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Concomitant use not recommended: Alcohol: Acute alcohol intoxication is associated with an increased risk of lactic acidosis particularly in case of: fasting or malnutrition, hepatic insufficiency.
Avoid consumption of alcohol and alcohol-containing medications.
Iodinated contrast media: Intravascular administration of iodinated contrast media may lead to renal failure, resulting in metformin accumulation and a risk of lactic acidosis.
Metformin hydrochloride must be discontinued prior to, or at the time of the test and not reinstituted until 48 hours afterwards, and only after renal function has been re-evaluated and found to be normal.
Combinations requiring precautions for use: Medicinal products with intrinsic hyperglycaemic activity [e.g. glucocorticoids (systemic and local routes) and sympathomimetics]: More frequent blood glucose monitoring may be required, especially at the beginning of treatment. If necessary, adjust the metformin dosage during therapy with the other drug and upon its discontinuation.
Diuretics, especially loop diuretics: They may increase the risk of lactic acidosis due to their potential to decrease renal function.
