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Prompt hemodialysis is also generally recommended in order to correct the acidosis and remove metformin. Discontinuation of metformin or supplementation with vitamin B12 has been necessary. Malabsorption of vitamin B12, due to intrinsic factor deficiency and possibly other mechanisms, has been reported in as many as 30% of patients treated with metformin. Metformin should also not be administered to patients with acute or chronic metabolic acidosis. GastrointestinalGastrointestinal side effects of metformin have included nausea, anorexia, metallic taste, diarrhea, dyspepsia, flatulence, nausea, vomiting and abdominal pain. 6%) patients discontinued Glipizide and Metformin hydrochloride tablets due to hypoglycemic symptoms and one required medical intervention due to hypoglycemia.

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