Metformin side effects

GI upset is the most common metformin side effect; switching to extended-release usually helps. A provider can adjust dosing and monitor labs online.

Also called: metformin nausea · metformin diarrhea · extended release metformin

Medically reviewed by Dr. Ikechukwu Ogbu, MD
MD · Board-Certified, Internal Medicine · Last reviewed

Seek urgent care or the ER if you have:

  • Symptoms that are sudden, severe, or rapidly worsening
  • High fever (over 103°F / 39.4°C) that doesn't respond to treatment
  • Chest pain, trouble breathing, fainting, or confusion
  • Signs of dehydration — dizziness, dark urine, unable to keep fluids down
  • Symptoms in someone who is pregnant, immunocompromised, or over 65

What metformin side effects could be

The most common causes a clinician considers. This isn't a diagnosis — it's the differential a provider works through with you.

Type 2 diabetes

Commonly relevant when someone is researching "metformin side effects" — worth reviewing with a clinician who knows your history.

Prediabetes

Commonly relevant when someone is researching "metformin side effects" — worth reviewing with a clinician who knows your history.

PCOS

Commonly relevant when someone is researching "metformin side effects" — worth reviewing with a clinician who knows your history.

Typical workup

What a clinician usually orders or asks about when someone presents with metformin side effects.

  • Focused history: timing, triggers, severity, and prior treatments related to "metformin side effects"
  • Targeted physical exam of the involved system
  • Rule-in / rule-out workup for the most likely causes: Type 2 diabetes, Prediabetes, PCOS
  • Medication reconciliation, side-effect review, and any lab monitoring the drug requires

When to see a clinician

  • You're starting, stopping, or switching a medication and want a clinician's read on side effects
  • You've had a new symptom you think might be medication-related
  • You're due for the lab monitoring this medication requires
  • You want a second opinion on whether the medication is still the right choice

Conditions this often points to

Medications commonly used

Common questions