Before you begin taking a medication, be sure to inform your doctor of any medical conditions or Allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should take Pms Metformin. 

Alcohol intake: Anyone taking metformin should avoid excessive alcohol intake.

Blood sugar control: If you have fever, trauma, infection, or surgery, you may have a temporary loss of blood sugar control. At such times, your doctor may think it is necessary to stop metformin and temporarily inject insulin. Metformin may be started again after the problem is resolved.

Blood sugar monitoring: Monitor your blood sugar regularly at intervals as discussed with your doctor or diabetes educator.

Diabetes complications: The use of metformin (or any other medication used for diabetes) will not prevent the development of complications particular to diabetes mellitus (e.g., Kidney Disease, nerve disease, eye disease).

Diet: Metformin is a treatment to be taken in combination with a proper diet. Metformin is not a substitute for proper diet.

Dye or contrast agents: If you are going to have an X-ray procedure that uses dye or a contrast agent, you may need to stop taking Pms Metformin for a short time. Contact your doctor for instructions.

Kidney problems:  Kidney disease or reduced kidney function causes Pms Metformin to build up in the body, causing side effects. If you have kidney problems, your doctor should closely monitor your condition while you are taking metformin, as it may affect kidney function.

Lactic acidosis: Lactic acidosis is a rare but serious problem that occurs due to metformin accumulation (i.e., the body doesn't get rid of it fast enough) during treatment. If you have severe kidney disease you are at higher risk of developing lactic acidosis. Since alcohol may increase the risk of lactic acidosis, do not drink a lot of alcohol over the short- or long-term while taking Pms Metformin. When it does occur (very rarely), it is fatal in 50% of cases. There have been no reports of lactic acidosis in Canada when metformin was used as directed. If you experience symptoms of lactic acidosis (e.g., weakness, tiredness, drowsiness, unusual muscle pain, trouble breathing, stomach pain with nausea, vomiting or diarrhea, feeling cold, dizziness, light-headedness, or slow or irregular heartbeat), stop taking Pms Metformin and get immediate medical attention.

Liver function: Decreased liver function has been linked to lactic acidosis. Pms Metformin is not recommended for people with severely reduced liver function. If you have moderately reduced liver function, discuss with your doctor how Pms Metformin may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Pms Metformin, and whether any special monitoring is needed.

Low blood sugar: Under usual circumstances, low blood sugar does not occur for people who take only metformin. Low blood sugar could occur when not enough food is eaten, especially when strenuous exercise is undertaken at the same time or when large amounts of alcohol have been consumed.

Reduced response: Over a period of time, you may become progressively less responsive to a particular treatment for diabetes because your diabetes worsens. If metformin fails to lower blood sugar to target levels, talk to your doctor. Your doctor may want to stop metformin or recommend another medication.

Surgery: Pms Metformin should be stopped temporarily for surgery (except for minor surgery where food and fluid intake is not restricted). You will be restarted on Pms Metformin once you are eating and drinking and your kidney function has been tested and is normal. Talk to your doctor for specific instructions.

Vitamin B12 levels: Pms Metformin may decrease vitamin B12 levels. Your doctor will monitor your B12 levels with blood tests while you are taking Pms Metformin.

Pregnancy: Pms Metformin should not be used during pregnancy. If you become pregnant while taking Pms Metformin, contact your doctor immediately.

Breast-feeding: Metformin is believed to pass into breast milk. Pms Metformin should not be used if you are breast-feeding.

Children: The safety and effectiveness of Pms Metformin have not been established for children.

Seniors: Kidney function often decreases with age. As a result, seniors may be more likely to experience side effects of Pms Metformin.

Before you begin using a medication, be sure to inform your doctor of any medical conditions or Allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use Tresiba Flextouch (Insulin-degludec-ultra-long-acting).

Allergic reactions: If you notice signs of a serious allergic reaction (swelling of face or throat, sudden sweating, vomiting, difficulty breathing, rapid heartbeat, itchy skin rash, and dizziness), stop using the medication and seek immediate medical attention.

Appearance of insulin: The contents of the pre-filled pen or insulin cartridge degludec should be clear and colourless. Do not use Tresiba Flextouch (Insulin-degludec-ultra-long-acting) if you notice anything unusual about its appearance, such as cloudiness, discoloration, or clumping.

Blood glucose monitoring: It is important for anyone using insulin to monitor their blood glucose levels regularly, as recommended by their doctor or diabetes educator. It is especially important to test blood glucose more often when your insulin dose or schedule changes, or when you are ill or under stress. If blood tests consistently show high or low blood glucose levels, contact your doctor or diabetes educator.

Changes at injection site: Fatty tissue under the skin at the injection site may shrink or thicken if you inject yourself too often at the same site. To help avoid this effect, change the site with each injection. Talk to your doctor or diabetes educator if you notice your skin pitting or thickening at the injection site.

Changes in insulin requirements: Many things can affect blood glucose levels and insulin requirements. These include:

• certain medical conditions (e.g., infections, Thyroid conditions, or kidney or liver disease)
• certain medications that increase or decrease blood glucose levels
• diet
• exercise
• illness
• injury
• stress
• surgery
• travelling over time zones

It is important to tell your doctor about your current health situation and any changes that may affect the amount of insulin you need. Blood glucose should be monitored regularly as recommended by your doctor or diabetes educator.

Diabetes identification: It is important to either wear a bracelet (or necklace) or carry a card indicating you have diabetes and are taking insulin.

Family and friends: Educate your family and friends about the signs and symptoms of hypoglycemia (low blood glucose). Keep a Glucagon kit available and instruct them on its proper use in case you experience severe low blood glucose or you lose consciousness.

High blood glucose (hyperglycemia): Hyperglycemia may occur if your insulin dose is too low or you miss a dose of insulin. Symptoms of hyperglycemia generally build up over hours or days. Contact your doctor or diabetes educator if you experience symptoms of hyperglycemia, such as increased need to urinate, nausea, vomiting, drowsiness, Dry Mouth, flushed dry skin, loss of appetite, and a fruity odour to your breath.

If hyperglycemia is permitted to continue, a condition known as diabetic ketoacidosis may occur. In this condition, your body starts to use body fat as fuel, eventually leading to a large concentration of acid in the blood stream. This can result in unconsciousness, coma, or death. To prevent this from occurring, you may need to have your insulin dose adjusted.

Kidney function: Kidney Disease or reduced kidney function may change the amount of insulin needed by the body. If you have kidney problems, discuss with your doctor how Tresiba Flextouch (Insulin-degludec-ultra-long-acting) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Tresiba Flextouch (Insulin-degludec-ultra-long-acting), and whether any special monitoring is needed. Your doctor may want to test your kidney function regularly with blood tests while you are taking Tresiba Flextouch (Insulin-degludec-ultra-long-acting).

Liver function: Liver disease or reduced liver function may change the amount of insulin needed by the body. If you have liver problems, discuss with your doctor how Tresiba Flextouch (Insulin-degludec-ultra-long-acting) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Tresiba Flextouch (Insulin-degludec-ultra-long-acting), and whether any special monitoring is needed. Your doctor may want to test your liver function regularly with blood tests while you are taking Tresiba Flextouch (Insulin-degludec-ultra-long-acting).

Low blood glucose (hypoglycemia): Hypoglycemia may occur if too much insulin is used, if meals are missed, or if you exercise more than usual. Symptoms of mild-to-moderate hypoglycemia may occur suddenly and can include cold sweat, nervousness or shakiness, fast heartbeat, headache, hunger, confusion, lightheadedness, weakness, and numbness or tingling (tongue, lips, or fingers). Mild-to-moderate hypoglycemia may be treated by eating foods or drinks that contain sugar. You should always carry a quick source of sugar, such as hard candies, glucose tablets, juice, or regular soft drinks (not diet soft drinks). If you experience symptoms of hypoglycemia, eat one of these sources of sugar and then rest. If you feel symptoms of hypoglycemia coming on, don't take insulin.

Signs of severe hypoglycemia can include disorientation, loss of consciousness, and seizures. People who are unable to take sugar by mouth or who are unconscious may require an injection of glucagon or treatment with intravenous (into the vein) glucose.

Pregnancy: It is essential to maintain good blood glucose control throughout pregnancy. Insulin requirements usually decrease during the first trimester and increase during the second and third trimesters. Therefore, contact your doctor if you are pregnant or are thinking about pregnancy.

Breast-feeding: It is not known if insulin degludec passes into breast milk. If you are a breast-feeding mother and are using Tresiba Flextouch (Insulin-degludec-ultra-long-acting), it may affect your baby. Talk to your doctor about whether you should continue breast-feeding. Breast-feeding mothers may require adjustments in their insulin dose or diet.

Children: The safety and effectiveness of using Tresiba Flextouch (Insulin-degludec-ultra-long-acting) have not been established for children who are less than 2 years of age.