Lactic acidosis is a rare, but serious, metabolic complication that can occur due to metformin accumulation.
Avandamet is metformin and rosiglitazone; Glucovance is metformin and glyburide; Invokamet is metformin and canagliflozin; Janumet is metformin and sitagliptin; Synjardy is metformin and empagliflozin; Xigduo XR is metformin and dapagliflozin.
In June 2022, the UK Medicines and Healthcare products Regulatory Agency (MHRA) published advice, stating that low vitamin B12 is now considered to be a common side effect of metformin. The MHRA advises checking levels in patients with symptoms of B12 deficiency, as well as monitoring those at risk of B12.
