Pionorm M 15 Tablet SR

Lactic acidosis associated with Pionorm M treatment is a rare but fatal adverse effect. Lactic acidosis appears to result from biguanide interference causing an increase in production and decrease in clearance of lactate leading to higher cellular lactate levels. A decrease in pyruvate carboxylase activity, the rate-limiting enzyme in the formation of glucose from lactate, can also decrease hepatic metabolism of lactate. leading to increasing lactic acidosis. Signs and symptoms of Pionorm M induced lactic acidosis are nonspecific and include anorexia, nausea, vomiting, altered level of consciousness, hyperpnoea, abdominal pain, and thirst. 

No, you should not take alcohol with Pionorm M, because it can cause serious side effects which includes hypoglycemia (low blood sugar). The risk of hypoglycemia is higher when you're drinking and taking Pionorm M than if you're just taking Pionorm M. Some of the signs of hypoglycemia include dizziness, confusion, and drowsiness.

Yes, Pionorm M can cause low blood sugar (hypoglycemia). However, this can also occur if you delay or miss a meal, drink alcohol, exercise more than usual, can't eat due to stomach upset, and taking other antidiabetic medicine with metformin. So, regular monitoring of blood glucose level is needed and be cautious of symptoms of hypoglycemia, always keep glucose-rich food with you. 

Yes, Pionorm M is safe to use, many people have side effects at first, they usually diminish and then go away completely in a few weeks. A few people find they cannot tolerate metformin, there are other drugs but metformin is usually the first choice. It is very safe

Pionorm M should be taken with food to reduce stomach and bowel side effects, which may experience the first few weeks of treatment. Also, exercise regularly and test for sugar in your blood or urine as directed.