Do not use in severe kidney disease, diabetic ketoacidosis, severe dehydration, serious infection or heavy alcohol use. These raise the risk of a rare but serious complication called lactic acidosis (symptoms: rapid breathing, severe weakness, unusual muscle pain. Seek urgent care). Your doctor will check kidney function periodically, and may pause metformin around scans using contrast dye or major surgery. Long-term use can reduce vitamin B12 levels. Mild nausea or loose stools usually settle. Tell your doctor if pregnant or breastfeeding. Store below 30°C. This product information is for general guidance only and does not replace professional medical advice. Always consult a qualified healthcare provider before starting any new medication or supplement. Keep all medicines out of reach of children.