Absorption of various substances, including vitamin B12 may be impaired.
Metabolism and nutrition disorders: Common: Vitamin B12 decrease/deficiency.
Skin reactions have been reported rarely.
Hypoglycemia is rare with a biguanide given alone, although it may occur if other contributing factors or drugs are present.
Lactic acidosis, sometimes fatal, has occurred with biguanides, primarily with phenformin. When it has occurred with metformin most cases have been reported in patients whose condition contra-indicated the use of the drug, particularly those with renal impairment.
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