METFORMIN+METHYLCOBALAMIN may cause a rare and serious side-effect ‘lactic acidosis’ (buildup of lactic acid in the blood), characterized by abdominal pain, muscle cramps, vomiting, severe fatigue, and difficulty breathing. It is a life-threatening condition that requires immediate medical attention. Inform your doctor if you have any severe liver or kidney problems as their normal functioning is required to eliminate excess lactic acid from the body.  Do not consume excess alcohol as it increases the risk of lactic acidosis. It should be used with caution in patients with heart diseases as it increases the risk of heart failure. If you have dehydration (severe loss of body fluids) due to severe vomiting, diarrhoea, exposure to heat, or fever, stop taking METFORMIN+METHYLCOBALAMIN and immediately seek medical attention. METFORMIN+METHYLCOBALAMIN may cause electrolyte imbalance, so taking this medicine during dehydration can worsen the condition.  

Drug-Drug Interaction: METFORMIN+METHYLCOBALAMIN may interact with other antidiabetic drugs, diuretics or water pills, nonsteroidal anti-inflammatory drugs (ibuprofen and celecoxib), antacids (cimetidine and omeprazole), antiasthma drug (salbutamol), corticosteroids, anti-HIV drug (dolutegravir), iodinated X-ray contrast agents, anti-epileptic drugs (topiramate and lamotrigine), antibiotic (neomycin), a medication used to treat high blood pressure (verapamil), antibacterial (rifampicin and trimethoprim), a medication to treat chest pain (ranolazine), anticancer (vandetanib), and an antifungal drug (isavuconazole).

Drug-Food Interaction: Avoid intake of alcoholic beverages with METFORMIN+METHYLCOBALAMIN as it increases the risk of lactic acidoses.

Drug-Disease Interaction: METFORMIN+METHYLCOBALAMIN should be avoided in patients with heart diseases (like congestive heart failure and myocardial infarction), and alcoholic abuse.

• Fill your half plate with starchy veggies, a quarter with proteins, and a quarter with whole grain.
• Eat at regular intervals. Do not take the long gap between a meal or snack.
• Monitor your blood sugar level regularly, especially when there are a lot of fluctuations.
• Invest at least 150 min of moderate-intensity physical activity and 15 minutes of high-intensity exercise every week.
• Lose weight gradually to achieve a healthy body mass index (18.5 to 24.9).
• Replace refined carbohydrates containing whole-grain foods and increase intake of fruits and veggies and other fibre-enriched foods.
• Reduce intake of saturated fat (or hidden fats) in food like chips, crisps, pastries, biscuits, and samosas. Choose omega 3 fatty acid-containing oils for daily cooking. You may use palm oil, mustard oil, groundnut oil, rice bran oil, and safflower oil for frying.
• Do not take stress as it may elevate your blood sugar level. You may adopt stress management techniques like mindfulness, yoga, or meditation to control stress-related blood sugar changes.
• Opt for low-fat dairy products (low-fat yoghurt, fat-free milk, and cheese, etc.).
• Keep your blood pressure as normal (120/80) as possible as it reduces the risk of cardiovascular diseases in diabetes patients.

Beware of hypoglycemia (low blood sugar level) symptoms include sweating, dizziness, palpitations, shivering, intense thirst, dry mouth, dry skin, frequent urination, etc. Whenever you experience these symptoms, try to eat 5-6 candies or 3 glucose biscuits or 3 teaspoons of honey/sugar and get in touch with your doctor. Make sure you carry these with you at all times, especially for long travels.