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Educate patients and their families about the symptoms of lactic acidosis and if these symptoms occur instruct them to discontinue Glucovance and report these symptoms to their healthcare provider.

A serious but rare side effect of metformin is lactic acidosisLactic acidosis occurs in one out of every 30,000 patients and is fatal in 50of casesThe symptoms of lactic acidosis are:

It is not known whether Glucovance will harm an unborn babySimilar diabetes medications have caused severe hypoglycemia in newborn babies whose mothers had used the medication near the time of deliveryTell your doctor if you are pregnant or plan to become pregnant.

A single-dosemetformin-nifedipine drug interaction study in normal healthy volunteers demonstrated that coadministration of nifedipine increased plasma metformin C max and AUC by 20and 9respectivelyand increased the amount excreted in the urineT max and half-life were unaffectedNifedipine appears to enhance the absorption of metforminMetformin had minimal effects on nifedipine.

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reevaluate egfr 48 hours after the imaging procedure, and restart glucovance mite if renal function is stable.