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Metformin is also associated with a rare but serious side effect called lactic acidosis, which requires emergency treatment in the hospital

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While not required, this identification can be valuable in medical emergencies or if you become unable to communicate your medical needs

You should contact your GP or pharmacist immediately if you experience any of the following whilst taking either substance alone or in combination: Chest pain, palpitations, or irregular heartbeat Severe or persistent headaches Shortness of breath or difficulty breathing Significant changes in blood pressure (if you monitor at home) Severe gastrointestinal symptoms Mood changes, severe anxiety, or depression Signs of allergic reaction (rash, swelling, difficulty breathing) Symptoms of hypoglycaemia (if diabetic): shakiness, confusion, sweating, rapid heartbeat Before starting this combination , arrange an appointment with your GP to discuss: Your reasons for considering both substances Your complete medication list, including all supplements and over-the-counter products Any pre-existing medical conditions, particularly cardiovascular disease, diabetes, liver or kidney problems Baseline measurements of blood pressure, heart rate, and relevant blood tests A monitoring plan if the combination is deemed appropriate Your community pharmacist can also provide valuable advice regarding potential drug interactions, appropriate dosing, and quality considerations for berberine supplements

Semaglutide is a helpful drug for many people with type 2 diabetes or obesity