METFORMIN KERN PHARMA 850 mg FILM-COATED TABLETS

2. What you need to know before you take Metformin Kern Pharma

Do not take Metformin Kern Pharma

• If you are allergic (hypersensitive)to metformin or any of the other ingredients of this medicine (listed in section 6).
• If you have liver problems.
• If you have severe kidney function impairment.
• If you have uncontrolled diabetes with, for example, severe hyperglycemia (high blood sugar), nausea, vomiting, diarrhea, rapid weight loss, lactic acidosis (see "Risk of lactic acidosis" below) or ketoacidosis. Ketoacidosis is a disorder in which substances called "ketone bodies" accumulate in the blood, which can lead to a pre-diabetic coma. Symptoms include stomach pain, rapid and deep breathing, drowsiness or an unusual fruity odor of the breath.
• If you have lost a lot of water from your body (dehydration), for example due to prolonged or severe diarrhea or if you have vomited several times in a row. Dehydration can trigger kidney problems, which can put you at risk of developing lactic acidosis (see "Warnings and precautions").
• If you have a severe infection, for example an infection that affects your lungs, bronchi or kidneys. Severe infections can trigger kidney problems, which can put you at risk of developing lactic acidosis (see "Warnings and precautions").
• If you are receiving treatment for acute heart failure or if you have recently had a heart attack, if you have severe circulation problems (such as shock) or if you have difficulty breathing. This can lead to a lack of oxygenation in the tissues, which can put you at risk of developing lactic acidosis (see below "Warnings and precautions").
• If you drink a lot of alcohol.

If any of the above circumstances apply to you, consult your doctor before starting to take this medicine.

Make sure to consult your doctor if:

• you need an examination such as an X-ray or a scan that involves injecting a contrast medium into your blood that contains iodine.
• you need to undergo major surgery.

You should stop taking Metformin for a certain period of time before and after the examination or surgery. Your doctor will decide if you need any other treatment during this time.

It is important that you follow your doctor's instructions precisely.

Warnings and precautions

Risk of lactic acidosis.

Metformin can cause a very rare but very serious side effect called lactic acidosis, especially if your kidneys do not work properly. The risk of developing lactic acidosis is also increased with uncontrolled diabetes, severe infections, prolonged fasting or alcohol consumption, dehydration (see more information below), liver problems, and any medical disorder in which a part of the body has a reduced oxygen supply (such as acute and severe heart diseases). If any of the above applies to you, consult your doctor for further instructions.

Consult your doctor immediately if:

• You know you have a genetic disease that affects the mitochondria (the energy-producing components within cells), such as MELAS syndrome (mitochondrial encephalomyopathy, myopathy, lactic acidosis, and stroke-like episodes) or maternally inherited diabetes and deafness (MIDD).
• You experience any of the following symptoms after starting treatment with metformin: seizure, cognitive impairment, difficulty with body movements, symptoms indicative of nerve damage (e.g., pain or numbness), migraine, and hearing loss.

Stop taking Metformin Kern Pharma for a short period of time if you have a disorder that may be associated with dehydration(significant loss of body fluids), such as severe vomiting, diarrhea, fever, heat exposure, or if you drink less fluid than usual. Consult your doctor for further instructions.

Stop taking Metformin Kern Pharma and contact a doctor or the nearest hospital immediately if you experience any of the symptoms that lactic acidosis produces, as this disorder can lead to a coma.

The symptoms of lactic acidosis include:

• vomiting
• stomach pain (abdominal pain)
• muscle cramps
• general feeling of discomfort, with intense fatigue
• difficulty breathing
• decrease in body temperature and heart rate

Lactic acidosis is a medical emergency and should be treated in a hospital.

If you need to undergo major surgery, you should stop taking Metformin while the procedure is being performed and for a period of time after it. Your doctor will decide when you should stop taking Metformin and when you can restart it.

Metformin alone does not cause hypoglycemia (a concentration of glucose in the blood that is too low). However, if you take Metformin with other medicines to treat diabetes that can cause hypoglycemia (such as sulfonylureas, insulin, meglitinides), there is a risk of hypoglycemia. If you experience symptoms of hypoglycemia, such as weakness, dizziness, increased sweating, increased heart rate, vision disorders, or difficulty concentrating, it is usually helpful to eat or drink something that contains sugar.

During treatment with Metformin, your doctor will check your kidney function regularly and at least once a year or more frequently if you are an elderly person and/or if your kidney function is deteriorating.

Taking Metformin Kern Pharma with other medicines

If you need to be given an injection of a contrast medium that contains iodine into your bloodstream, for example, in the context of an X-ray or examination, you should stop taking Metformin before the injection or at the time of the injection. Your doctor will decide when you should stop taking Metformin and when you can restart it.

Tell your doctor if you are taking, have recently taken, or might take any other medicines. You may need more frequent blood glucose and kidney function tests, or your doctor may need to adjust the dose of Metformin. It is especially important to mention the following:

• medicines that increase urine production (diuretics).
• medicines used to treat pain and inflammation (NSAIDs and COX-2 inhibitors, such as ibuprofen and celecoxib).
• certain medicines to treat high blood pressure (ACE inhibitors and angiotensin II receptor antagonists).
• beta-2 agonists, such as salbutamol or terbutaline (used to treat asthma).
• corticosteroids (used to treat various conditions, such as severe skin inflammation or asthma).
• medicines that can alter the amount of Metformin in your blood, especially if you have reduced kidney function (such as verapamil, rifampicin, cimetidine, dolutegravir, ranolazine, trimethoprim, vandetanib, isavuconazole, crizotinib, olaparib).
• other medicines used to treat diabetes.

Taking Metformin Kern Pharma with alcohol

Avoid excessive alcohol consumption while taking Metformin, as this can increase the risk of lactic acidosis (see section "Warnings and precautions").

Pregnancy, breastfeeding, and fertility

Diabetic women who are pregnant or plan to become pregnant should not receive treatment with metformin. Instead, insulin should be used to keep blood glucose levels as close to normal as possible. Tell your doctor if you are pregnant or plan to become pregnant so that your treatment can be changed to insulin.

This medicine should not be used during breastfeeding. If you are pregnant or breastfeeding, or think you may be pregnant or are planning to have a baby, ask your doctor or pharmacist for advice before taking this medicine.

Driving and using machines

Metformin alone does not cause hypoglycemia (a concentration of glucose in the blood that is too low). This means it will not affect your ability to drive or use machines.

However, be especially careful if you take Metformin with other medicines to treat diabetes that can cause hypoglycemia (such as sulfonylureas, insulin, meglitinides). The symptoms of hypoglycemia include weakness, dizziness, increased sweating, increased heart rate, vision disorders, or difficulty concentrating. Do not drive or use machines if you start to feel these symptoms.

3. How to take Metformin Kern Pharma

Follow the instructions for taking this medicine exactly as indicated by your doctor or pharmacist. If you are in doubt, consult your doctor or pharmacist again.

Metformin cannot replace the benefits of a healthy lifestyle. Continue to follow any dietary advice your doctor has given you and exercise regularly.

Recommended dose

Children aged 10 years and older and adolescents usually start with 500 mg or 850 mg of Metformin once a day. The maximum daily dose is 2,000 mg divided into 2 or 3 doses. Treatment of children between 10 and 12 years is only recommended under specific advice from your doctor, as clinical experience in this patient group is limited.

Adults usually start with 500 mg or 850 mg of Metformin, two or three times a day. The maximum daily dose is 3,000 mg divided into 3 doses.

If you have reduced kidney function, your doctor may prescribe a lower dose.

If you are also given insulin, your doctor will tell you how to start taking Metformin.

Monitoring

• Your doctor will perform regular blood glucose tests and adjust your Metformin dose according to your blood glucose levels. Make sure to talk to your doctor regularly. This is especially important for children, adolescents, or if you are an elderly person.
• Your doctor will also check how well your kidneys are working at least once a year. You may need more frequent checks if you are an elderly person or if your kidneys are not working normally.

How to take Metformin Kern Pharma

Take Metformin with meals or after meals. This will help prevent digestive side effects. Do not chew or crush the tablets. Swallow each tablet with a glass of water.

• If you take one dose a day, take it in the morning (at breakfast).
• If you take two doses a day, take them in the morning (at breakfast) and at night (at dinner).
• If you take three doses a day, take them in the morning (at breakfast), at noon (at lunch), and at night (at dinner).

If, after some time, you think the effect of Metformin is too strong or too weak, consult your doctor or pharmacist.

If you take more Metformin Kern Pharma 850 mg than you should

If you have taken more Metformin than you should, you may suffer from lactic acidosis. The symptoms of lactic acidosis are non-specific, such as vomiting, stomach pain (abdominal pain) with cramps, a general feeling of discomfort with intense fatigue, and difficulty breathing. Additional symptoms may include a decrease in body temperature and heart rate. If you experience any of these symptoms, seek medical attention immediately, as lactic acidosis can lead to a coma. Stop taking Metformin Kern Pharma immediately and contact your doctor or the nearest hospital as soon as possible.

In case of overdose or accidental ingestion, consult your doctor or pharmacist immediately or call the Toxicology Information Service. Phone: 91 562 04 20, indicating the medicine and the amount ingested.

If you forget to take Metformin Kern Pharma

Do not take a double dose to make up for forgotten doses. Take the next dose at the usual time.

If you have any other questions about the use of this product, ask your doctor or pharmacist.

4. Possible side effects

Like all medicines, this medicine can cause side effects, although not everybody gets them. The following side effects may occur:

Metformin can cause a very rare but very serious side effect called lactic acidosis (see section "Warnings and precautions"), if this happens to you, you must stop taking Metformin Kern Pharma and contact a doctor or the nearest hospital immediately, as lactic acidosis can lead to a coma.

Very common side effects (affecting more than 1 in 10 people):

• digestive problems, such as nausea, vomiting, diarrhea, stomach pain (abdominal pain), and loss of appetite. These side effects occur more frequently at the start of treatment with Metformin. Spreading the doses throughout the day and taking Metformin during or immediately after a meal can help reduce these side effects. If the symptoms persist, stop taking Metformin Kern Pharma and consult your doctor.

Common side effects (affecting less than 1 in 10 people):

• changes in taste.

Very rare side effects (affecting less than 1 in 10,000 people):

• lactic acidosis. It is a very rare but serious complication, especially if your kidneys do not work properly.
• the symptoms of lactic acidosis are non-specific (see section "Warnings and precautions").
• abnormalities in liver function tests or hepatitis (inflammation of the liver; this can cause fatigue, loss of appetite, weight loss, with or without a yellowish tint to the skin or the whites of the eyes). If this happens to you, stop taking Metformin Kern Pharma and talk to your doctor.
• skin reactions such as redness of the skin (erythema), itching, or an itchy rash (urticaria).
• low vitamin B12 levels in the blood.

Children and adolescents

Limited data in children and adolescents showed that the side effects were similar in nature and severity to those observed in adults.

Reporting of side effects

If you experience any side effects, talk to your doctor or pharmacist, even if it is possible side effects not listed in this leaflet. You can also report them directly through the Spanish Pharmacovigilance System for Human Use Medicines: www.notificaRAM.es. By reporting side effects, you can help provide more information on the safety of this medicine.

5. Storing Metformin Kern Pharma

Keep this medicine out of the sight and reach of children.

If a child is being treated with Metformin, it is recommended that parents and caregivers supervise the use of this medicine.

Do not use this medicine after the expiry date which is stated on the carton after "EXP". The expiry date is the last day of the month shown.

This medicine does not require any special storage conditions.

Medicines should not be disposed of via wastewater or household waste. Return the containers and any unused medicine to the pharmacy. If you are in doubt, ask your pharmacist how to dispose of the containers and any unused medicine. This will help protect the environment.

6. Packaging Contents and Additional Information

Composition of Metformina Kern Pharma

• The active ingredient is metformine hydrochloride.

Each film-coated tablet of Metformina Kern Pharma contains 850 mg of metformine hydrochloride equivalent to 663 mg of metformine.

• The other components (excipients) are: povidone K90, magnesium stearate, hypromellose, macrogol 400 and macrogol 6000.

Appearance of the Product and Packaging Contents

Metformina Kern Pharma is presented in the form of film-coated tablets, white-yellow in color, oval, biconvex with a notch between M and B on one side and a notch on the other side.

Packaging type blister pack (PVC/PVdC Aluminum) with 50, 60 or 500 (clinical packaging) tablets.

Marketing Authorization Holder and Manufacturer

Holder

Kern Pharma, S.L.

Venus, 72 - Pol. Ind. Colón II

08228 Terrassa - Barcelona, Spain

Manufacturer

SAG MANUFACTURING S.L.U

National Highway I, Km 36

San Agustín de Guadalix 28750

Madrid, Spain

GALENICUM HEALTH S.L.U.

Sant Gabriel, 50,

Esplugues de Llobregat

08950, Barcelona

Spain

This prospectus was approved in: March 2025

Detailed and updated information on this medication is available on the website of the Spanish Agency for Medicines and Health Products (AEMPS) http://www.aemps.gob.es/.