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When to seek medical attention: Severe, persistent vomiting or diarrhoea that prevents adequate fluid intake Signs of dehydration (dark urine, dizziness, reduced urination) Severe abdominal pain, particularly if radiating to the back (possible pancreatitis) Right upper abdominal pain, fever or jaundice (possible gallbladder disease) Symptoms of lactic acidosis (unusual muscle pain, difficulty breathing, severe fatigue, stomach discomfort) Any visual changes if you have diabetes, particularly with pre-existing retinopathy Reduced urine output or swelling (possible kidney problems) Most side effects improve within 4-8 weeks as your body adjusts to the medications

DOI: 10.1159/000358623 [Google Scholar] Wei JP, Yang CL, Leng WH, Ding LL, Zhao GH

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