Uses of Riomet ER:

• It is used to lower blood sugar in patients with high blood sugar (diabetes).

What do I need to tell my doctor BEFORE I take Riomet ER?

• If you have an allergy to metformin or any other part of Riomet ER (metformin extended-release suspension).
• If you are allergic to Riomet ER (metformin extended-release suspension); any part of Riomet ER (metformin extended-release suspension); or any other drugs, foods, or substances. Tell your doctor about the allergy and what signs you had.
• If you have any of these health problems: Acidic blood problem, kidney disease, or liver disease.
• If you have had a recent heart attack or stroke.
• If you are not able to eat or drink like normal, including before certain procedures or surgery.
• If you are having an exam or test with contrast or have had one within the past 48 hours, talk with your doctor.

This is not a list of all drugs or health problems that interact with Riomet ER (metformin extended-release suspension).

Tell your doctor and pharmacist about all of your drugs (prescription or OTC, natural products, vitamins) and health problems. You must check to make sure that it is safe for you to take Riomet ER (metformin extended-release suspension) with all of your drugs and health problems. Do not start, stop, or change the dose of any drug without checking with your doctor.

What are some things I need to know or do while I take Riomet ER?

• Tell all of your health care providers that you take Riomet ER (metformin extended-release suspension). This includes your doctors, nurses, pharmacists, and dentists.
• Talk with your doctor before you drink alcohol.
• Do not drive if your blood sugar has been low. There is a greater chance of you having a crash.
• Check your blood sugar as you have been told by your doctor.
• Have blood work checked as you have been told by the doctor. Talk with the doctor.
• It may be harder to control blood sugar during times of stress such as fever, infection, injury, or surgery. A change in physical activity, exercise, or diet may also affect blood sugar.
• Follow the diet and workout plan that your doctor told you about.
• If diarrhea happens or you are throwing up, call your doctor. You will need to drink more fluids to keep from losing too much fluid.
• Be careful in hot weather or while being active. Drink lots of fluids to stop fluid loss.
• If you are 65 or older, use Riomet ER (metformin extended-release suspension) with care. You could have more side effects.
• There is a chance of pregnancy in women of childbearing age who have not been ovulating. If you want to avoid pregnancy, use birth control while taking Riomet ER (metformin extended-release suspension).
• Tell your doctor if you are pregnant, plan on getting pregnant, or are breast-feeding. You will need to talk about the benefits and risks to you and the baby.

How is this medicine (Riomet ER) best taken?

Use Riomet ER (metformin extended-release suspension) as ordered by your doctor. Read all information given to you. Follow all instructions closely.

• Take with meals.
• Keep taking Riomet ER (metformin extended-release suspension) as you have been told by your doctor or other health care provider, even if you feel well.
• Measure liquid doses carefully. Use the measuring device that comes with Riomet ER (metformin extended-release suspension). If there is none, ask the pharmacist for a device to measure Riomet ER (metformin extended-release suspension).
• Take with the evening meal if taking once daily.
• Shake well before use.

What do I do if I miss a dose?

• Skip the missed dose and go back to your normal time unless your doctor tells you to do something else.
• Do not take 2 doses at the same time or extra doses.

What are some side effects that I need to call my doctor about right away?

WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:

• Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.
• Very bad belly pain.
• It is common to have stomach problems like upset stomach, throwing up, or diarrhea when you start taking Riomet ER (metformin extended-release suspension). If you have stomach problems later during treatment, call your doctor right away. This may be a sign of an acid health problem in the blood (lactic acidosis).
• Low blood sugar can happen. The chance may be raised when Riomet ER (metformin extended-release suspension) is used with other drugs for diabetes. Signs may be dizziness, headache, feeling sleepy or weak, shaking, fast heartbeat, confusion, hunger, or sweating. Call your doctor right away if you have any of these signs. Follow what you have been told to do for low blood sugar. This may include taking glucose tablets, liquid glucose, or some fruit juices.

What are some other side effects of Riomet ER?

All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away:

• Stomach pain or diarrhea.
• Gas.
• Upset stomach or throwing up.
• Heartburn.
• Feeling tired or weak.
• Headache.

These are not all of the side effects that may occur. If you have questions about side effects, call your doctor. Call your doctor for medical advice about side effects.

You may report side effects to the FDA at 1-800-332-1088. You may also report side effects at https://www.fda.gov/medwatch.

If OVERDOSE is suspected:

If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened.

How do I store and/or throw out Riomet ER?

• Store in the original container at room temperature.
• Store in a dry place. Do not store in a bathroom.
• Throw away any part not used 100 days after Riomet ER (metformin extended-release suspension) was mixed.
• Keep all drugs in a safe place. Keep all drugs out of the reach of children and pets.
• Throw away unused or expired drugs. Do not flush down a toilet or pour down a drain unless you are told to do so. Check with your pharmacist if you have questions about the best way to throw out drugs. There may be drug take-back programs in your area.

Consumer Information Use and Disclaimer

• If your symptoms or health problems do not get better or if they become worse, call your doctor.
• Do not share your drugs with others and do not take anyone else's drugs.
• Some drugs may have another patient information leaflet. Check with your pharmacist. If you have any questions about Riomet ER (metformin extended-release suspension), please talk with your doctor, nurse, pharmacist, or other health care provider.
• If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened.

Frequently asked questions

• What is the safest diabetes medication?
• Does metformin cause weight loss?
• When is the best time to take metformin?
• Can you take metformin without food?
• Does metformin lower A1C, if so how much?
• How long does metformin take to work?
• What are the symptoms of lactic acidosis caused by metformin?
• Why does Metformin smell like fish?
• Does metformin cause hypoglycemia?