Metformin

⚠️ Safety & Warnings

Severity: Moderate

Adverse Effects:
Gastrointestinal upset (nausea, diarrhea, metallic taste), B12 deficiency with long-term use,
RARE: lactic acidosis (risk in renal/hepatic/cardiac failure)

Contraindications:
Severe renal impairment (eGFR <30), acute/chronic metabolic acidosis,
hemodynamic instability, lactate metabolism disorders

Precautions:
Caution in elderly, dehydration, hypoxic states (e.g. CHF), hepatic disease,
withhold before iodinated contrast imaging