusual bleeding or bruising, persistent sore throat or fever, unusual change in the amount of urine. This medication can cause low blood sugar (hypoglycemia). The symptoms include chills, cold sweat, dizziness, drowsiness, shaking, rapid heart rate, weakness, headache, fainting, tingling of the hands or feet, or hunger. It is a good habit to carry glucose tablets or gel to treat low blood sugar. If you are in a situation where you don't have these reliable forms of glucose, eat a quick source of sugar such as table sugar, honey, or candy, or drink a glass of orange juice or non-diet soda to quickly raise your blood sugar level. Tell your doctor immediately about the reaction. To help prevent hypoglycemia, eat meals on a regular schedule and do not skip meals. Symptoms of high blood sugar (hyperglycemia) include thirst, increased urination, confusion, drowsiness, flushing, rapid breathing, or fruity breath odor. If these symptoms occur, tell your doctor immediately. Your medication dosage may need to be increased. An allergic reaction to this drug is unlikely, but seek immediate medical attention if it occurs. Symptoms of an allergic reaction include: rash, itching, swelling, dizziness, trouble breathing. If you notice other effects not listed above, contact your doctor or pharmacist.


See also the Warnings section. This medication should not be used if you have certain medical conditions. Before using this medicine, consult your doctor or pharmacist if you have: kidney disease, liver disease, conditions that may cause a low oxygen blood level or poor circulation (e.g., severe congestive heart failure, recent heart attack, recent stroke), lack of body fluids (dehydration), serious infection, metabolic acidosis (e.g., diabetic ketoacidosis), Type I diabetes (insulin-dependent diabetes). Before using this medication, tell your doctor or pharmacist your medical history, especially of: severe breathing problems (e.g., obstructive lung disease, severe asthma), blood disorders (e.g., anemia, vitamin B-12 deficiency), high blood pressure, scheduled upcoming surgery, fertility problems (e.g., ovulation problems), alcohol use, any allergies. Limit alcohol while using this medication. This medication may make you more sensitive to the sun. Avoid prolonged sun exposure, tanning booths or sunlamps. Use a sunscreen and wear protective clothing when outdoors. During times of stress, such as fever, infection, injury or surgery, it may be more difficult to control your blood sugar. Consult your doctor, as a change in your medication may be required. Caution is advised when using this drug in the elderly because they may be more sensitive to the effects of the drug. This medication is not recommended for use during pregnancy due to possible fetal harm. Consult your doctor for more details. It is not known whether this drug passes into breast milk. Breast-feeding is not recommended while using this drug.

Drug Interactions

Before using this medication, tell your doctor or pharmacist of all prescription and nonprescription products you may use, especially of: other diabetes drugs (e.g., insulin, rosiglitazone), beta-blockers (e.g., propranolol), "water pills" (diuretics such as hydrochlorothiazide, furosemide), cimetidine, birth control pills, estrogens, corticosteroids (e.g., prednisone), niacin, phenytoin, decongestants (e.g., pseudoephedrine), calcium channel blockers (e.g., nifedipine), phenothiazines (e.g., chlorpromazine), isoniazid, thyroid drugs, aspirin-like drugs, non-steroidal anti-inflammatory drugs (NSAIDs), azole antifungals (e.g., fluconazole, ketoconazole), "blood thinners" (e.g., warfarin), MAO inhibitors (e.g., furazolidone, linezolid, moclobemide, phenelzine procarbazine, selegiline, isocarboxazid, tranylcypromine), probenecid, chloramphenicol, diazoxide, clofibrate, rifampin, sulfonamides (e.g., sulfa antibiotics), fenugreek, ginseng. If you are scheduled to undergo any x-ray or scanning procedure using injectable iodinated contrast material, be sure to inform your doctor that you are taking this medication. You will need to temporarily stop this medication around the time of your procedure. Consult your doctor for further instructions. Do not start or stop any medicine without doctor or pharmacist approval.


If overdose is suspected, contact your local poison control center or emergency room immediately. Symptoms of overdose may include: sweating, shakiness, vision changes, rapid or trouble breathing, severe drowsiness, slow or irregular heartbeat.


Do not share this medication with others. It is recommended you attend a diabetes education program to understand diabetes and all the important aspects of its treatment including meals/diet, exercise, personal hygiene, medications and regular eye, foot, and medical exams. Consult your doctor or pharmacist. Keep all medical appointments. Laboratory and/or medical tests (e.g., liver and kidney function tests, fasting blood glucose, hemoglobin A1c, complete blood counts) will be performed to monitor for side effects and response to therapy. Regularly check your blood or urine for sugar, as directed by your doctor or pharmacist.

Missed Dose

If you miss a dose, use it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up.


Store at room temperature at 68 to 77 degrees F (20 to 25 degrees C) away from light and moisture. Brief storage from 59 to 86 degrees F (15 to 30 degrees C) is permitted. Do not store in the bathroom. Keep all medicines away from children and pets.

Medical Alert

Your condition can cause complications in a medical emergency. For enrollment information call MedicAlert at 1-800-854-1166 (USA), or 1-800-668-1507 (Canada).