Dr. Manoj Meena MBBS , General Physician

Lactic acidosis associated with Mf treatment is a rare but fatal adverse effect. Lactic acidosis appears to result from biguanide interference causing an increase in production and decrease in clearance of lactate leading to higher cellular lactate levels. A decrease in pyruvate carboxylase activity, the rate-limiting enzyme in the formation of glucose from lactate, can also decrease hepatic metabolism of lactate. leading to increasing lactic acidosis. Signs and symptoms of Mf induced lactic acidosis are nonspecific and include anorexia, nausea, vomiting, altered level of consciousness, hyperpnoea, abdominal pain, and thirst. 

Dr. Vedprakash Verma MBBS, MD , Cardiology

Yes, Mf is safe to use, many people have side effects at first, they usually diminish and then go away completely in a few weeks. A few people find they cannot tolerate metformin, there are other drugs but metformin is usually the first choice. It is very safe

Dr. Mayank Yadav MBBS , General Physician

Yes, Mf commonly cause stomach upset like diarrhea, abdominal pain, nausea, and vomiting. To avoid these side effects you should take Mf with your meal and increase the dose gradually.

Dr. Ramraj MBBS , Other

Yes, Mf can cause low blood sugar (hypoglycemia). However, this can also occur if you delay or miss a meal, drink alcohol, exercise more than usual, can't eat due to stomach upset, and taking other antidiabetic medicine with metformin. So, regular monitoring of blood glucose level is needed and be cautious of symptoms of hypoglycemia, always keep glucose-rich food with you. 

Dr. Ashish Mishra MBBS , Pathology

Yes, you can take Mf with gliclazide, no harmful interactions have been reported between them. However, it is not necessary that no interaction can happen between these two. But before taking such kind of combination you must consult your doctor.