Important Warnings
Schedule H: use under medical supervision. Metformin may rarely cause lactic acidosis—risk increases with severe kidney disease, dehydration, sepsis, excessive alcohol use, liver disease, or hypoxia; stop and seek care if rapid breathing, severe weakness, abdominal pain, or unusual sleepiness occurs. Dapagliflozin may cause genital/urinary infections, volume depletion/low BP, and (rare) ketoacidosis even with near-normal sugars—seek urgent care for nausea/vomiting, abdominal pain, rapid breathing, confusion. Assess kidney function before and during therapy; not recommended in severe renal impairment; temporary interruption may be needed during acute illness, prolonged fasting, major surgery, or iodinated contrast procedures as per clinician advice. Monitor for hypoglycaemia when used with insulin or sulfonylureas.
Pregnancy Safety
Not recommended; consult doctor (metformin may be used in selected cases but dapagliflozin is generally avoided in pregnancy).
Alcohol Interaction
Avoid or use with caution; alcohol increases risk of metformin-associated lactic acidosis and can worsen hypoglycaemia.
Storage
Store below 25°C in a dry place, protected from light and moisture. Keep in original blister pack and out of reach of children.
