If patients need to have major surgery, they must stop taking Metphar XR during and for some time after the procedure. The doctor will decide when patients must stop and when to restart the treatment with Metphar XR.
During treatment with Metphar XR, the doctor will check the kidney function at least once a year or more frequently if the patient is an elderly and/or if there is worsening kidney function.
Patients may see some remains of the tablets in the stools. No need to worry - this is normal for this type of tablet.
Patients should continue to follow any dietary advice that the doctor has given and should make sure to eat carbohydrates regularly throughout the day.
Do not stop taking this medicine without speaking to the doctor.
Risk of lactic acidosis: Metphar XR may cause a very rare, but very serious side effect called lactic acidosis, particularly if the kidneys are not working properly. The risk of developing lactic acidosis is also increased with uncontrolled diabetes, serious infections, prolonged fasting or alcohol intake, dehydration (see further information as follows), liver problems and any medical conditions in which a part of the body has a reduced supply of oxygen (such as acute severe heart disease).
If any of the previously mentioned applies, talk to the doctor for further instructions.
Stop taking Metphar XR for a short time if a condition that may be associated with dehydration (significant loss of body fluids) is present such as severe vomiting, diarrhea, fever, exposure to heat or if drinking less fluid than normal. Talk to the doctor for further instructions.
Stop taking Metphar XR and contact a doctor or the nearest hospital immediately if experiencing some of the symptoms of lactic acidosis, as this condition may lead to coma.
Symptoms of lactic acidosis include: vomiting; stomach ache (abdominal pain); muscle cramps; a general feeling of not being well with severe tiredness; difficulty in breathing; reduced body temperature and heartbeat.
Lactic acidosis is a medical emergency and must be treated in a hospital.
Metphar XR with alcohol: Avoid excessive alcohol intake while taking Metphar XR since this may increase the risk of lactic acidosis (see Risk of lactic acidosis as previously mentioned).
Driving and using machines: Metphar XR taken on its own does not cause 'hypos' (symptoms of low blood sugar or hypoglycaemia, such as faintness, confusion and increased sweating) and therefore should not affect the ability to drive or use machinery.
Patients should be aware, however, that Metphar XR taken with other antidiabetic medicines can cause hypos, so in this case they should take extra care when driving or operating machinery.
Use in Elderly: If the patient is older than 75 years, treatment with Metphar XR should not be started to lower the risk of developing type 2 diabetes.