Yes, the use of Metformin+Linagliptin can lead to lactic acidosis which is also known as MALA (Metformin-associated lactic acidosis). It is caused by increased levels of lactic acid in the blood. It is a very rare side effect associated with the use of metformin and therefore it is avoided in patients with underlying kidney disease, old age patients or who take large amounts of alcohol. Symptoms of lactic acidosis may include muscle pain or weakness, dizziness, tiredness, feeling of cold in arms and legs, difficulty in breathing, nausea, vomiting, stomach pain or slow heart rate. If you have these symptoms, stop taking Metformin+Linagliptin and immediately consult your doctor.

The use of Metformin+Linagliptin may cause some common side effects like hypoglycemia (low blood sugar level), altered taste, nausea, stomach pain, diarrhea, and headache. It can also lead to a serious but rare side effect known as lactic acidosis. Additionally, its long-term use can also lead to vitamin B12 deficiency.

The use of Metformin+Linagliptin should be avoided in patients with known allergy to any of the components of this medicine. The use of this medicine should be avoided in patients with severe kidney impairment, liver impairment, congestive heart failure, lactic acidosis or diabetic ketoacidosis. Therefore, consult your doctor before using Metformin+Linagliptin.

No, it is not safe to take Metformin+Linagliptin along with alcohol. Doing so can increase the chances of lactic acidosis, particularly in cases of fasting, malnutrition or kidney dysfunction. However, if you are not sure, consult your doctor.

Keep this medicine in the packet or the container it came in, tightly closed. Store it according to the instructions mentioned on the pack or label. Dispose of the unused medicine. Make sure it is not consumed by pets, children and other people.

The use of Metformin+Linagliptin does not usually cause hypoglycemia (low blood sugar level) on its own. But, it could occur if there is insufficient supplementation of calories while taking this medicine. Symptoms of hypoglycemia include nausea, headache, irritability, hunger, sweating, dizziness, fast heart rate, and feeling anxious or shaky. The symptoms are more likely to be noticed if you miss or delay your food, drink alcohol, over-exercise or take any other antidiabetic medicine along with it. Hence, regular monitoring of blood sugar level is important. It is recommended to always carry glucose tablets, honey or fruit juice with you.

Yes, long-term use of Metformin+Linagliptin can cause vitamin B12 deficiency as it interferes with absorption of vitamin B12 in the stomach. If untreated, it may cause anemia and nerve problems. These may further cause a tingling sensation and numbness in hands and feet, weakness, urinary problems, change in mental status and difficulty in maintaining balance (ataxia). Consult your doctor if you experience these symptoms. Your doctor may advise monitoring of B12 levels and prescribe a vitamin B12 supplement if required.