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Avoid Concomitant Use: There are no known interactions where it is recommended to avoid concomitant use.
Increased Effect/Toxicity: The levels/effects of metformin may be increased by: Cephalexin; cimetidine; iodinated contrast agents; pegvisomant.
Decreased Effect: The levels/effects of metformin may be decreased by: Corticosteroids (orally inhaled); corticosteroids (systemic); luteinizing hormone-releasing hormone analogs; somatropin; thiazide diuretics.
Ethanol/Nutrition/Herb Interactions: Ethanol: Avoid or limit ethanol (incidence of lactic acidosis may be increased; may cause hypoglycemia).
Food: Food decreases the extent and slightly delays the absorption. May decrease absorption of vitamin B12 and/or folic acid.
Herb/Nutraceutical: Caution with chromium, garlic, gymnema (may cause hypoglycemia).
