Metformin + Methylcobalamin

No, you should not take alcohol with Metformin + Methylcobalamin, because it can cause serious side effects which includes hypoglycemia (low blood sugar). The risk of hypoglycemia is higher when you're drinking and taking Metformin + Methylcobalamin than if you're just taking Metformin + Methylcobalamin. Some of the signs of hypoglycemia include dizziness, confusion, and drowsiness.

Yes, Metformin + Methylcobalamin can cause night sweat, the exact mechanism of sweating is not known. But some research suggests that Metformin + Methylcobalamin causes hypoglycemia (low blood sugar) especially at night which can cause night sweats. Need to monitor your blood glucose level regularly, and talk to your doctor as your dose of Metformin + Methylcobalamin may need to be adjusted.

Yes, Metformin + Methylcobalamin can cause some sleep problems, especially insomnia. On the other hand, Metformin + Methylcobalamin has proven to be useful for preventing sleep apnea. The exact relationship between Metformin + Methylcobalamin and sleep problems is still not clear, and further studies are needed for a clearer understanding.

Lactic acidosis associated with Metformin + Methylcobalamin 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 Metformin + Methylcobalamin induced lactic acidosis are nonspecific and include anorexia, nausea, vomiting, altered level of consciousness, hyperpnoea, abdominal pain, and thirst. 

The long-term use can lead to the deficiency of Vitamin B12, which can further lead to megaloblastic anemia. Furthermore, Long-term Metformin use can also lead to kidney and liver problems.