Metgem

Yes, you can take Metgem with a beta-blocker. People with diabetes tend to develop heart disease or stroke at an earlier age than the general population. One reason for this is that high glucose levels increase your risk of high blood pressure (hypertension). No harmful interactions are seen between them. However, a recent study suggests that beta-blockers can decrease the plasma level of Metgem and long-term use can increase lactic acid and uric acid in the blood.

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. 

Metgem is used with a proper diet and exercise program, to treat diabetes. It is also used with other medication to reduce the high blood sugar. It is used in a patient with type2 diabetes. It is also used in the treatment of polycystic ovarian syndrome (PCOS) and cancer.

Yes, Metgem 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

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