natgillin/translations-raw huggingface dataset:
A study conducted in seven normal healthy volunteers showed that cimetidine (400 mg twice daily) increased metformin systemic exposure (area under the curve, AUC) by 50% and Cmax by 81%. 
Ispitivanje provedeno na sedam zdravih dobrovoljaca pokazalo je da je cimetidin (400 mg dvaput na dan) povećao sistemsku izloženost metforminu (površina ispod krivulje, AUC) za 50% i Cmax za 81%.
Alogliptin is primarily excreted unchanged in the urine and metabolism by the cytochrome (CYP) P450 enzyme system is negligible (see section 5.2). 
Alogliptin se prvenstveno izlučuje nepromijenjen u mokraći, a metabolizam putem enzimatskog sustava citokroma (CYP) P450 mu je zanemariv (vidjeti dio 5.2).
Renal clearance of metformin is >400 mL/min indicating that metformin is eliminated by glomerular filtration and tubular secretion. 
Bubrežni klirens metformina je >400 ml/min, što ukazuje da se metformin eliminira glomerularnom filtracijom i tubularnom sekrecijom.
Medicinal products with intrinsic hyperglycaemic activity Glucocorticoids (given by systemic and local routes), beta-2-agonists and diuretics (see also section 4.4) have intrinsic hyperglycaemic activity. 
Lijekovi s intrinzičnom hiperglikemijskom aktivnošću Glukokortikoidi (primijenjeni sistemskim ili lokalnim putem), beta-2-agonisti i diuretici (vidi također dio 4.4) imaju intrinzičku hiperglikemijsku aktivnost.
Total exposure (AUC(0-inf)) to alogliptin following administration of a single dose was similar to exposure during one dose interval (AUC(0-24)) after 6 days of once daily dosing. 
Ukupna izloženost (AUC(0-inf)) alogliptinu nakon primjene jednokratne doze bila je slična izloženosti nakon intervala od 6 dana primjene jedanput na dan (AUC(0-24)).
After an oral dose of metformin, the maximum plasma concentration (Cmax) is reached in approximately 2.5 hours (Tmax). 
Nakon primjene peroralne doze metformina najveća koncentracija u plazmi (Cmax) se postiže nakon približno 2,5 sata (tmax).
Very rare (may affect up to 1 in 10,000 people): - Lactic acidosis (a build-up of lactic acid in the blood) is a very serious side effect that may lead to coma. 
Vrlo rijetke (može se javiti u do 1 na 10 000 osoba): - Laktacidoza (nakupljanje mliječne kiseline u krvi) je vrlo ozbiljna nuspojava koja može izazvati komu.
It does not stimulate insulin secretion and, therefore, does not produce hypoglycaemia. 
Ne potiče lučenje inzulina i stoga ne dovodi do hipoglikemije.
Studies in lactating rats indicate that alogliptin is excreted in milk. 
Ispitivanja u štakorica u laktaciji pokazuju da se alogliptin izlučuje u mlijeko.
Administration of Vipdomet with food resulted in no change in total exposure (AUC) to alogliptin or metformin. 
Primjenom Vipdometa s hranom nije bilo promjene u ukupnoj izloženosti (AUC) alogliptinu ili metforminu.
Maximum daily dose is 12.5 mg 
Maksimalna dnevna doza iznosi 12,5 mg.
Evaluation should include serum electrolytes and ketones, blood glucose and, if indicated, blood pH, lactate, pyruvate and metformin levels. 
Pretrage trebaju uključivati elektrolite u serumu i ketone, glukozu u krvi i, ako je indicirano, pH krvi, te razine laktata, piruvata i metformina.
Metformin is contraindicated in patients with GFR<30 mL/min and should be temporarily discontinued in the presence of conditions that alter renal function (see section 4.3). 
Metformin je kontraindiciran u bolesnika s GFR<30 ml/min i njegovu je primjenu potrebno privremeno prekinuti ako su prisutna stanja koja mijenjaju funkciju bubrega (vidjeti dio 4.3).
Taking Vipdomet in combination with medicines called pioglitazone or insulin can cause too low blood sugar levels (hypoglycaemia), which may affect your ability to drive and use machines. 
Uzimanje Vipdometa u kombinaciji s pioglitazonom ili inzulinom može uzrokovati pretjerano nizak šećer u krvi (hipoglikemija), što može utjecati na sposobnost upravljanja vozilima i strojevima.
The study demonstrated that alogliptin did not increase the risk of having a MACE compared to placebo [Hazard Ratio: 0.96; 1-sided 99% Confidence Interval: 0-1.16]. 
Ispitivanje je pokazalo da alogliptin nije povećao rizik za MACE u usporedbi s placebom [omjer hazarda: 0,96; 1-strano 99% Interval pouzdanosti: 0-1,16].
Common (may affect up to 1 in 10 people): - Symptoms of low blood sugar (hypoglycaemia) may occur when Vipdomet is taken in combination with insulin or sulphonylureas (e.g. glipizide, tolbutamide, glibenclamide). 
Česte (mogu se pojaviti kod do 1 od 10 osoba): - Simptomi niskog šećera u krvi (hipoglikemija) mogu se javiti kada se Vipdomet uzima u kombinaciji s inzulinom ili sulfonilurejama (npr. glipizid, tolbutamid, glibenklamid).
Interactions with metformin 
Interakcije s metforminom
Vipdomet is indicated in the treatment of adult patients aged 18 years and older with type 2 diabetes mellitus: 
Vipdomet je indiciran za liječenje odraslih bolesnika u dobi od 18 godina i starijih sa šećernom bolešću tipa 2:
If you need to have major surgery you must stop taking Vipdomet during and for some time before and after the procedure. 
Ako se morate podvrgnuti velikom kirurškom zahvatu, morate prestati uzimati lijek Vipdomet tijekom i još neko vrijeme nakon zahvata.
- Severe and persistent pain in the abdomen (stomach area) which might reach through to your back as well as nausea and vomiting, as it could be a sign of an inflamed pancreas (pancreatitis). 
- Jaka i ustrajna bol u trbuhu (u području želuca) koja može sezati do leđa, kao i mučnina i povraćanje, što može biti znak upale gušterače (pankreatitis).
The pharmacokinetics of alogliptin has been shown to be similar in healthy subjects and in patients with type 2 diabetes mellitus. 
Pokazalo se da je farmakokinetika alogliptina slična kod zdravih ispitanika i bolesnika sa šećernom bolešću tipa 2.
There was no change in the time to peak plasma concentration (Tmax) for alogliptin, but there was a delayed Tmax for metformin of 1.5 hours. 
Nije bilo promjene u vremenu do vršne koncentracije u plazmi (tmax) za alogliptin, ali tmax za metformin bio je odgođen za 1,5 sat.
If acidosis of either form occurs, Vipdomet must be stopped immediately and other appropriate corrective measures initiated. 
Ako se u bilo kojem obliku pojavi acidoza, Vipdomet treba odmah prekinuti i poduzeti odgovarajuće mjere liječenja radi korekcije.
Maximum daily dose The maximum recommended daily dose of 25 mg alogliptin should not be exceeded. 
Maksimalna dnevna doza Maksimalna preporučena dnevna doza od 25 mg alogliptina se ne smije prekoračiti.
The European Medicines Agency has waived the obligation to submit the results of studies with Vipdomet in all subsets of the paediatric population in the treatment of type 2 diabetes mellitus (see section 4.2 for information on paediatric use). 
Europska agencija za lijekove odgodila je obvezu podnošenja rezultata ispitivanja lijeka Vipdomet u jednoj ili više podskupinama pedijatrijske populacije za liječenje šećerne bolesti tipa 2 (vidjeti dio 4.2 za informacije o pedijatrijskoj primjeni).
As Vipdomet contains metformin, any patient with type 2 diabetes mellitus previously well controlled on Vipdomet who develops laboratory abnormalities or clinical illness (especially vague and poorly defined illness) should be evaluated promptly for evidence of ketoacidosis or lactic acidosis. 
Budući da Vipdomet sadrži metformin, kod svih bolesnika sa šećernom bolešću tipa 2 koji su ranije bili dobro kontrolirani lijekom Vipdomet, a u kojih se razviju abnormalnosti u laboratorijskim nalazima ili klinička bolest (posebice nejasna i loše definirana bolest), treba odmah ispitati dokaze na ketoacidozu ili laktacidozu.
What Vipdomet contains - The active substances are alogliptin and metformin hydrochloride. 
Što Vipdomet sadrži - Djelatne tvari su alogliptin i metforminklorid.
DPP-4 is the principal enzyme involved in the rapid degradation of the incretin hormones, glucagon-like peptide-1 (GLP-1) and GIP (glucose-dependent insulinotropic polypeptide), which are released by the intestine and levels are increased in response to a meal. 
DPP-4 je glavni enzim uključen u brzu razgradnju inkretinskih hormona, glukagonu sličnog peptida-1 (GLP-1) i GIP (inzulinotropnog polipeptida ovisnog o glukozi), koji se izlučuju u crijevu i razine su im povišene kao odgovor na obrok.
Maximum daily dose is 3,000 mg Dose reduction may be considered in relation to declining renal function. 
Maksimalna dnevna doza je 3000 mg Može se razmotriti sniženje doze s obzirom na slabljenje funkcije bubrega.
In the alogliptin group, 12.7% (344 subjects) experienced an event within the secondary MACE composite endpoint, compared with 13.4% (359 subjects) in the placebo group [Hazard Ratio = 0.95; 1-sided 99% Confidence Interval: 0-1.14]. 
U skupini na alogliptinu, 12,7% (344 ispitanika) imalo je događaj unutar sekundarnog MACE kompozitnog ishoda, u usporedbi s 13,4% (359 ispitanika) u skupini na placebu [omjer hazarda = 0,95; 1-strano 99% Interval pouzdanosti: 0-1,14].
However, dosing of alogliptin should be conservative in patients with advanced age due to the potential for decreased renal function in this population 
Međutim, u bolesnika uznapredovale dobi doziranje alogliptina treba biti konzervativno zbog moguće smanjene funkcije bubrega u toj populaciji.
It should also be taken with meals to reduce the gastrointestinal adverse reactions associated with metformin. 
Također ga treba uzimati uz obroke kako bi se smanjile gastrointestinalne nuspojave povezane s metforminom.
Alogliptin has not been studied in patients with severe hepatic impairment (Child-Pugh score >9). 
Alogliptin nije ispitan u bolesnika sa teškim oštećenjem jetre (Child-Pugh indeks >9).
Special caution should be exercised in situations where renal function may become impaired, for example when initiating antihypertensive or diuretic therapy or when starting treatment with a nonsteroidal anti-inflammatory drug (NSAID). 
Poseban oprez nužan je u okolnostima kad bi funkcija bubrega mogla postati poremećena, na primjer kad se započinje terapija antihipertenzivima ili diureticima ili kad se započinje liječenje nesteroidnim protuupalnim lijekovima (NSAIL).
Alogliptin works to increase the levels of insulin in the body after a meal and decrease the amount of sugar in the body. 
Alogliptin djeluje tako da podiže razine inzulina u tijelu nakon obroka i smanjuje količinu šećera u krvi.
Stop taking Vipdomet and contact a doctor or the nearest hospital immediately if you experience some of the symptoms of lactic acidosis, as this condition may lead to coma. 
Prestanite uzimati Vipdomet i odmah se obratite liječniku ili otiđite u najbližu bolnicu ako osjetite neke od simptoma laktacidoze, jer to stanje može dovesti do kome.
Total and peak exposure to alogliptin increased proportionately across single doses of 6.25 mg up to 100 mg alogliptin (covering the therapeutic dose range). 
Ukupna i vršna izloženost alogliptinu se proporcionalno povećavala povišenjem jednokratnih doza od 6,25 mg do 100 mg alogliptina (što obuhvaća opseg terapijske doze).
Overall, treatment with the recommended total daily dose of 25 mg alogliptin in combination with metformin improved glycaemic control. 
Sveukupno, liječenje preporučenom ukupnom dnevnom dozom od 25 mg alogliptina u kombinaciji s metforminom poboljšalo je kontrolu glikemije.
Metformin is a biguanide with antihyperglycaemic effects, lowering both basal and postprandial plasma glucose. 
Metformin je bigvanid s antihiperglikemijskim učincima koji smanjuje i bazalnu i postprandijalnu glukozu u plazmi.
No dose adjustment is necessary (see section 4.2). 
Nije potrebna prilagodba doze (vidjeti dio 4.2).
In a clinical trial of alogliptin as mono-therapy, the incidence of hypoglycaemia was similar to that of placebo, and lower than placebo in another trial as add-on to a sulphonylurea. 
U kliničkom ispitivanju alogliptina kao monoterapije, incidencija hipoglikemije bila je slična kao za placebo, odnosno niža nego za placebo u drugom ispitivanju alogliptina kao dodatka sulfonilureji.
Maximum daily dose is 2,000 mg The starting dose is at most half of the maximum dose. 
Maksimalna dnevna doza je 2000 mg Početna doza iznosi najviše polovicu maksimalne doze.
It is assumed that the pharmacokinetics of metformin absorption is non-linear. 
Pretpostavlja se da je farmakokinetika metformina nelinearna.
However, as the distribution of AUC values for alogliptin in these patients was within the same range as control subjects, no dose adjustment of alogliptin for patients with mild renal impairment is necessary (see section 4.2). 
Međutim, kako je distribucija AUC vrijednosti za alogliptin u tih bolesnika bila unutar istog raspona kao i u kontrolnih ispitanika, prilagodba doze alogliptina u bolesnika s blagim oštećenjem bubrega nije potrebna (vidjeti dio 4.2).
crospovidone Type A, magnesium stearate, hypromellose, talc, titanium dioxide (E171) and yellow iron oxide (E172). 
magnezijev stearat, hipromeloza, talk, titanijev dioksid (E171) i žuti željezov oksid (E172).
Concomitant treatment with alogliptin and metformin did not produce new toxicities and no effects on the toxicokinetics of either compound were observed. 
Istodobna primjena alogliptina i metformina ne izaziva nove toksičnosti niti su opaženi učinci na toksikokinetiku bilo koje od djelatnih tvari.
Lactic acidosis is a serious adverse reaction, which may occur very rarely (<1/10,000), and is attributed to the metformin component of Vipdomet (see section 4.4). 
Laktacidoza je ozbiljna nuspojava koja se može javiti vrlo rijetko (<1/10 000) i pripisuje se komponenti metformina u Vipdometu (vidjeti dio 4.4).
Vipdomet should not be used in patients with type 1 diabetes mellitus. 
Vipdomet se ne smije primjenjivati u bolesnika sa šećernom bolešću tipa 1.
In case of hypoglycaemia, a lower dose of the thiazolidinedione or metformin may be considered. 
U slučaju hipoglikemije, potrebno je razmotriti nižu dozu tiazolidindiona ili metformina.
Vipdomet has no or negligible influence on the ability to drive and use machines. 
Vipdomet ne utječe ili zanemarivo utječe na sposobnost upravljanja vozilima i rada sa strojevima.
Vipdomet is taken when your blood sugar cannot be adequately controlled by diet, exercise and other anti-diabetic medicines such as metformin alone; insulin alone; or metformin and pioglitazone taken together. 
Vipdomet se uzima kad se Vaš šećer u krvi ne može odgovarajuće kontrolirati dijetom, tjelovježbom i drugim antidijabetičkim lijekovima poput samog metformina, samog inzulina, ili metformina i pioglitazona uzetih zajedno.
10 film-coated tablets 14 film-coated tablets 20 film-coated tablets 28 film-coated tablets 56 film-coated tablets 60 film-coated tablets 98 film-coated tablets 112 film-coated tablets 120 film-coated tablets 180 film-coated tablets 196 film-coated tablets 200 film-coated tablets 
10 filmom obloženih tableta 14 filmom obloženih tableta 20 filmom obloženih tableta 28 filmom obloženih tableta 56 filmom obloženih tableta 60 filmom obloženih tableta 98 filmom obloženih tableta 112 filmom obloženih tableta 120 filmom obloženih tableta 180 filmom obloženih tableta 196 filmom obloženih tableta 200 filmom obloženih tableta
If you stop taking Vipdomet 
Ako prestanete uzimati Vipdomet
Pack sizes of 10, 14, 20, 28, 56, 60, 98, 112, 120, 180, 196, 200 or multipacks containing 196 (2 packs of 98) film-coated tablets. 
Veličine pakiranja od 10, 14, 20, 28, 56, 60, 98, 112, 120, 180, 196, 196, 200 ili višestruka pakiranja koja sadrže 196 (2 pakiranja po 98) filmom obloženih tableta.
In addition, a prospective randomised cardiovascular outcomes safety study was conducted with 5,380 patients with high underlying cardiovascular risk to examine the effect of alogliptin compared with placebo (when added to standard of care) on major adverse cardiovascular events (MACE) including time to the first occurrence of any event in the composite of cardiovascular death, nonfatal myocardial infarction and nonfatal stroke in patients with a recent (15 to 90 days) acute coronary event. 
Dodatno,prospektivno randomizirano ispitivanje sigurnosti s obzirom na kardiovaskularne ishode provedeno je na 5380 bolesnika s visokim podležećim kardiovaskularnim rizikom kako bi se ispitao učinak alogliptina u usporedbi s placebom (kao dodatak standardnoj terapiji) na velike kardiovaskularne štetne događaje (engl. major adverse cardiovascular events, MACE) uključujući i vrijeme do prve pojave bilo kojeg od događaja kardiovaskularne smrti, infarkta miokarda bez smrtnog ishoda i moždanog udara bez smrtnog ishoda u bolesnika s nedavnim (15 do 90 dana) akutnim koronarnim događajem.
Metformin is contra-indicated 
Metformin je kontraindiciran.
After administration of single oral doses of up to 800 mg in healthy subjects, alogliptin was rapidly absorbed with peak plasma concentrations occurring 1 to 2 hours (median Tmax) after dosing. 
Nakon primjene jednokratnih peroralnih doza do 800 mg zdravim ispitanicima, alogliptin se brzo apsorbirao s vršnom koncentracijom u plazmi nakon 1 do 2 sata (medijan Tmax) nakon doziranja.
Any unused medicinal product or waste material should be disposed of in accordance with local requirements. 
Neiskorišteni lijek ili otpadni materijal potregno je zbrinuti sukladno nacionalnim propisima.
Specific pharmacokinetic drug interaction studies have not been performed with Vipdomet. 
Specifična farmakokinetička ispitivanja interakcija lijeka Vipdometa nisu provedena.
Maximum daily dose is 6.25 mg * Alogliptin dose adjustment is based on a pharmacokinetic study where kidney function was assessed using creatinine clearance (CrCl) levels estimated from the Cockcroft-Gault equation. 
6,25 mg. * Prilagodba doze alogliptina temelji se na farmakokinetičkom ispitivanju u kojem je bubrežna funkcija procjenjivana primjenom razina klirensa kreatinina (CrCl) procijenjenih pomoću Cockcroft-Gaultove jednadžbe.
- Hypersensitivity to the active substances or to any of the excipients listed in section 6.1 or history of a serious hypersensitivity reaction, including anaphylactic reaction, anaphylactic shock, and angioedema, to any dipeptidyl-peptidase-4 (DPP-4) inhibitor (see sections 4.4 and 4.8) - Any type of acute metabolic acidosis (such as lactic acidosis, diabetic ketoacidosis) - Diabetic pre-coma - Severe renal failure (GFR <30 mL/min) - Acute conditions with the potential to alter renal function such as: - dehydration - severe infection - shock - Acute or chronic disease which may cause tissue hypoxia (see section 4.4) such as: - cardiac or respiratory failure - recent myocardial infarction - shock - Hepatic impairment (see section 4.4) - Acute alcohol intoxication, alcoholism (see sections 4.4 and 4.5) 
- preosjetljivost na djelatne tvari ili bilo koju od pomoćnih tvari navedenih u dijelu 6.1 ili ozbiljne reakcije preosjetljivosti u anamnezi, uključujući anafilaktičku reakciju, anafilaktički šok i angioedem na bilo koji inhibitor dipeptidil-peptidaze-4 (DPP-4) (vidjeti dijelove 4.4 i 4.8) - bilo koja vrsta akutne metaboličke acidoze (kao što je laktacidoza, dijabetička ketoacidoza) - dijabetička pretkoma - teško zatajenje bubrega (GFR<30 ml/min) - akutna stanja koja mogu oštetiti funkciju bubrega kao što su: - dehidracija - teška infekcija - šok - akutna ili kronična bolest koja može uzrokovati hipoksiju tkiva (vidjeti dio 4.4) kao što su: - zatajenje srca ili respiratornog trakta - nedavni infarkt miokarda - šok - oštećenje jetre (vidjeti dio 4.4) - akutna intoksikacija alkoholom, alkoholizam (vidjeti dijelove 4.4 i 4.5).
Skin and subcutaneous tissue disorders pruritus common very rare common rash common common erythema very rare exfoliative skin conditions including StevensJohnson syndrome not known erythema multiforme not known angioedema not known urticaria not known very rare 
Poremećaji kože i potkožnog tkiva pruritus često vrlo rijetko često osip često često eritem vrlo rijetko eksfolijativna stanja kože uključujući StevensJohnson sindrom nepoznato multiformni eritem nepoznato angioedem nepoznato urtikarija nepoznato vrlo rijetko
(-infinity, 0.059) 
(-beskonačno, 0,059)
It is especially important to mention the following: - hydrocortisone and prednisolone (corticosteroids), used to treat diseases that involve inflammation like asthma and arthritis - cimetidine, used to treat stomach problems - bronchodilators (beta-2 agonists), used to treat asthma - medicines which increase urine production (diuretics) - medicines used to treat pain and inflammation (NSAID and COX-2-inhibitors, such as ibuprofen and celecoxib), - certain medicines used for the treatment of high blood pressure (ACE inhibitors and angiotensin II receptor antagonists) - medicines containing alcohol. 
Osobito je važno spomenuti sljedeće: - hidrokortizon ili prednizolon (kortikosteroidi) koji se koriste za liječenje upalnih bolesti poput astme i artritisa - cimetidin, koristi se za liječenje želučanih tegoba - bronhodilatatori (beta-2 agonisti), koriste se za liječenje astme - lijekove koji povećavaju stvaranje mokraće (diuretici) - lijekove koji se primjenjuju za liječenje boli i upale (NSAIL i COX-2-inhibitori, kao što su ibuprofen i celekoksib) - određene lijekove za liječenje povišenog krvnog tlaka (ACE inhibitori i antagonisti receptora angiotenzina II) - lijekove koji sadrže alkohol.
Cationic substances that are eliminated by renal tubular secretion (e.g. cimetidine) may interact with metformin by competing for common renal tubular transport systems. 
Kationske tvari koje se eliminiraju bubrežnom tubularnom sekrecijom (npr. cimetidin) mogu ući u interakciju s metforminom nadmećući se za zajednički bubrežni tubularni transportni sustav.
Minimal quantities of alogliptin are removed by haemodialysis (approximately 7% of the substance was removed during a 3 hour haemodialysis session). 
Hemodijalizom se uklanjaju minimalne količine alogliptina (tijekom 3-satne hemodijalize uklonjeno je približno 7% lijeka).
Alogliptin has not been studied in patients with severe hepatic impairment (Child-Pugh score >9) and is, therefore, not recommended for use in such patients (see sections 4.2, 4.3 and 5.2). 
Alogliptin nije ispitan u bolesnika s teškim oštećenjem jetre (Child-Pugh indeks >9) te se u tih bolesnika njegova primjena ne preporučuje (vidjeti dijelove 4.2, 4.3 i 5.2).
What Vipdomet is Vipdomet contains two different medicines called alogliptin and metformin in one tablet: 
Što je Vipdomet Vipdomet sadrži dvije različite djelatne tvari alogliptin i metformin u jednoj tableti:
Risk related to metformin 
Rizik vezan uz metformin
Alogliptin as add-on therapy to metformin 
Alogliptin kao dodatak terapiji metforminom
If you forget to take Vipdomet 
Ako ste zaboravili uzeti Vipdomet
What Vipdomet is used for 
Za što se Vipdomet koristi
Very common (may affect more than 1 in 10 people): - Stomach ache - Diarrhoea - Loss of appetite - Feeling sick - Being sick. 
Vrlo česte (mogu se pojaviti kod više od 1 od 10 osoba): - Bol u trbuhu - Proljev - Gubitak teka - Mučnina - Povraćanje.
Hypersensitivity reactions, including anaphylactic reactions, angioedema and exfoliative skin conditions including Stevens-Johnson syndrome and erythema multiforme have been observed for DPP-4 inhibitors and have been spontaneously reported for alogliptin in the post-marketing setting. 
Reakcije preosjetljivosti, uključujući anafilaktičke reakcije, angioedem i eksfolijativna stanja kože uključujući Stevens-Johnsonov sindrom i multiformni eritem opažena su za DPP-4 inhibitore i spontano su prijavljene za alogliptin nakon stavljanja lijeka u promet.
Symptoms of lactic acidosis include: - vomiting - stomach ache (abdominal pain) - muscle cramps - a general feeling of not being well with severe tiredness 
Simptomi laktacidoze uključuju: - povraćanje - bol u trbuhu (bol u abdomenu) - grčevi u mišićima - opće loše osjećanje uz jaki umor
When renal function is impaired, renal clearance is decreased in proportion to that of creatinine and, thus, the elimination half-life is prolonged leading to increased levels of metformin in the plasma. 
Kad je funkcija bubrega oštećena, bubrežni klirens se smanjuje razmjerno smanjenju klirensa kreatinina, te se poluvijek eliminacije produljuje i dovodi do povećanih razina metformina u plazmi.