• Do not confuse metformin with metronidazole.

• Patients stabilized on a diabetic regimen who are exposed to stress, fever, trauma, infection, or surgery may require administration of insulin. Withhold metformin and reinstitute after resolution of acute episode.

» Metformin should be temporarily discontinued in patients requiring surgery involving restricted intake of food and fluids. Resume metformin when oral intake has resumed and renal function is normal.

» Withhold metformin before or at the time of studies requiring IV administration of iodinated contrast media and for 48 hr after study.

• PO: Administer metformin with meals to minimize GI effects.

» XR tablets must be swallowed whole; do not crush or chew.